Nokea
The nurse is monitoring a laboring client with oxytocin infusion. What finding requires immediate intervention?
- A. Contractions lasting 60 seconds.
- B. Contractions every 2 minutes.
- C. Fetal heart rate of 100 beats/minute.
- D. Client reports back pain.
Correct Answer: C
Rationale: A fetal heart rate of 100 bpm indicates bradycardia, requiring immediate intervention to ensure fetal well-being.
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Which intervention is most appropriate for a mother with mastitis?
- A. Advise the mother to stop breastfeeding temporarily
- B. Encourage continued breastfeeding
- C. Apply cold compresses to the affected breast
- D. Refer the mother to a lactation consultant
Correct Answer: B
Rationale: Continuing breastfeeding helps resolve mastitis by clearing milk ducts.
The nurse is preparing a client for a biophysical profile (BPP). What does this test assess?
- A. Fetal genetic disorders.
- B. Amniotic fluid index and fetal well-being.
- C. Maternal blood flow.
- D. Cervical length.
Correct Answer: B
Rationale: A biophysical profile evaluates fetal well-being by assessing movements, tone, breathing, and amniotic fluid volume.
A nurse is assessing a newborn immediately following a vaginal birth. For which of the following findings should the nurse intervene?
- A. Molding
- B. Vernix Caseosa
- C. Acrocyanosis
- D. Sternal retractions
Correct Answer: D
Rationale: Sternal retractions in a newborn may indicate respiratory distress or difficulty breathing. It is important for the nurse to intervene and assess the newborn's respiratory status further as this finding could be a sign of underlying respiratory issues that require immediate attention. The nurse should monitor the newborn's oxygen saturation, respiratory rate, and any other signs of distress to ensure appropriate intervention is provided promptly.
The nurse knows that contraindication of the induction of labor includes:
- A. Placenta previa
- B. Diabetes mellitus
- C. PROM
- D. Isoimmunization
Correct Answer: A
Rationale: Placenta previa is a contraindication for the induction of labor because the placenta partially or completely covers the cervix. Inducing labor in this situation can lead to complications such as excessive bleeding and compromised blood flow to the baby. Therefore, it is important to avoid inducing labor in cases of placenta previa to ensure the safety of both the mother and the baby.
Early PPH is defined as blood loss greater than ____ 24h after delivery
- A. 500 mL 24h after normal delivery
- B. 1000 48h after c/s (lat
- C. 1500 mL after 48hr
- D. 750 mL after 24h vaginal delivery
Correct Answer: D
Rationale: Early postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL within the first 24 hours after vaginal delivery. This definition is crucial because it helps healthcare providers identify and promptly address any excessive bleeding that may occur in the immediate postpartum period. Monitoring postpartum bleeding is essential to prevent complications related to PPH, such as maternal anemia, hypovolemic shock, and even maternal death. By knowing the definition of early PPH, healthcare providers can take timely interventions to manage and treat postpartum hemorrhage effectively.