Nokea
Which factor will increase the risk for hypotonic uterine dystocia in a postpartum client?
- A. Twin gestation
- B. Gestational anemia
- C. Hypertonic contractions
- D. Gestational hypertension
Correct Answer: A
Rationale: The correct answer is A: Twin gestation. In twin gestation, there is an increased risk of hypotonic uterine dystocia due to the higher likelihood of uterine overdistention. This can lead to decreased uterine muscle tone and ineffective contractions, resulting in difficulty in the progress of labor.
Summary:
B: Gestational anemia does not directly increase the risk for hypotonic uterine dystocia.
C: Hypertonic contractions are associated with hyperactivity of the uterus, not hypotonic uterine dystocia.
D: Gestational hypertension may lead to other complications but is not directly related to hypotonic uterine dystocia in a postpartum client.
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What adverse fetal effect is associated with undernutrition?
- A. hyperglycemia
- B. impaired bone development
- C. cardiovascular disorders
- D. psychiatric disorders
Correct Answer: B
Rationale: The correct answer is B: impaired bone development. Undernutrition during pregnancy can lead to inadequate nutrient supply for fetal bone development. Calcium and other minerals are essential for bone growth. Hyperglycemia (A) is associated with maternal diabetes, not undernutrition. Cardiovascular disorders (C) are more commonly linked to maternal obesity. Psychiatric disorders (D) are not directly caused by undernutrition in the fetus. In summary, impaired bone development is the most direct adverse fetal effect of undernutrition.
Which finding would indicate concealed hemorrhage in abruptio placentae?
- A. Bradycardia
- B. Hard boardlike abdomen
- C. Decrease in fundal height
- D. Decrease in abdominal pain
Correct Answer: B
Rationale: The correct answer is B: Hard boardlike abdomen. This finding indicates concealed hemorrhage in abruptio placentae because it suggests intra-abdominal bleeding causing rigidity and firmness. This is due to blood pooling in the abdomen, leading to a tense, boardlike feeling upon palpation. The other choices are incorrect because: A) Bradycardia is not a specific indicator of concealed hemorrhage in this context; C) Decrease in fundal height is more characteristic of a missed miscarriage or intrauterine fetal demise; D) Decrease in abdominal pain is not typically associated with concealed hemorrhage, which often presents with severe abdominal pain.
In which situation would a dilation and curettage (D&C) be indicated?
- A. Complete abortion at 8 weeks
- B. Incomplete abortion at 16 weeks
- C. Threatened abortion at 6 weeks
- D. Incomplete abortion at 10 weeks
Correct Answer: D
Rationale: A dilation and curettage (D&C) is indicated for an incomplete abortion at 10 weeks because it involves dilating the cervix and removing remaining products of conception from the uterus to prevent infection or excessive bleeding. Incomplete abortion at 16 weeks (Choice B) would be too advanced for a D&C and may require a different procedure. A complete abortion at 8 weeks (Choice A) does not require a D&C as all products of conception have already been expelled. Threatened abortion at 6 weeks (Choice C) indicates a possible miscarriage, but a D&C is not necessary unless the miscarriage is confirmed and incomplete.
Which condition is most commonly associated with late decelerations of the fetal heart rate?
- A. Head compression
- B. Maternal hypothyroidism
- C. Uteroplacental insufficiency
- D. Umbilical cord compression
Correct Answer: C
Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.
Which maternal condition always necessitates delivery by cesarean birth?
- A. Partial abruptio placentae
- B. Total placenta previa
- C. Ectopic pregnancy
- D. Eclampsia
Correct Answer: B
Rationale: The correct answer is B: Total placenta previa. In total placenta previa, the placenta completely covers the opening of the cervix, posing a risk of severe bleeding during vaginal delivery. Cesarean birth is necessary to prevent maternal hemorrhage and ensure a safe delivery.
Partial abruptio placentae (A) may require cesarean birth if there is significant bleeding or fetal distress, but it's not an absolute indication for cesarean section. Ectopic pregnancy (C) and eclampsia (D) do not always necessitate cesarean birth unless there are other obstetric indications.