Nokea
The nurse is planning to admit a pregnant client who is obese. Which potential client needs should the nurse anticipate?
- A. Routine administration of subcutaneous heparin may be prescribed.
- B. Bed rest as a necessary preventive measure may be prescribed.
- C. An overbed lift may be necessary if the client requires a cesarean section.
- D. Thromboembolism stockings or sequential compression devices may be prescribed.
Correct Answer: D
Rationale: Obese clients may need thromboembolism prevention and specialized equipment for safe cesarean handling.
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The nurse is explaining how a newly delivered baby initiates respiration. Which statement explains this process?
- A. Chemical thermal and mechanical factors
- B. Increase of po2 and decreased pco2
- C. Continued function of foramen ovale
- D. Drying off the infant
Correct Answer: A
Rationale: The correct statement explaining how a newly delivered baby initiates respiration is "Chemical thermal and mechanical factors." When a baby is born, various factors come into play to stimulate the baby's first breath. Chemically, the baby senses a decrease in oxygen and an increase in carbon dioxide levels, triggering the respiratory centers in the brain to start the breathing process. Thermally, exposure to the cooler air outside the womb stimulates the baby's skin receptors, encouraging the baby to take a breath. Mechanically, the pressure changes during delivery and the physical stimulation of the baby's face and body also play a role in initiating respiration. Overall, it is the combined effect of these chemical, thermal, and mechanical factors that help a newly delivered baby begin breathing independently.
A labor client has been diagnosed with CPD following attempts of pushing for 2 hours with no progress. Based on the info, which birth method is available when you have CPD (baby can't come out)?
- A. C/S
- B. Induced labor
- C. Vaginal birth with vacuum
- D. Insert foley catheter to empty bladder and make more room
Correct Answer: A
Rationale: CPD (cephalopelvic disproportion) occurs when the baby's head or body is too large to pass through the mother's pelvis. In cases where CPD is diagnosed and labor has stalled despite adequate efforts (such as pushing for 2 hours with no progress), the safest and most appropriate method to deliver the baby is through a cesarean section (C/S). This surgical procedure allows for a safe delivery when vaginal delivery is not possible due to CPD, ensuring the well-being of both the baby and the mother. Induced labor, vaginal birth with vacuum, or inserting a foley catheter to empty the bladder would not be effective or safe in cases of CPD where the baby cannot pass through the birth canal.
How should a nurse handle a newborn with meconium-stained amniotic fluid?
- A. Suction the airway immediately after birth
- B. Monitor for signs of aspiration
- C. Encourage immediate skin-to-skin contact
- D. Administer antibiotics to the newborn immediately
Correct Answer: A
Rationale: Suctioning the airway immediately reduces the risk of aspiration and respiratory complications.
How would a patient who has taken Lamaze education respond when the health-care provider recommends breaking the bag of waters in early labor?
- A. As long as it will speed up my labor, that is fine.â€
- B. I trust whatever intervention you think is right.â€
- C. What are the risks and benefits of breaking my water right now?â€
- D. Will I be able to get an epidural after you break my water?â€
Correct Answer: C
Rationale: Lamaze encourages informed decision-making, prompting patients to ask about risks and benefits.
A 28-year-old patient has decided to use the patch contraception. The nurse is educating her on the best site to use. Where is the best place to put the patch? Select one that does not that apply.
- A. Buttocks
- B. Leg
- C. Breast
- D. Arm
Correct Answer: C
Rationale: The best sites for applying the contraceptive patch are the buttocks, arm, and leg. These areas have sufficient fat and are away from areas that might rub off the patch. Choice B (Neck) is incorrect as the neck is not recommended for patch application due to the potential for irritation and the high blood flow area. Choice C (Breast) is not recommended because the breast tissue may affect the adhesion of the patch.