Nokea
Which medications could potentially cause hyperstimulation of the uterus during labor? (Select all that apply.)
- A. Oxytocin (Pitocin)
- B. Misoprostol (Cytote
- C. Dinoprostone (Cervidil)
- D. Methylergonovine maleate (Methergin
Correct Answer: A
Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is a uterotonic agent commonly used to induce or augment labor. It can cause hyperstimulation of the uterus, leading to uterine hypertonicity and potentially compromising fetal oxygenation. Misoprostol, Dinoprostone, and Methylergonovine maleate are not known to cause hyperstimulation of the uterus during labor.
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What can amniotomy cause?
- A. six-hour decrease of labor
- B. chorioamnionitis
- C. elevated blood pressure
- D. second stage labor dystocia
Correct Answer: B
Rationale: Amniotomy can cause chorioamnionitis, as the procedure involves breaking the amniotic sac which increases the risk of introducing bacteria into the uterus. This can lead to infection of the fetal membranes, causing chorioamnionitis. Choices A, C, and D are incorrect as amniotomy does not directly cause a six-hour decrease of labor, elevated blood pressure, or second stage labor dystocia.
Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
- A. Unruptured membranes
- B. intravenous (IV) fluid.
- C. Fetus has known heart defect
- D. must act quickly to improve placental blood flow and fetal oxygen supply
Correct Answer: A
Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby.
Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients.
Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication.
Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.
The nurse in the post-delivery unit is encouraging skin-to-skin contact for a mother and neonate after cesarean delivery. Which action, if noticed by the nurse, requires immediate intervention by the nurse?
- A. Mother is sitting up with the neonate prone on her chest.
- B. Mother is supine with the neonate prone on her chest.
- C. The neonate is prone on mother’s chest and facing to the side.
- D. Neonate is prone with mother resting in semi-Fowler’s position.
Correct Answer: B
Rationale: B is the correct answer because having the mother in a supine position with the neonate prone on her chest can potentially increase the risk of neonatal suffocation or accidental injury due to the baby slipping off. This position restricts the baby's ability to breathe properly and may lead to adverse outcomes.
A: Sitting up with the neonate prone on her chest allows for better supervision and support for the baby's breathing.
C: The neonate facing to the side is a safe position for skin-to-skin contact and breastfeeding.
D: Neonate resting in semi-Fowler's position is a safe and comfortable position that allows for proper breathing and bonding between mother and baby.
A nurse is examining a G1P0 who is 10 weeks gestation. The nurse notes a bluish coloration of her cervix. The nurse should document this finding as which positive sign?
- A. Quickening
- B. Goodell’s sign
- C. Chadwick’s sign
- D. Hegar’s sign
Correct Answer: C
Rationale: The correct answer is C: Chadwick's sign. Chadwick's sign refers to the bluish coloration of the cervix due to increased vascularity in early pregnancy. This is a positive sign of pregnancy, indicating the presence of hormonal changes and increased blood flow to the cervix. Quickening is the first fetal movements felt by the mother, typically around 18-20 weeks gestation. Goodell's sign refers to the softening of the cervix, not discoloration. Hegar's sign is the softening of the lower uterine segment, also not related to discoloration. Chadwick's sign specifically describes the bluish discoloration of the cervix due to increased blood flow, making it the correct answer in this scenario.
What is a complication of uterine rupture?
- A. DIC
- B. nuchal cord
- C. polyhydramnios
- D. oligohydramnios
Correct Answer: A
Rationale: The correct answer is A: DIC (Disseminated Intravascular Coagulation). Uterine rupture can lead to severe bleeding, causing DIC. This is because the release of blood into the abdomen triggers the body's clotting system, resulting in the consumption of clotting factors and platelets. This can lead to widespread clotting in small blood vessels and ultimately result in bleeding disorders.
Summary:
- B: Nuchal cord is when the umbilical cord is wrapped around the baby's neck, not directly related to uterine rupture.
- C: Polyhydramnios is excessive amniotic fluid, not a direct complication of uterine rupture.
- D: Oligohydramnios is decreased amniotic fluid, not a direct complication of uterine rupture.