Nokea
What is the most common cause of placenta accreta?
- A. malnutrition
- B. smoking
- C. previous cesarean birth
- D. obesity
Correct Answer: B
Rationale: Previous cesarean births are a leading cause of placenta accreta, where the placenta attaches too deeply into the uterine wall.
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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.
The nurse is caring for a postpartum person after a hemorrhage. How does the nurse monitor for decreased perfusion?
- A. Monitor lochia.
- B. Measure blood loss.
- C. Check temperature.
- D. Monitor 24-hour urine output.
Correct Answer: B
Rationale: After postpartum hemorrhage, monitoring the 24-hour urine output can help assess for signs of decreased perfusion.
The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.)
- A. Post-term fetus
- B. Maternal fever
- C. Placenta previa
- D. Induction of labor
Correct Answer: A
Rationale: A. Post-term fetus: Fetal scalp stimulation can be contraindicated in post-term fetuses due to the potential risks associated with uterine hyperstimulation and decreased fetal reserve in these pregnancies.
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.
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.