Nokea
What condition is related to an increased risk for fetal demise?
- A. diabetes
- B. migraine headache
- C. spina bifida
- D. thyroid disorder
Correct Answer: A
Rationale: The correct answer is A: diabetes. Diabetes is associated with an increased risk of fetal demise due to complications such as congenital anomalies, macrosomia, and placental insufficiency. High blood sugar levels can lead to adverse effects on the fetus, including stillbirth. Migraine headache (B) and spina bifida (C) are not directly linked to fetal demise. Thyroid disorders (D) can impact pregnancy outcomes but are not specifically associated with an increased risk of fetal demise.
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What is a potential risk associated with prolonged second stage labor?
- A. decreased risk of instrumental delivery
- B. decreased risk of cesarean birth
- C. increased risk of fetal distress
- D. increased risk of rapid delivery
Correct Answer: C
Rationale: The correct answer is C: increased risk of fetal distress. Prolonged second stage labor can lead to decreased oxygen supply to the fetus, causing fetal distress. This can result in adverse outcomes for the baby. Other options are incorrect because prolonged second stage labor is actually associated with an increased risk of instrumental delivery (A), an increased risk of cesarean birth (B), and not rapid delivery (D) as it is a prolonged process.
Which clinical finding can be determined only by electronic fetal monitoring?
- A. Variability
- B. Tachycardia
- C. Bradycardia
- D. Fetal response to contractions
Correct Answer: D
Rationale: The correct answer is D because electronic fetal monitoring is the only method that can directly measure and display the fetal heart rate in response to contractions. Variability, tachycardia, and bradycardia can also be observed through electronic fetal monitoring, but fetal response to contractions specifically requires continuous monitoring of the fetal heart rate during contractions. Therefore, D is the only clinical finding that can be determined exclusively through electronic fetal monitoring. Variability (A), tachycardia (B), and bradycardia (C) can be identified through other means of monitoring and assessment as well.
A primipara patient who is 12 weeks gestation is being scheduled for an abdominal ultrasound. The client asks the nurse why she needs this test. What is the nurse’s best response?
- A. This test is to determine the position of the fetus.
- B. This test is to determine if there is enough amniotic fluid.
- C. This test is to determine how many weeks gestation you are.
- D. This test is to determine fetal breathing movements.
Correct Answer: C
Rationale: The correct answer is C: This test is to determine how many weeks gestation you are. At 12 weeks gestation, an ultrasound is commonly performed to accurately determine the gestational age of the fetus. This is important for monitoring fetal development and ensuring proper prenatal care.
A: This test is to determine the position of the fetus - Incorrect. The position of the fetus is usually determined in later stages of pregnancy and not the primary objective of an early pregnancy ultrasound.
B: This test is to determine if there is enough amniotic fluid - Incorrect. Amniotic fluid levels are typically assessed in later stages of pregnancy, not at 12 weeks gestation.
D: This test is to determine fetal breathing movements - Incorrect. Fetal breathing movements are typically observed in the third trimester, not at 12 weeks gestation.
In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding?
- A. The fetus is at 30 weeks of gestation.
- B. The mother has a history of fast labors.
- C. The mother has been given an epidural block.
- D. The mother has mild preeclampsia but is not in labor.
Correct Answer: A
Rationale: The correct answer is A because at 30 weeks of gestation, a fetal heart rate of 160 to 170 bpm is considered normal due to the fetus's stage of development. Fetal heart rates gradually decrease as gestation progresses. Choices B, C, and D are incorrect because they do not directly impact the fetal heart rate based on gestational age. Choice B, fast labors, does not affect the baseline fetal heart rate. Choice C, epidural block, may cause maternal hypotension but typically doesn't affect the fetal heart rate. Choice D, mild preeclampsia, may lead to fetal distress but does not directly influence the baseline fetal heart rate.
The nurse is making a plan of care for a patient who is in the first 24-hour period past a cesarean delivery. Which interventions will the nurse include in regards to medications? Select all that apply.
- A. Continue a daily stool softener.
- B. Manage pain with morphine.
- C. Ensure the availability of naloxone.
- D. Provide prophylaxis antibiotics.
Correct Answer: C
Rationale: The correct answer is C: Ensure the availability of naloxone. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, which could occur if the patient is receiving morphine for pain management post-cesarean delivery. It is essential to have naloxone readily available to counteract any potential opioid-related respiratory depression.
A: Continuing a daily stool softener is not directly related to medications typically given post-cesarean delivery and is not a priority in the immediate post-operative period.
B: Managing pain with morphine is a common practice post-cesarean delivery, but the focus here is on the intervention related to medication safety, which is ensuring naloxone availability.
D: Providing prophylactic antibiotics is important post-cesarean delivery to prevent infection but is not directly related to medication safety in this scenario.