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When a pregnant woman arrives at the labor suite, she tells the nurse that she wants to have an epidural for delivery. What is a contraindication to an epidural block?
- A. Abnormal clotting
- B. Previous cesarean delivery
- C. History of migraine headaches
- D. History of diabetes mellitus
Correct Answer: A
Rationale: An epidural block is not used if a woman has abnormal blood clotting.
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What is the Dick-Read method of childbirth preparation based on?
- A. Mild sedation throughout labor
- B. Relaxation techniques
- C. Skin stimulation
- D. Deep massage
Correct Answer: B
Rationale: The Dick-Read method depends on the use of relaxation techniques to reduce the discomforts of labor.
A woman requests a pudendal block to manage her labor pain. What statement by the woman indicates a need for further explanation about the pudendal block?
- A. I'm having a contraction. Can I get the pudendal block now?'
- B. I'll get the pudendal block right before I deliver.'
- C. The nurse-midwife will insert the needles into my vagina.'
- D. It takes a few minutes after the medicine is administered to make me feel numb.'
Correct Answer: A
Rationale: The pudendal block does not block pain from contractions and is given just before birth.
Which narcotic antagonist is used to reverse narcotic-induced respiratory depression?
- A. Hydroxyzine (Vistaril)
- B. Phenobarbital
- C. Naloxone (Narcan)
- D. Nitrous oxide
Correct Answer: C
Rationale: Naloxone (Narcan) is used to reverse respiratory depression caused by narcotics.
What nursing assessment should be reported immediately after an amniotomy?
- A. Fetal heart rate is regular at 154 beats/minute.
- B. Amniotic fluid is clear with flecks of vernix.
- C. Amniotic fluid is watery and pale green.
- D. Maternal temperature is 37.8?°C.
Correct Answer: C
Rationale: Amniotic fluid should be clear. Green fluid indicates the fetus has passed meconium, which is associated with fetal compromise.
A patient who received an epidural block asks why her blood pressure is taken so often. What is the nurse's best response to explain the frequent blood pressure assessments?
- A. They ensure that unsafe levels of hypertension do not occur.
- B. They help assess for the need for further pain relief.
- C. They monitor the progress of labor.
- D. They ensure adequate placental perfusion.
Correct Answer: D
Rationale: The hypotension that accompanies an epidural block may cause inadequate perfusion of the placenta, leading to fetal hypoxia.