What medication is used for cervical ripening?
- A. amniotomy
- B. Hemabate
- C. misoprostol
- D. progesterone
Correct Answer: C
Rationale: The correct answer is C: misoprostol. Misoprostol is used for cervical ripening in obstetrics due to its ability to soften and dilate the cervix, making it favorable for induction of labor. It is a prostaglandin E1 analogue that helps prepare the cervix for childbirth. Amniotomy (A) is the artificial rupture of membranes and does not directly aid in cervical ripening. Hemabate (B) is a medication used to treat postpartum hemorrhage, not for cervical ripening. Progesterone (D) is a hormone that helps maintain pregnancy and is not used for cervical ripening.
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What is one potential fetal complication of using the vacuum extractor?
- A. cephalohematoma
- B. face presentation
- C. fetal growth restriction
- D. scalp fracture
Correct Answer: A
Rationale: The correct answer is A: cephalohematoma. When using a vacuum extractor during childbirth, the device applies suction to the baby's head to assist with delivery. This suction can cause a collection of blood between the baby's skull and periosteum, resulting in a cephalohematoma. This complication is due to the pressure exerted on the baby's head during the extraction process. Cephalohematoma is a common side effect of vacuum extraction and typically resolves on its own. Face presentation and fetal growth restriction are not directly related to the use of a vacuum extractor. Scalp fracture is a rare but serious complication that can occur if excessive force is applied during vacuum extraction, leading to bone injury, which is different from the collection of blood in a cephalohematoma.
Which statement by the patient indicates to the nurse that the patient understands danger signs during the second trimester?
- A. I should contact the doctor if I experience heartburn.
- B. I should contact the doctor if I experience constipation.
- C. I should contact the doctor if I experience hurting when I urinate.
- D. I should contact the doctor if I experience leg cramps.
Correct Answer: C
Rationale: The correct answer is C because pain while urinating can be a sign of a urinary tract infection, which is common during pregnancy and can lead to complications if not treated promptly. Heartburn, constipation, and leg cramps are common discomforts during pregnancy but are not typically considered emergency danger signs. Therefore, option C is the most critical symptom that requires immediate medical attention to prevent potential harm to the mother and baby.
An emergency cesarean is being implemented. The patient describes tingling in her ears and a metallic taste with the administration of regional anesthesia. The nurse is aware that which incidence has occurred?
- A. Manifestation of maternal respiratory depression related to anesthesia
- B. Inadvertent injection of the anesthetic agent into the maternal bloodstream
- C. Maternal hypotension is occurring related to administration of anesthesia
- D. Expected manifestations related to anesthetic medications are present
Correct Answer: B
Rationale: The correct answer is B: Inadvertent injection of the anesthetic agent into the maternal bloodstream. This is indicated by the patient experiencing tingling in her ears and a metallic taste, which are signs of systemic toxicity from the anesthetic agent. The anesthetic has entered the bloodstream instead of staying localized to the intended area. Other choices are incorrect as A is more related to opioid overdose, C is more related to hypotension, and D implies that these symptoms are normal when they are not.
Multiple gestation can lead to what labor complication?
- A. tachysystole
- B. postterm birth
- C. postterm birth
- D. early declarations
Correct Answer: C
Rationale: The correct answer is C: postterm birth. Multiple gestation, such as twins or triplets, often leads to a higher risk of postterm birth due to the increased likelihood of preterm labor and delivery. This is because the uterus may become overdistended and unable to maintain the pregnancy to full term, resulting in postterm birth.
Incorrect choices:
A: Tachysystole is excessive uterine contractions, which is not directly related to multiple gestation.
B: Postterm birth is already covered as the correct answer.
D: Early decelerations are a common finding in labor but not specifically associated with multiple gestation complications.
When assessing a prenatal client at follow-up prenatal visits during the second trimester, the nurse should anticipate which assessments to be performed at each visit? Select all that apply.
- A. Cervical examination
- B. Weight, height, BMI
- C. Fetal ultrasound
- D. Fundal height
Correct Answer: B
Rationale: The correct answer is B: Weight, height, BMI. During each second-trimester prenatal visit, it is essential to monitor the client's weight, height, and BMI to ensure appropriate maternal and fetal health. Weight gain is a crucial indicator of fetal growth and maternal well-being. Height and BMI can provide insights into the client's nutritional status and overall health.
Explanation of why other choices are incorrect:
A: Cervical examination is typically not performed routinely during second-trimester prenatal visits unless there are specific concerns such as preterm labor risk.
C: Fetal ultrasound is usually scheduled at specific times during pregnancy, not necessarily at every second-trimester visit.
D: Fundal height measurement is important, but it is usually performed starting in the second trimester to assess fetal growth and position, not necessarily at every visit.