Nokea
What is a common reason for cesarean birth?
- A. cephalic presentation
- B. laboring person’s BMI of 23
- C. labor dystocia
- D. lack of adequate pain control
Correct Answer: C
Rationale: Labor dystocia, or failure to progress, is a common reason for a cesarean birth.
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The nurse in labor and delivery notices an increase in the number of women requesting cesarean births. Which are the parameters and criteria used when making the decision to perform a cesarean delivery on maternal request (CDMR)? Select all that apply.
- A. Patient is able to self-pay for the procedure.
- B. Patient is willing to defer from legal litigation.
- C. Mother is planning to only have one child.
- D. Patient is aware of possible neonatal complications.
Correct Answer: D
Rationale: Choice B is correct because CDMR (cesarean delivery on maternal request) is often performed after 39 weeks gestation when the mother is fully aware of the risks and potential complications involved with the procedure.
The nurse is educating a primigravida patient during her first prenatal clinic appointment about follow-up prenatal care. How often will follow-up prenatal clinic visits be scheduled if the patient has a low-risk pregnancy and develops no complications? Select all that apply.
- A. Every 2 weeks for the first 28 weeks
- B. Every 4 weeks until 30 weeks
- C. Every 4 weeks until 28 weeks
- D. Every 2 weeks after 28 completed weeks until 36 weeks gestation
Correct Answer: C
Rationale: Ballottement is a physical examination technique used to detect the presence of a floating fetus or other abnormalities. A gentle tap on the cervix causes a rebound or sensation, confirming fetal presence.
What is the most likely cause for this fetal heart rate pattern?
- A. Administration of an epidural for pain relief during labor
- B. Cord compression
- C. Breech position of fetus
- D. Administration of meperidine (Demerol) for pain relief during labor
Correct Answer: B
Rationale: The fetal heart rate pattern described in the question, which likely includes decelerations, is indicative of cord compression. Cord compression occurs when there is pressure on the umbilical cord, leading to temporary reduction or blockage of blood flow and oxygen supply to the fetus. This can result in variable decelerations in the fetal heart rate pattern. Common scenarios that can cause cord compression include changes in fetal position, cord prolapse, or excessive uterine contractions. It is important to promptly address cord compression to prevent fetal distress and potential complications during labor and delivery. The other options listed may also influence fetal heart rate, but in this scenario, cord compression is the most likely cause based on the described heart rate pattern.
To clarify the fetal condition when baseline variability is absent, the nurse should first
- A. monitor fetal oxygen saturation using fetal pulse oximetry.
- B. notify the physician so that a fetal scalp blood sample can be obtaine
- C. apply pressure to the fetal scalp with a glove finger using a circular motion.
- D. increase the rate of nonadditive IV fluid to expand the mother's blood volume
Correct Answer: C
Rationale: When baseline variability is absent in fetal monitoring, it may indicate fetal hypoxia or acidemia. The appropriate action to further evaluate the fetal condition would be to notify the physician so that a fetal scalp blood sample can be obtained. This blood sample can provide important information about the oxygenation status of the fetus, helping to guide the management and interventions needed to support the baby's well-being. Monitoring fetal oxygen saturation using fetal pulse oximetry (choice A) or performing other interventions such as applying pressure to the fetal scalp (choice D) or increasing IV fluids for the mother (choice E) would not provide as direct or specific information about the fetal condition as obtaining a blood sample would.
How often is oxytocin usually increased for induction or augmentation of labor?
- A. every 10 minutes
- B. every 30 minutes
- C. every 60 minutes
- D. every 90 minutes
Correct Answer: C
Rationale: Oxytocin is typically increased every 60 minutes during labor induction.