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A woman with a multiple fetus pregnancy asks, <What are the chances of having an uncomplicated pregnancy?= The nurse's best response is that
- A. Spontaneous abortion is more common with twins
- B. Women pregnant with twins are less likely to develop complications
- C. Twins are less likely to have complications that single babies
- D. Perinatal mortality rate of monoamniotic siblings is 50%
Correct Answer: C
Rationale: The nurse's best response would be that twins are less likely to have complications than single babies. This is because multiple pregnancies do have an increased risk of complications compared to singleton pregnancies, but within the realm of multiple pregnancies, twins typically have better outcomes compared to higher-order multiples like triplets or quadruplets. Twins are more likely to be born at term, have higher birth weights, and are less likely to experience certain complications such as prematurity-related issues. Therefore, the chances of having an uncomplicated pregnancy are generally better with twins compared to higher-order multiples.
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A client at 28 weeks' gestation reports uterine contractions every 10 minutes. What is the priority nursing action?
- A. Encourage rest and hydration.
- B. Assess for signs of preterm labor.
- C. Administer tocolytic medication.
- D. Perform a vaginal examination.
Correct Answer: B
Rationale: Assessing for preterm labor signs, including cervical changes, is critical to determine the appropriate intervention.
How can a nurse support a mother planning to formula-feed her newborn?
- A. Discourage frequent feeding to avoid overfeeding
- B. Recommend holding the baby during feeding
- C. Provide information about formula preparation
- D. Advise limiting formula feeding to once daily
Correct Answer: C
Rationale: Providing accurate information about formula preparation ensures safe and adequate feeding.
The nurse is reviewing a prenatal client's record and notes a diagnosis of oligohydramnios. What complication is associated with this condition?
- A. Preterm labor.
- B. Fetal growth restriction.
- C. Cord prolapse.
- D. Placenta previa.
Correct Answer: B
Rationale: Oligohydramnios, or low amniotic fluid levels, is often associated with fetal growth restriction.
If the physician indicates shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist?
- A. Assisting the woman into McRoberts maneuver
- B. Calling a second physician to assist
- C. Preparing for immediate c/s delivery
- D. Utilizing fundal pressure to push the fetus out
Correct Answer: A
Rationale: In the scenario of shoulder dystocia during the delivery of a macrosomic fetus, the appropriate action for the nurse to assist would be to help the woman into the McRoberts maneuver. The McRoberts maneuver involves flexing the mother's thighs tightly against her abdomen to flatten the pelvis, allowing for more space to maneuver the baby's shoulder out from behind the pubic bone. This maneuver is often effective at resolving shoulder dystocia without the need for additional interventions such as a cesarean section or fundal pressure. It is a recommended initial step in managing shoulder dystocia and has been shown to be successful in many cases.
The nurse provides counseling on coitus interruptus. What important counseling should be included?
- A. The partners must communicate well to use this method.
- B. This method is 100 percent effective because semen does not enter the vagina.
- C. BBT must be used with this method.
- D. All persons are able to control ejaculate in time to withdraw.
Correct Answer: A
Rationale: The important counseling that should be included when discussing coitus interruptus (withdrawal method) is that the partners must communicate well to use this method effectively. Coitus interruptus involves the male partner withdrawing his penis from the vagina before ejaculation to prevent sperm from entering the woman's reproductive tract. Effective communication between partners is crucial to ensure that the method is used correctly and consistently. This method does not protect against sexually transmitted infections (STIs), so it's also important to discuss alternative methods of contraception for STI prevention. The statement that this method is 100 percent effective is incorrect, as pre-ejaculate can contain sperm and there is a risk of pregnancy if withdrawal is not done correctly.