Nokea
What is the expected effect of pudendal anesthesia?
- A. loss of sensation in the perineum
- B. decreased ability to move one's legs
- C. permanent loss of motor function
- D. loss of consciousness
Correct Answer: A
Rationale: The correct answer is A: loss of sensation in the perineum. Pudendal anesthesia specifically targets the pudendal nerve, which supplies sensation to the perineum. By blocking this nerve, the expected effect is a loss of sensation in the perineal region. Choices B, C, and D are incorrect because pudendal anesthesia does not affect motor function, consciousness, or the ability to move one's legs. It is important to understand the specific nerve being targeted and its function to determine the expected effects of anesthesia.
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Induction of labor is considered an acceptable obstetric procedure if it is a safe time to deliver the fetus. The charge nurse on the labor and birth unit is often asked to schedule patients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction, including which of the following? (Select all that apply.)
- A. Fetal death
- B. Postterm pregnancy
- C. Rupture of membranes at or near term
- D. Convenience of the patient or her health care provider
Correct Answer: B
Rationale: The correct answer is B: Postterm pregnancy. Induction of labor is considered appropriate for postterm pregnancies to prevent potential complications for the mother and fetus. Postterm pregnancy is defined as a pregnancy that extends beyond 42 weeks gestation, increasing the risk of stillbirth and other adverse outcomes. Therefore, inducing labor in postterm pregnancies can help to ensure the well-being of both the mother and fetus.
Rationale for Incorrect Choices:
A: Fetal death - Induction of labor is not appropriate in cases of fetal death as there is no live fetus to deliver.
C: Rupture of membranes at or near term - Rupture of membranes alone does not always necessitate induction of labor unless there are other medical indications.
D: Convenience of the patient or her health care provider - Induction of labor should not be performed for convenience but rather for medical reasons to ensure the safety of the mother and fetus.
While assisting with a vacuum extraction birth, which alteration should the nurse immediately report to the obstetric provider?
- A. Maternal pulse rate of 100 bpm
- B. Maternal blood pressure of 120/70 mm Hg
- C. Persistent fetal bradycardia below 100 bpm
- D. Decreased intensity of uterine contractions
Correct Answer: C
Rationale: The correct answer is C: Persistent fetal bradycardia below 100 bpm. This is crucial because it indicates fetal distress and requires immediate intervention to prevent potential harm to the baby. Bradycardia below 100 bpm may indicate inadequate oxygen supply to the fetus, necessitating urgent action. Maternal vital signs in choices A and B are within normal ranges. Choice D, decreased intensity of uterine contractions, while important, is not as critical as fetal bradycardia in this scenario.
The nurse is preparing a patient for a cesarean birth scheduled to be performed under general
- A. Which should the nurse plan to administer, if ordered by the health care provider, to prevent aspiration of gastric contents? (Select all that apply.)
- B. Citric acid (Bicitr
- C. Bromocriptine (Parlodel)
- D. Ranitidine (Zanta
Correct Answer: B
Rationale: The correct answer is B: Citric acid (Bicitr). Citric acid helps decrease the acidity of gastric contents, reducing the risk of aspiration during general anesthesia. Citric acid works as an antacid and helps neutralize stomach acid, which can help prevent complications during surgery.
Incorrect choices:
A: This choice is incorrect because it does not address the prevention of aspiration of gastric contents.
C: Bromocriptine is a medication used to treat conditions like hyperprolactinemia and Parkinson's disease. It is not indicated for preventing aspiration during surgery.
D: Ranitidine is an H2 blocker used to reduce stomach acid production. While it can help with heartburn and acid reflux, it is not typically used to prevent aspiration during surgery.
A laboring patient has asked the nurse to assist her in utilizing a cutaneous stimulation strategy for pain management. The nurse would
- A. assist her into the shower.
- B. apply a heat pack to lower back.
- C. help her to create a relaxing mental scen
- D. encourage cleansing breaths and slow-paced breathing.
Correct Answer: B
Rationale: The correct answer is B because applying a heat pack to the lower back can help alleviate labor pain through cutaneous stimulation. Heat therapy can increase blood flow, relax muscles, and reduce pain perception. Choice A is not specific to cutaneous stimulation and may not provide effective pain relief. Choice C focuses on mental imagery, not cutaneous stimulation. Choice D, while helpful for pain management, does not involve cutaneous stimulation.
Which fetal position increases the likelihood of a longer and more painful labor?
- A. Left occiput posterior
- B. Left occiput anterior
- C. Right occiput anterior
- D. Right occiput transverse
Correct Answer: A
Rationale: The correct answer is A: Left occiput posterior. In this position, the baby's head is facing the mother's sacrum, making labor longer and more painful due to the baby's position causing more pressure on the mother's back and pelvis. Left occiput anterior (B) and Right occiput anterior (C) are favorable positions for a smoother labor. Right occiput transverse (D) can also lead to a longer and more complicated labor, but not as much as Left occiput posterior.