Nokea
What intervention may be used to manage failure to descend during labor?
- A. administering pain medication
- B. allowing the patient to rest
- C. continuing to push for an extended period of time
- D. using forceps or a vacuum to assist delivery
Correct Answer: D
Rationale: The correct answer is D because using forceps or a vacuum to assist delivery can help manage failure to descend during labor by aiding in the descent of the baby through the birth canal. Forceps or vacuum extraction can provide the necessary assistance to safely deliver the baby when maternal pushing alone is insufficient.
Explanation for why the other choices are incorrect:
A: Administering pain medication does not address the underlying issue of failure to descend during labor.
B: Allowing the patient to rest may not resolve the issue of failure to descend and could potentially delay necessary interventions.
C: Continuing to push for an extended period of time without progress can lead to maternal exhaustion and fetal distress without addressing the root cause of failure to descend.
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The nurse documents a prenatal patient’s GTPAL as G5T2P1A1L4. Which obstetric history is consistent with this assessment?
- A. The woman is currently pregnant, has five living children.
- B. The woman is currently pregnant and had two preterm pregnancies.
- C. The woman is not currently pregnant and has had one abortion.
- D. The woman is currently pregnant and had one set of twins.
Correct Answer: A
Rationale: Rationale:
1. G5 = Gravida 5 (woman has been pregnant 5 times)
2. T2 = Term births 2 (woman has had 2 full-term pregnancies)
3. P1 = Preterm births 1 (woman has had 1 preterm pregnancy)
4. A1 = Abortions 1 (woman has had 1 abortion)
5. L4 = Living children 4 (woman has 4 living children)
Summary:
- Choice A is correct as it aligns with the GTPAL components.
- Choice B is incorrect because it does not match the number of term and preterm births.
- Choice C is incorrect as it does not reflect the number of living children.
- Choice D is incorrect as it does not indicate any preterm pregnancies.
A nurse is reviewing the record of a woman who has just been told that she is pregnant. The physician has documented the presence of Goodell’s sign. The nurse determines this sign refers to which of the following?
- A. A softening of the tip of the cervix
- B. A soft blowing sound that corresponds to the maternal pulse
- C. Enlargement of the uterus
- D. A softening of the lower uterine segment
Correct Answer: A
Rationale: The correct answer is A: A softening of the tip of the cervix. Goodell's sign is a softening of the tip of the cervix, which is one of the early signs of pregnancy due to increased vascularity and edema. This sign is often used by healthcare providers to confirm pregnancy.
Rationale:
1. Goodell's sign specifically refers to the softening of the cervix, not any other part of the reproductive system.
2. It is an important early sign of pregnancy due to hormonal changes.
3. Enlargement of the uterus (Choice C) typically occurs later in pregnancy, not as an early sign.
4. A blowing sound corresponding to maternal pulse (Choice B) and softening of the lower uterine segment (Choice D) are not associated with Goodell's sign.
How soon should delivery of the fetus occur when a Category III FHR tracing is diagnosed?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: B
Rationale: The correct answer is B: 30 minutes. When a Category III FHR tracing is diagnosed, it indicates severe fetal distress. Prompt delivery is crucial to prevent adverse outcomes. 30 minutes allows for timely intervention without risking further harm to the fetus. Option A (15 minutes) may be too rushed, potentially causing unnecessary stress during the delivery process. Options C (45 minutes) and D (60 minutes) delay delivery, increasing the risk of complications due to prolonged fetal distress. Timing is critical in ensuring the best possible outcome for both the mother and the baby.
The physician has ordered an amnioinfusion for the laboring patient. Which data supports the use of this therapeutic procedure?
- A. Presenting part not engaged
- B. +4 meconium-stained amniotic fluid on artificial rupture of membranes (AROM)
- C. Breech position of fetus
- D. Twin gestation
Correct Answer: B
Rationale: The correct answer is B because +4 meconium-stained amniotic fluid on AROM indicates meconium passage by the fetus, which can lead to meconium aspiration syndrome. Amnioinfusion can help dilute the meconium, reducing the risk of respiratory complications for the newborn.
A: Presenting part not engaged is not a direct indication for amnioinfusion.
C: Breech position of the fetus does not specifically warrant amnioinfusion.
D: Twin gestation alone is not a direct indication for amnioinfusion.
Which statement correctly describes the nurse's responsibility related to electronic monitoring?
- A. Report abnormal findings to the physician before initiating corrective actions.
- B. Teach the woman and her support person about the monitoring equipment and discuss any of their questions.
- C. Document the frequency, duration, and intensity of contractions measured by the
- D. Inform the support person that the nurse will be responsible for all comfort
Correct Answer: B
Rationale: The correct answer is B because it aligns with the nurse's responsibility to educate and provide information to the patient and their support person. Teaching about the monitoring equipment and addressing any questions ensures that the patient and their support person are informed and empowered. This promotes patient understanding and involvement in their care, leading to better outcomes.
Choice A is incorrect because the nurse should initiate corrective actions promptly for abnormal findings without waiting for physician input. Choice C is incorrect as it focuses solely on documentation rather than patient education. Choice D is incorrect as it neglects the importance of involving the support person in the care process.