Nokea
What can amniotomy cause?
- A. six-hour decrease of labor
- B. chorioamnionitis
- C. elevated blood pressure
- D. second stage labor dystocia
Correct Answer: B
Rationale: Amniotomy can cause chorioamnionitis, as the procedure involves breaking the amniotic sac which increases the risk of introducing bacteria into the uterus. This can lead to infection of the fetal membranes, causing chorioamnionitis. Choices A, C, and D are incorrect as amniotomy does not directly cause a six-hour decrease of labor, elevated blood pressure, or second stage labor dystocia.
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Observation of a fetal heart rate pattern indicates an increase in heart rate from the prior baseline rate of 152 bpm. Which physiologic mechanisms would account for this situation?
- A. Inhibition of epinephrine
- B. Inhibition of norepinephrine
- C. Stimulation of the vagus nerve
- D. Sympathetic stimulation
Correct Answer: D
Rationale: The correct answer is D: Sympathetic stimulation. Sympathetic stimulation increases heart rate by releasing norepinephrine, which acts on beta-adrenergic receptors in the heart. This leads to an increase in heart rate. Choices A and B are incorrect because inhibition of epinephrine or norepinephrine would not cause an increase in heart rate. Choice C is incorrect because stimulation of the vagus nerve would actually decrease heart rate by releasing acetylcholine, which acts on muscarinic receptors in the heart.
A 20-year-old gravida 1 para 0 presents to the prenatal clinic with a chief complaint that she feels like she is pregnant. Which are presumptive signs of pregnancy? Select all that apply.
- A. Linea nigra
- B. Breast tenderness
- C. Leukorrhea
- D. Chadwick’s sign
Correct Answer: A
Rationale: The correct answer is A: Linea nigra. Linea nigra is a presumptive sign of pregnancy, which refers to a dark line that appears on the abdomen. This sign is caused by hormonal changes during pregnancy. Breast tenderness (B) and leukorrhea (C) are actually probable signs of pregnancy, not presumptive signs. Chadwick's sign (D) is also a probable sign, not a presumptive sign. Presumptive signs are subjective symptoms reported by the patient and are not definitive indicators of pregnancy.
When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?
- A. Early decelerations
- B. Variable decelerations
- C. Nonperiodic accelerations
- D. Increase in baseline variability
Correct Answer: B
Rationale: The correct answer is B: Variable decelerations. When the mother's membranes rupture during active labor, variable decelerations should be observed in the fetal heart rate. This is because the rupture of membranes can lead to umbilical cord compression, causing variable decelerations in the fetal heart rate pattern. Variable decelerations are characterized by abrupt and visually apparent decreases in heart rate variability.
A: Early decelerations are usually associated with head compression during contractions and are benign.
C: Nonperiodic accelerations are not a typical pattern seen in response to ruptured membranes during labor.
D: An increase in baseline variability is a positive sign and does not specifically indicate the occurrence of variable decelerations related to umbilical cord compression.
Which medications could potentially cause hyperstimulation of the uterus during labor? (Select all that apply.)
- A. Oxytocin (Pitocin)
- B. Misoprostol (Cytote
- C. Dinoprostone (Cervidil)
- D. Methylergonovine maleate (Methergin
Correct Answer: A
Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is a uterotonic agent commonly used to induce or augment labor. It can cause hyperstimulation of the uterus, leading to uterine hypertonicity and potentially compromising fetal oxygenation. Misoprostol, Dinoprostone, and Methylergonovine maleate are not known to cause hyperstimulation of the uterus during labor.
Gestational diabetes increases what complication of labor?
- A. breech
- B. macrosomia
- C. macrosomia
- D. precipitous birth
Correct Answer: B
Rationale: The correct answer is B: macrosomia. Gestational diabetes can lead to fetal macrosomia, where the baby is larger than average, increasing the risk of complications during labor such as shoulder dystocia. This is due to the excess glucose crossing the placenta and stimulating the baby's pancreas to produce more insulin, resulting in increased growth. Choice A, breech presentation, is not directly associated with gestational diabetes. Choice C is a duplicate of the correct answer. Choice D, precipitous birth, is not a common complication of gestational diabetes but rather refers to an extremely rapid labor process.