Nokea
The nurse thoroughly dries the infant immediately after birth primarily to
- A. reduce heat loss from evaporation.
- B. stimulate crying and lung expansion.
- C. increase blood supply to the hands and feet.
- D. remove maternal blood from the skin surfac
Correct Answer: A
Rationale: The correct answer is A because drying the infant helps reduce heat loss through evaporation, preventing hypothermia. Wet skin can lead to rapid heat loss. This is critical for newborns who are at risk of temperature instability.
Choice B is incorrect because drying the infant is not primarily done to stimulate crying and lung expansion. Choice C is incorrect because drying does not increase blood supply to the hands and feet. Choice D is incorrect because maternal blood is typically cleared from the infant's skin through other means, not primarily by drying.
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Which assessment would be important for a 6-hour-old infant who has bruising over the cheeks from a forceps birth?
- A. Presence of newborn reflexes
- B. Symmetry of facial movements
- C. Caput and molding of the head
- D. Anterior and posterior fontanels
Correct Answer: B
Rationale: The correct answer is B: Symmetry of facial movements. Bruising over the cheeks can indicate potential nerve damage from the forceps birth. Assessing facial movements helps determine if there is any nerve injury affecting facial muscles. Presence of newborn reflexes (A) is important but not directly related to facial nerve injury. Caput and molding of the head (C) are more related to the birthing process and not specific to facial nerve assessment. Anterior and posterior fontanels (D) are important for assessing fontanelle closure but not specific to facial nerve evaluation.
Which method of pain management would be safest for a gravida 3, para 2, admitted at 8 cm cervical dilation?
- A. Narcotics
- B. Spinal block
- C. Epidural anesthesia
- D. Breathing and relaxation techniques
Correct Answer: C
Rationale: The correct answer is C: Epidural anesthesia. At 8 cm cervical dilation, the patient is in active labor and close to delivery. Epidural anesthesia is the safest method as it provides effective pain relief without affecting the baby's central nervous system. Narcotics can pass through the placenta and affect the baby's breathing. Spinal block may cause a sudden drop in blood pressure. Breathing and relaxation techniques may not be sufficient at 8 cm dilation. Epidural anesthesia is the most appropriate for pain management in this scenario.
During labor a vaginal examination should be performed only when necessary because of the risk of
- A. infection.
- B. fetal injury.
- C. discomfort.
- D. perineal traum
Correct Answer: A
Rationale: Step 1: Vaginal examination during labor can introduce bacteria, leading to infection.
Step 2: Infections can be harmful to both the mother and the baby.
Step 3: Minimizing unnecessary vaginal exams reduces the risk of infection.
Summary: Choice A is correct because infection poses serious risks. Choices B, C, and D are incorrect as they do not directly address the primary risk associated with vaginal examinations during labor.
Which fetal position may cause the laboring patient increased back discomfort?
- A. Left occiput anterior
- B. Left occiput posterior
- C. Right occiput anterior
- D. Right occiput transverse
Correct Answer: B
Rationale: The correct answer is B: Left occiput posterior. In this position, the baby's occiput is towards the mother's back, leading to increased back discomfort during labor. The baby's position can put pressure on the mother's sacrum and lower back, causing more pain. Choices A, C, and D do not involve the baby's occiput being posterior, so they would not result in the same level of back discomfort.
Which clinical finding would be an indication to the nurse that the fetus may be compromised?
- A. Active fetal movements
- B. Fetal heart rate in the 140s
- C. Contractions lasting 90 seconds
- D. Meconium-stained amniotic fluid
Correct Answer: D
Rationale: The correct answer is D. Meconium-stained amniotic fluid indicates fetal distress due to possible hypoxia. Meconium in the fluid can lead to meconium aspiration syndrome, a serious condition. The other choices are incorrect because active fetal movements (A) and a fetal heart rate in the 140s (B) are normal signs of fetal well-being. Contractions lasting 90 seconds (C) could indicate labor progress but do not necessarily indicate fetal compromise.