Nokea
What pregnant person is at high risk for labor dystocia?
- A. 38-week gestation
- B. 41-year-old
- C. prenatal anemia
- D. no prenatal care
Correct Answer: B
Rationale: The correct answer is B: 41-year-old. Advanced maternal age increases the risk of labor dystocia due to reduced uterine muscle tone and coordination. Older individuals are more likely to experience prolonged labor or difficulty with fetal descent. Choice A (38-week gestation) is not a risk factor for labor dystocia. Prenatal anemia (Choice C) may lead to complications during pregnancy but is not directly linked to labor dystocia. Lack of prenatal care (Choice D) can increase the risk of complications but is not a specific risk factor for labor dystocia.
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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 of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
- A. External fetal monitoring (EFM)
- B. Internal fetal monitoring
- C. Intrauterine pressure catheter (IUP
- D. Maternal comments based on perception
Correct Answer: C
Rationale: The correct answer is C: Intrauterine pressure catheter (IUP). This device directly measures the pressure within the uterus, providing precise data on uterine contraction strength. It is considered the gold standard for assessing uterine activity.
A: External fetal monitoring (EFM) measures fetal heart rate and uterine contractions but doesn't provide direct information on contraction strength.
B: Internal fetal monitoring measures fetal heart rate and uterine contractions internally but focuses on fetal well-being, not contraction strength.
D: Maternal comments based on perception are subjective and not reliable for accurately assessing uterine contraction strength.
The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.
- A. Fetuses in breech position unable to deliver vaginally
- B. Increased number of elective or maternal request cesareans
- C. Incidences of women of older maternal age getting pregnant
- D. Decreasing rate of malpractice litigation with cesarean birth
Correct Answer: B
Rationale: The correct answer is B: Increased number of elective or maternal request cesareans. This is correct because the rise in elective cesarean births, often due to patient preference or convenience, can contribute to the overall high rates of cesarean births.
A: Fetuses in breech position unable to deliver vaginally - This is a valid reason for cesarean births, but it does not address the question about high rates of cesarean births.
C: Incidences of women of older maternal age getting pregnant - While advanced maternal age can be a factor in cesarean births, it is not directly related to the high rates of cesarean births at the facility.
D: Decreasing rate of malpractice litigation with cesarean birth - This is an irrelevant factor in determining the reasons for high rates of cesarean births at the facility.
In a spontaneous abortion, if bleeding from the retained products of conception cannot be stopped, what is the next course of action?
- A. surgery for a dilation and curettage
- B. surgery for a hysterectomy
- C. administration of magnesium sulfate
- D. administration of calcium gluconate
Correct Answer: C
Rationale: The correct answer is C: administration of magnesium sulfate. This is because magnesium sulfate is used to control bleeding in cases of retained products of conception in a spontaneous abortion. It works by causing uterine contractions, which help expel the remaining tissue and stop the bleeding. Surgery for dilation and curettage (choice A) is typically performed if bleeding persists after medical management. Surgery for a hysterectomy (choice B) is not necessary for managing bleeding in this situation. Administration of calcium gluconate (choice D) is not indicated for controlling bleeding in cases of retained products of conception.
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.