Nokea
What action by the physician will the nurse anticipate?
- A. Perform an amniotomy.
- B. Initiate tocolytic drugs.
- C. Order a sedative for the patient.
- D. Plan to do an emergency cesarean section.
Correct Answer: A
Rationale: Medical treatment for hypotonic labor dysfunction includes an amniotomy as the first remedy if the membranes are intact.
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What is the most appropriate nursing diagnosis?
- A. Anxiety related to the development of postpartum complications
- B. Ineffective individual coping related to unfamiliarity with procedures
- C. Risk for ineffective parenting related to emergency cesarean section
- D. Grieving related to loss of expected birth experience
Correct Answer: D
Rationale: Women who have cesarean births usually need greater support than those who have vaginal births. They may feel grief, guilt, or anger, because the expected course of birth did not occur.
Which laboring patient should the nurse attend to first?
- A. 18-year-old primigravida with a fetal breech presentation
- B. 25-year-old multigravida with history of previous cesarean section
- C. 35-year-old multigravida with history of precipitate birth
- D. 16-year-old primigravida with a twin pregnancy
Correct Answer: C
Rationale: A precipitate birth is completed in less than 3 hours and can lead to complications like uterine rupture or cervical lacerations, requiring immediate attention.
What is the best response?
- A. The fundus is not assessed until the second postoperative day.
- B. The fundus is assessed by 'walking' fingers from the side of the uterus to the midline.
- C. The fundus is assessed only if large clots appear in lochia.
- D. The fundus is assessed only once every shift.
Correct Answer: B
Rationale: Assessment of the fundus following a cesarean section is done as usual, but using especially gentle fundal massage.
What nursing care should be provided to a woman with a third-degree laceration immediately after delivery?
- A. Warm compresses to the perineum
- B. Cold pack to the perineum
- C. Warm sitz bath
- D. Elevation of hips to prevent edema
Correct Answer: B
Rationale: Ice is applied to the perineum to reduce bruising and edema.
What complications of overstimulation of uterine contractions may occur?
- A. Water intoxication
- B. Impaired placental exchange of oxygen and nutrients
- C. Increased blood pressure
- D. Convulsions
- E. Uterine rupture
Correct Answer: A,B,E
Rationale: The most common complications are impaired placental exchange, uterine rupture, and water intoxication due to fluid retention.