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What is the purpose of performing an amniotomy during labor?
- A. to induce labor and promote cervical dilation
- B. to reduce the risk of infection
- C. to augment labor and prevent prolonged labor
- D. to prevent fetal infection
Correct Answer: C
Rationale: Performing an amniotomy during labor is done to augment labor by releasing amniotic fluid, which can help progress labor by increasing uterine contractions and encouraging the descent of the baby's head. This can help prevent prolonged labor and facilitate a smoother delivery process. Options A, B, and D are incorrect because inducing labor, reducing the risk of infection, and preventing fetal infection are not the primary purposes of performing an amniotomy.
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A nurse is assisting with a vaginal delivery. What is the most important intervention when the head begins to crown?
- A. apply gentle downward pressure
- B. apply upward pressure
- C. assist with positioning
- D. assist with perineal massage
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This intervention helps prevent rapid delivery to avoid perineal tearing and allows controlled stretching of the perineum. Applying upward pressure (B) can increase the risk of tearing. Positioning (C) is important but not the most critical at this stage. Perineal massage (D) is typically done before crowning, not during.
A 36-week pregnant woman presents to the labor and delivery unit in preterm labor. What is the priority intervention?
- A. Administer corticosteroids to promote fetal lung maturity
- B. Administer magnesium sulfate to stop labor
- C. Perform an emergency cesarean section
- D. Perform a nonstress test (NST)
Correct Answer: A
Rationale: The correct answer is A: Administer corticosteroids to promote fetal lung maturity. This is the priority intervention in preterm labor as it helps accelerate fetal lung development, reducing the risk of respiratory distress syndrome. Administering magnesium sulfate (B) is used for neuroprotection in preterm labor but is not the priority in this case. Emergency cesarean section (C) is not indicated unless there is a life-threatening situation. Performing a nonstress test (D) is important for fetal monitoring but is not the priority intervention in this scenario.
What is the primary purpose of using a fetal monitor during labor?
- A. to assess fetal heart rate variability
- B. to monitor for fetal distress
- C. to monitor maternal vital signs
- D. to assess the mother's emotional state
Correct Answer: C
Rationale: The correct answer is C: to monitor maternal vital signs. During labor, monitoring maternal vital signs such as blood pressure, heart rate, and oxygen saturation is crucial to ensure the well-being of both the mother and the baby. Changes in these vital signs can indicate potential complications that may require immediate intervention. Fetal heart rate variability (A) is important but not the primary purpose of using a fetal monitor. Monitoring for fetal distress (B) is indeed important, but the primary purpose is to ensure the mother's health. Assessing the mother's emotional state (D) is not the primary reason for using a fetal monitor during labor.
A 32-week pregnant woman is admitted with preterm labor. What is the most appropriate intervention to delay labor?
- A. Administer magnesium sulfate
- B. Perform an emergency cesarean section
- C. Administer a prostaglandin inhibitor
- D. Start a Pitocin infusion
Correct Answer: A
Rationale: The correct answer is A: Administer magnesium sulfate. Magnesium sulfate is commonly used to delay preterm labor by relaxing uterine smooth muscle. It inhibits contractions and delays labor progression. It is a standard treatment to prevent preterm birth and reduce the risk of complications for both the mother and the baby.
Choice B: Emergency cesarean section is not indicated for delaying preterm labor unless there are severe complications putting the mother or baby at immediate risk.
Choice C: Administering a prostaglandin inhibitor may help in some cases, but magnesium sulfate is the preferred choice for delaying labor in preterm pregnancies.
Choice D: Starting a Pitocin infusion would actually stimulate contractions and hasten labor, which is the opposite of what is needed in this scenario.
A nurse is caring for a birthing person who is experiencing a late deceleration in fetal heart rate. What is the most appropriate action for the nurse to take?
- A. turn the laboring person to the left side
- B. increase maternal oxygen supply
- C. prepare for an emergency cesarean section
- D. administer terbutaline
Correct Answer: A
Rationale: The correct action for a nurse when a birthing person experiences late deceleration in fetal heart rate is to turn the laboring person to the left side. This helps improve placental perfusion by reducing pressure on the vena cava, enhancing blood flow to the uterus, and thus improving oxygenation to the fetus. This action can help alleviate the late deceleration and prevent fetal distress. Increasing maternal oxygen supply (choice B) is important but not the first-line intervention for late decelerations. Emergency cesarean section (choice C) is not typically indicated for late decelerations unless other interventions fail. Administering terbutaline (choice D) is not appropriate for late decelerations as it is a tocolytic used to inhibit uterine contractions and prevent preterm labor.