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Which aspect of newborn assessment may be limited by the application of a vacuum extractor at birth?
- A. Anterior fontanel
- B. Coronal suture lines
- C. Posterior fontanel
- D. Biparietal diameter
Correct Answer: C
Rationale: The correct answer is C: Posterior fontanel. When a vacuum extractor is used during birth, it can cause swelling or molding of the baby's head, which may affect the assessment of the posterior fontanel. This fontanel is an important landmark for determining head size and shape. Swelling or molding can make it difficult to accurately assess the fontanel's size and shape, potentially impacting the overall assessment of the newborn's head.
A: The anterior fontanel is not typically affected by the use of a vacuum extractor.
B: The coronal suture lines are not directly impacted by the vacuum extractor.
D: The biparietal diameter can still be measured accurately even with molding caused by the vacuum extractor.
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The nurse is assisting a patient who wishes to use hydrotherapy during labor. What is the primary benefit of hydrotherapy?
- A. Accelerates cervical dilation.
- B. Increases maternal relaxation.
- C. Reduces the risk of perineal trauma.
- D. Shortens the duration of labor.
Correct Answer: B
Rationale: The correct answer is B: Increases maternal relaxation. Hydrotherapy during labor helps relax the mother by reducing stress, anxiety, and pain perception, promoting a sense of well-being. Relaxation can lead to better pain management and overall labor experience. Choice A is incorrect because hydrotherapy may not directly accelerate cervical dilation. Choice C is incorrect as it may reduce discomfort but does not necessarily prevent perineal trauma. Choice D is incorrect as the duration of labor can vary and is not solely determined by hydrotherapy.
A laboring patient who imagines her body opening to let the baby out is using a mental technique called
- A. imagery.
- B. effleurag
- C. dissociation.
- D. distraction.
Correct Answer: A
Rationale: The correct answer is A: imagery. Imagery involves creating mental pictures or sensations to help focus and relax the mind. In this scenario, the laboring patient visualizes her body opening to facilitate the birthing process, which can help reduce anxiety and pain perception. Effleurage (B) is a massage technique, dissociation (C) is a coping strategy to mentally detach from pain, and distraction (D) involves diverting attention away from pain stimuli. However, in this case, the patient's focus on visualizing the birthing process aligns with the use of imagery.
What drug is an anxiolytic that relieves apprehension and creates a feeling of calm?
- A. hydroxyzine
- B. fentanyl
- C. codeine
- D. morphine
Correct Answer: A
Rationale: The correct answer is A: hydroxyzine. Hydroxyzine is an anxiolytic medication that acts on the central nervous system to relieve apprehension and induce a calming effect. It is commonly used to treat anxiety and tension. Fentanyl, codeine, and morphine are opioid medications primarily used for pain relief and do not have anxiolytic properties. Therefore, hydroxyzine is the correct choice for a drug that specifically targets anxiety and promotes a feeling of calm.
While assisting with a vacuum extraction birth, which alteration should the nurse immediately report to the obstetric provider?
- A. Maternal pulse rate of 100 bpm
- B. Maternal blood pressure of 120/70 mm Hg
- C. Persistent fetal bradycardia below 100 bpm
- D. Decreased intensity of uterine contractions
Correct Answer: C
Rationale: The correct answer is C: Persistent fetal bradycardia below 100 bpm. This is crucial because it indicates fetal distress and requires immediate intervention to prevent potential harm to the baby. Bradycardia below 100 bpm may indicate inadequate oxygen supply to the fetus, necessitating urgent action. Maternal vital signs in choices A and B are within normal ranges. Choice D, decreased intensity of uterine contractions, while important, is not as critical as fetal bradycardia in this scenario.
During a vaginal exam, the nurse identifies that the fetal station is at +2. What does this finding indicate?
- A. The fetus is high in the pelvis.
- B. The presenting part is at the ischial spines.
- C. The presenting part is below the ischial spines.
- D. The presenting part is crowning.
Correct Answer: C
Rationale: The correct answer is C because when the fetal station is at +2, it indicates that the presenting part is below the ischial spines. This means the baby's head is 2 cm below the ischial spines, which is a significant milestone in the descent of the fetus through the birth canal. The other choices are incorrect because: A) +2 station indicates descent, not that the fetus is high in the pelvis; B) Ischial spines are at 0 station, not +2; D) Crowning is at +5 station, not +2.