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What is the recommended frequency for assessing maternal vital signs during the first hour after delivery?
- A. every 15 minutes
- B. every 30 minutes
- C. once, then hourly
- D. once, then every 4 hours
Correct Answer: A
Rationale: The correct answer is A (every 15 minutes) because immediate postpartum assessment is crucial for early detection of complications. Monitoring vital signs every 15 minutes allows for prompt identification of issues like hemorrhage or infection. Choice B (every 30 minutes) may lead to a delayed response to critical changes. Choice C (once, then hourly) may miss rapid changes in the first hour. Choice D (once, then every 4 hours) is too infrequent for the critical postpartum period. Regular monitoring is essential for ensuring maternal safety.
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A pregnant patient has received the results of her triple-screen testing and it is positive. What would the nurse anticipate as the next step in the patient’s plan of care?
- A. No further testing is indicated at this time because results are normal.
- B. Refer to the physician for additional testing.
- C. Validate the results with the lab facility.
- D. Repeat the test in 2 weeks and have the patient return for her regularly scheduled prenatal visit.
Correct Answer: B
Rationale: A positive triple-screen test suggests an increased risk of genetic abnormalities, requiring additional diagnostic testing.
Which factors should be considered a contraindication for transcervical chorionic villus sampling?
- A. Rh-negative mother
- B. Gestation less than 15 weeks
- C. Maternal age younger than 35 years
- D. Positive for group B Streptococcus
Correct Answer: D
Rationale: Maternal infection, such as group B Streptococcus, is a contraindication for the procedure due to the risk of infection.
A patient in labor is having difficulty pushing during the second stage of labor. Which of the following interventions would be most helpful?
- A. Increase the epidural dose
- B. Encourage the patient to bear down with each contraction
- C. Perform a cesarean section
- D. Place the patient in a lithotomy position
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to bear down with each contraction. This is the most helpful intervention as it helps the patient effectively push during the second stage of labor, facilitating the descent of the baby through the birth canal. Increasing the epidural dose (choice A) can further impair the patient's ability to push. Performing a cesarean section (choice C) is not necessary unless there are other complications. Placing the patient in a lithotomy position (choice D) is a common position for delivery but does not address the issue of difficulty pushing.
Which foods should the nurse suggest for improving folic acid intake?
- A. Potatoes and grapes
- B. Cranberries and squash
- C. Apples and corn
- D. Oranges and spinach
Correct Answer: D
Rationale: Oranges and spinach are rich in folic acid, which is crucial for preventing neural tube defects during pregnancy.
How long should clamping of the cord be delayed in an uncomplicated delivery to increase the newborn's hemoglobin levels and improve circulation?
- A. 30–60 seconds
- B. 15–30 seconds
- C. 30 seconds
- D. Delayed cord clamping is not recommended.
Correct Answer: A
Rationale: The correct answer is A (30-60 seconds) for delayed cord clamping in an uncomplicated delivery. Delaying cord clamping for 30-60 seconds allows more blood to flow from the placenta to the baby, increasing the baby's hemoglobin levels and improving circulation. This extra blood transfer can provide the baby with essential nutrients and oxygen, reducing the risk of anemia and improving overall health outcomes.
Choice B (15-30 seconds) may not provide enough time for sufficient blood transfer compared to the optimal window of 30-60 seconds.
Choice C (30 seconds) is within the recommended range, but 30-60 seconds is considered more beneficial for maximizing blood flow to the newborn.
Choice D (Delayed cord clamping is not recommended) is incorrect as delayed cord clamping has been shown to have various benefits for newborns when done in uncomplicated deliveries.