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What do late decelerations indicate?
- A. A nonreassuring pattern
- B. Uteroplacental insufficiency
- C. Fetal heart depression
- D. Cord compression
- E. Head compression
Correct Answer: A,B,C
Rationale: Late decelerations indicate a nonreassuring pattern, uteroplacental insufficiency, and fetal heart depression.
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What signs and symptoms would lead the nurse to suspect false (prodromal) labor?
- A. Leaking of vaginal fluid
- B. Contractions intensify with ambulation
- C. Pink spotting
- D. Painless tightening of abdominal muscles
- E. Cervix thick and not effaced
Correct Answer: D,E
Rationale: Painless tightening of abdominal muscles (Braxton Hicks contractions) and a cervix that is thick and not effaced indicate false (prodromal) labor.
What is the most appropriate statement from the nurse when coaching the laboring woman with a fully dilated cervix to push?
- A. At the beginning of a contraction, hold your breath and push for 10 seconds.'
- B. Take a deep breath and push between contractions.'
- C. Begin pushing when a contraction starts and continue for the duration of the contraction.'
- D. At the beginning of a contraction, take two deep breaths and push with the second exhalation.'
Correct Answer: D
Rationale: When the cervix is fully dilated, the woman should take a deep breath and exhale at the beginning of a contraction, and then take another deep breath and push while exhaling.
What is the nurse primarily concerned about maintaining in the initial care of the newborn?
- A. Fluid intake
- B. Feeding schedule
- C. Thermoregulation
- D. Parental bonding
Correct Answer: C
Rationale: Thermoregulation is necessary to keep heat loss minimal and oxygen consumption low. Hypothermia can cause cold stress, which leads to hypoxia.
What is the best nursing action to implement when late decelerations occur?
- A. Reposition the patient to supine.
- B. Decrease flow of intravenous (IV) fluids.
- C. Increase oxygen to 10 L/minute.
- D. Prepare to increase oxytocin drip.
Correct Answer: C
Rationale: The major objective of care for late decelerations is to increase maternal oxygen. IV fluids are increased, oxytocin drips are stopped, and the patient is positioned to prevent supine hypotension.
How should the nurse intervene to relieve perineal bruising and edema following delivery?
- A. Place an ice pack on the area for 12 hours.
- B. Place a warm pack on the perineal area for 24 hours.
- C. Administer aspirin to relieve inflammation.
- D. Change the perineal pad frequently.
Correct Answer: A
Rationale: An ice pack can be placed on the mother's perineum to reduce bruising and edema for 12 hours followed by a warm pack after the first 12 to 24 hours after delivery.