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What is a potential complication for the neonate due to precipitous labor?
- A. respiratory distress
- B. low birth weight
- C. prelabor rupture of membranes
- D. placenta previa
Correct Answer: A
Rationale: The correct answer is A: respiratory distress. During precipitous labor, the rapid delivery can cause the neonate to experience respiratory distress due to inadequate time for fluid clearance from the lungs, leading to transient tachypnea or respiratory distress syndrome. This complication can result in difficulty breathing and require immediate medical intervention.
Summary:
B: Low birth weight is not directly associated with precipitous labor.
C: Prelabor rupture of membranes is unrelated to the speed of labor.
D: Placenta previa is a condition involving the placenta's position, not typically related to the duration of labor.
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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.
Which patient is a candidate for internal monitoring with an intrauterine pressure catheter?
- A. Obese patient whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds
- B. Gravida 1, para 0, whose contractions are 2 to 3 minutes apart, lasting 60 seconds
- C. Multigravida whose contractions are 2 minutes apart, lasting 60 to 70 seconds
- D. Gravida 2, para 1, in latent phase whose contractions are irregular and mild
Correct Answer: B
Rationale: The correct answer is B because the patient is a primigravida (first pregnancy) with frequent contractions (2 to 3 minutes apart, lasting 60 seconds), which indicates active labor and the need for internal monitoring with an intrauterine pressure catheter. This level of contraction frequency and duration suggests progression towards the active phase of labor, where accurate monitoring is crucial for the well-being of both the mother and the baby.
Choice A is incorrect because the contractions are not as frequent or long-lasting as in active labor. Choice C is incorrect because although the contractions are frequent, the duration is longer than typical active labor. Choice D is incorrect because the contractions are irregular and mild, indicating the latent phase of labor where internal monitoring is not necessary.
A gravida 1 para 0 who is 10 weeks pregnant has her first prenatal visit. After performing a history and physical, which test ordered by the physician should the nurse verify with the examiner?
- A. Serological test for syphilis
- B. Rubella vaccine
- C. Clean-catch urinalysis
- D. Abdominal ultrasound
Correct Answer: D
Rationale: The correct answer is D: Abdominal ultrasound. At 10 weeks gestation, an abdominal ultrasound is typically ordered to confirm the viability of the pregnancy, assess fetal development, and determine gestational age. This test allows the healthcare provider to visualize the fetus, placenta, and amniotic fluid. It is essential in monitoring the progress of the pregnancy and identifying any potential complications.
Rationale for other choices:
A: Serological test for syphilis - While this test is important in prenatal care to screen for syphilis, it is usually done as part of routine prenatal blood work and not typically verified immediately after the first visit.
B: Rubella vaccine - Administering the rubella vaccine during pregnancy is contraindicated as it poses a risk to the developing fetus.
C: Clean-catch urinalysis - While urinalysis is a common test in prenatal care to screen for urinary tract infections and other conditions, it is not typically the first test verified following
The nurses in a labor and delivery unit are concerned about the high incidence of cesarean deliveries at their facility and initiate an internal study. Which is the most likely condition the nurses will recognize as a contributor to the rate of cesarean births?
- A. The facility has a high rating for managing high-risk pregnancies.
- B. Policies and parameters for cesarean need to be reviewed and refined.
- C. Community education about the advantages of vaginal birth is deficient.
- D. The incidence of maternal requests for cesarean delivery is increasing.
Correct Answer: D
Rationale: Step 1: Maternal requests for cesarean delivery are a significant contributor to the high incidence of cesarean births.
Step 2: Maternal requests may stem from various factors such as fear of labor pain, convenience, or personal preferences.
Step 3: Nurses can address this issue by educating women on the risks and benefits of cesarean versus vaginal delivery.
Step 4: By understanding and addressing maternal requests, the facility can potentially lower the cesarean delivery rate.
Summary:
- Choice A is incorrect as high-risk pregnancies do not directly contribute to the rate of cesarean births.
- Choice B is incorrect as reviewing cesarean policies alone may not address the underlying issue of maternal requests.
- Choice C is incorrect as community education, while important, may not directly impact the rate of cesarean deliveries as compared to addressing maternal requests.
The nurse is educating a gravida 1 para 0 who is 28 weeks pregnant. Which educational topics are appropriate for the nurse to discuss with the patient at this prenatal visit? Select all that apply.
- A. Discussion of prenatal classes
- B. Discussion of alcohol use
- C. Discussion of family history for pregnancy-induced hypertension
- D. Discussion of signs and symptoms of preterm labor
Correct Answer: B
Rationale: The correct answer is B, Discussion of alcohol use. This topic is important for prenatal education to ensure the well-being of the mother and baby. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. The other choices are incorrect because:
A: Discussion of prenatal classes is relevant, but not a priority at 28 weeks.
C: Discussion of family history for pregnancy-induced hypertension is important but not usually discussed at every prenatal visit.
D: Discussion of signs and symptoms of preterm labor is crucial, but typically discussed later in pregnancy.