Nokea
Which of the following complications of labor and delivery may develop when a baby enters the pelvis in the LMP position?
- A. Cephalopelvic disproportion.
- B. Placental abruption.
- C. Breech presentation.
- D. Acute fetal distress.
Correct Answer: A
Rationale: LMP (left mentum posterior) position can lead to cephalopelvic disproportion, making delivery difficult.
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The nurse is caring for a client who is scheduled to have an amniocentesis. Which intervention is most important for the nurse to perform after the procedure?
- A. Evaluate need for Rh0D immunoglobulin
- B. Clean site
- C. Administer pain medication
- D. Perform vital signs
Correct Answer: A
Rationale: The correct answer is A: Evaluate need for Rh0D immunoglobulin. After an amniocentesis, it is crucial to assess if the client is Rh-negative and the fetus is Rh-positive. If this is the case, Rh0D immunoglobulin should be administered to prevent Rh incompatibility issues in future pregnancies. This intervention is critical to prevent hemolytic disease in the newborn.
Cleaning the site (B) is important for infection prevention but not the most critical post-procedure intervention. Administering pain medication (C) can be done based on client's discomfort level but not the top priority. Performing vital signs (D) is important but assessing Rh status and administering Rh0D immunoglobulin take precedence.
A doula is working with a laboring woman who is 6 cm dilated and is contracting every 3 min × 60 sec on an oxytocin drip. Which of the following interventions should the nurse suggest the doula perform?
- A. Regulate the oxytocin drip rate.
- B. Check the vaginal dilation of the client.
- C. Encourage the woman to use breathing techniques.
- D. Monitor the client for uterine hyperstimulation.
Correct Answer: C
Rationale: The doula's role is to provide emotional and physical support, such as encouraging breathing techniques. Regulating medications and monitoring for complications are the nurse's responsibilities.
A client on the obstetric unit is receiving IV medications per physician’s orders. On rounds the nurse notes that the client’s IV has infiltrated. Which of the following actions should the nurse perform first?
- A. Determine whether the infusion is a vesicant.
- B. Stop the infusion and remove the catheter.
- C. Document the occurrence in the medical record.
- D. Elevate the extremity and monitor the site.
Correct Answer: B
Rationale: Stopping the infusion and removing the catheter prevents further tissue damage from the infiltrated medication.
The umbilical cord is being clamped by the obstetrician. Which of the following physiological changes is taking place at this time?
- A. The baby’s blood bypasses its pulmonary system.
- B. The baby’s oxygen level begins to drop.
- C. Bacteria begin to invade the baby’s bowel.
- D. Bilirubin rises in the baby’s bloodstream.
Correct Answer: A
Rationale: Clamping the umbilical cord initiates the transition from fetal to neonatal circulation, allowing blood to bypass the pulmonary system as the lungs take over oxygen exchange.
A nurse hears a co-worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse’s best response?
- A. Technology use has to be combined with nursing judgment.
- B. The focus of effective nursing care is technology.
- C. If it’s so easy, why don’t you do it?
- D. That is true in the 20th century.
Correct Answer: A
Rationale: In many ways, technology makes work easier, but it does not replace nursing judgment. Technology does not replace your critical eye and clinical judgment. Most importantly, it is essential to remember that the focus of nursing care is not the machine or the technology; it is the patient.