Nokea
What is the cause?
- A. Prolonged pressure against the partially dilated cervix
- B. Small leak of fluid through the posterior fontanelle
- C. Pressure of the forceps during delivery
- D. The effect of the vacuum extractor
Correct Answer: D
Rationale: The 'chignon' is due to the effect of the vacuum extractor and will disappear in a few days.
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Which statement indicates a woman understands activity limitations for the management of preterm labor?
- A. After my shower in the morning, I do the laundry and straighten up the house; then I rest.'
- B. I pack a picnic basket and put it next to the sofa so I do not have to get up for food during the day.'
- C. I have a 2-year-old to care for, but I try to rest as much as I can.'
- D. I get really bored at home, so I go to the shopping mall for just a little while.'
Correct Answer: B
Rationale: Lengthy activity restrictions are often needed to prevent preterm birth. The nurse can help the woman identify ways to organize necessary activities and maximize rest.
How would the nurse position the woman to prevent compression of a prolapsed cord?
- A. On her right side with knees flexed
- B. On her left side with a pillow placed between her legs
- C. On her back with her head lower than the rest of her body
- D. Supine with her legs elevated and bent at the knee
Correct Answer: C
Rationale: The Trendelenburg's (head down) position displaces the fetus upward to stop compression of the prolapsed cord.
What nursing actions will the nurse anticipate implementing?
- A. Insert IV.
- B. Record a baseline fetal heart rate.
- C. Explain procedure to patient.
- D. Instruct patient to ambulate immediately afterward.
- E. Ensure a tocolytic is available.
Correct Answer: A,B,C
Rationale: The cervical ripening procedure should be explained, a fetal heart rate baseline recorded, and an IV line placed in case tocolytics are needed for uterine tachysystole.
What are the rationales for labor induction?
- A. Placenta previa
- B. Prolapse of cord
- C. High station of fetus
- D. Maternal diabetes
- E. Placental insufficiency
Correct Answer: D,E
Rationale: Maternal diabetes and placental insufficiency are rationales for induction. Placenta previa, prolapse of cord, and high station of fetus are contraindications.
What is the lowest Bishop score the patient should have prior to induction?
- A. 6
- B. 8
- C. 10
- D. 12
Correct Answer: A
Rationale: The Bishop score evaluates the suitability of the patient for a vaginal delivery. A minimum score of 6 is recommended by the American College of Obstetricians and Gynecologists (ACOG).