Nokea
What is the condition in which the umbilical cord vessels branch prior to insertion into the placenta?
- A. placenta previa
- B. placenta cervix
- C. velamentous insertion
- D. vasa previa
Correct Answer: C
Rationale: The correct answer is C: velamentous insertion. In this condition, the umbilical cord vessels branch before reaching the placenta, making them vulnerable to compression and rupture. Placenta previa (A) refers to the placenta covering the cervix, not cord insertion. Placenta cervix (B) is not a recognized term. Vasa previa (D) is when fetal vessels traverse the fetal membranes overlying the cervix, not related to branching of umbilical cord vessels before insertion into the placenta.
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The nurse is reviewing an electronic fetal monitor tracing from a patient in active labor and notes the fetal heart rate gradually drops to 20 beats per minute (bpm) below the baseline and returns to the baseline well after the completion of the patient's contractions. How will the nurse document these findings?
- A. Late decelerations
- B. Early decelerations
- C. Variable decelerations
- D. Proximal decelerations
Correct Answer: B
Rationale: The correct answer is B: Early decelerations. Early decelerations occur in response to fetal head compression during contractions, resulting in a gradual decrease in the fetal heart rate that mirrors the timing of contractions. In this scenario, the fetal heart rate drops to 20 bpm below the baseline during contractions and returns to baseline after contractions, indicating a benign pattern. Late decelerations (choice A) occur after the peak of the contraction and are associated with uteroplacental insufficiency. Variable decelerations (choice C) are abrupt decreases in fetal heart rate without a consistent timing in relation to contractions, often due to cord compression. Proximal decelerations (choice D) are not a recognized classification of decelerations in fetal monitoring.
The nurse is concerned that a patient’s uterine activity is too intense and that her obesity is
preventing accurate assessment of the actual intrauterine pressure. Based on this information,
which action should the nurse take?
- A. Reposition the tocotransducer.
- B. Reposition the Doppler transducer.
- C. Obtain an order from the health care provider for a spiral electrod
- D. Obtain an order from the health care provider for an intrauterine pressure catheter.
Correct Answer: D
Rationale: The correct answer is D: Obtain an order from the health care provider for an intrauterine pressure catheter. This is the most appropriate action because an intrauterine pressure catheter provides the most accurate assessment of intrauterine pressure, especially in cases where obesity may interfere with external monitoring methods. Repositioning the tocotransducer (choice A) or Doppler transducer (choice B) may not significantly improve accuracy in this situation. Obtaining an order for a spiral electrod (choice C) is not necessary as it does not directly address the issue of accurate intrauterine pressure assessment.
The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.
- A. Fetuses in breech position unable to deliver vaginally
- B. Increased number of elective or maternal request cesareans
- C. Incidences of women of older maternal age getting pregnant
- D. Decreasing rate of malpractice litigation with cesarean birth
Correct Answer: B
Rationale: The correct answer is B: Increased number of elective or maternal request cesareans. This is correct because the rise in elective cesarean births, often due to patient preference or convenience, can contribute to the overall high rates of cesarean births.
A: Fetuses in breech position unable to deliver vaginally - This is a valid reason for cesarean births, but it does not address the question about high rates of cesarean births.
C: Incidences of women of older maternal age getting pregnant - While advanced maternal age can be a factor in cesarean births, it is not directly related to the high rates of cesarean births at the facility.
D: Decreasing rate of malpractice litigation with cesarean birth - This is an irrelevant factor in determining the reasons for high rates of cesarean births at the facility.
A nurse is taking a birth history assessment on a client who is 8 weeks gestation and has one child who was born at 38 weeks. Which is consistent with this birth history?
- A. Primipara
- B. Primigravida
- C. Nulligravida
- D. Multipara
Correct Answer: D
Rationale: The correct answer is D: Multipara. This term refers to a woman who has given birth to two or more children. In this case, the client has one child already, making her a multipara.
A: Primipara refers to a woman who has given birth to one child, which does not match the client's birth history.
B: Primigravida refers to a woman who is pregnant for the first time, which also does not match the client's history.
C: Nulligravida refers to a woman who has never been pregnant, which is not the case for the client.
Therefore, the correct term to describe the client's birth history is Multipara, as she has one child and is currently 8 weeks gestation.
Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
- A. External fetal monitoring (EFM)
- B. Internal fetal monitoring
- C. Intrauterine pressure catheter (IUP
- D. Maternal comments based on perception
Correct Answer: C
Rationale: The correct answer is C: Intrauterine pressure catheter (IUP). This device directly measures the pressure within the uterus, providing precise data on uterine contraction strength. It is considered the gold standard for assessing uterine activity.
A: External fetal monitoring (EFM) measures fetal heart rate and uterine contractions but doesn't provide direct information on contraction strength.
B: Internal fetal monitoring measures fetal heart rate and uterine contractions internally but focuses on fetal well-being, not contraction strength.
D: Maternal comments based on perception are subjective and not reliable for accurately assessing uterine contraction strength.