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What does the nurse explain is used to soften the cervix with a 'cervical ripening' agent?
- A. Prostaglandin gel insertion
- B. Intravenous oxytocin
- C. Warm saline douches
- D. Nipple stimulation
Correct Answer: A
Rationale: Prostaglandin gel is inserted in the cervix and the woman remains in bed for 1 to 2 hours, being monitored for uterine contractions.
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What nursing assessment should be reported immediately after an amniotomy?
- A. Fetal heart rate is regular at 154 beats/minute.
- B. Amniotic fluid is clear with flecks of vernix.
- C. Amniotic fluid is watery and pale green.
- D. Maternal temperature is 37.8?°C.
Correct Answer: C
Rationale: Amniotic fluid should be clear. Green fluid indicates the fetus has passed meconium, which is associated with fetal compromise.
What should the nurse assess for in the newborn?
- A. Loss of hair from contact with forceps
- B. Sacral hematoma
- C. Facial asymmetry
- D. Shoulder dislocation
Correct Answer: C
Rationale: Pressure from forceps may injure the infant's facial nerve, which is evidenced by facial asymmetry.
What is this labor pattern considered?
- A. Normal
- B. Hypotonic
- C. Hypertonic
- D. FALSE
Correct Answer: B
Rationale: The woman with labor dysfunction related to decreased uterine muscle tone begins labor normally, but contractions diminish after the active phase.
Which interventions could a nurse apply to help stimulate contractions?
- A. Encouraging the patient to sit upright
- B. Assisting the patient to ambulate
- C. Stimulating the nipples
- D. Offering emotional support
- E. Allowing the patient to vent frustration
Correct Answer: A,B,C
Rationale: Sitting upright, ambulating, and stimulating the nipples may encourage progression of labor.
What would the nurse planning discharge instruction teach the woman to do?
- A. Report any increase in fetal activity.
- B. Notify her obstetrician if she has a temperature above 37.8?°C (100?°F).
- C. Massage her breasts to promote uterine relaxation.
- D. Rest in a side-lying Trendelenburg's position with hips elevated.
Correct Answer: B
Rationale: For the woman with premature rupture of membranes (PROM) who is not having labor induced right away, teaching combines information about infection and preterm labor. The woman should monitor her temperature and report a temperature greater than 37.8?°C (100?°F).