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Which of the following factors would affect pain perception or tolerance for the laboring patient?
- A. Right occiput posterior fetal position during labor
- B. Bishop score of 10 prior to the induction of labor
- C. Gynecoid pelvis
- D. Absence of Ferguson's reflex
Correct Answer: A
Rationale: The correct answer is A: Right occiput posterior fetal position during labor. This position can lead to intense back pain and prolonged labor, affecting pain perception. A posterior position can put pressure on the sacrum and cause increased discomfort. In contrast, choices B, C, and D do not directly impact pain perception during labor. Choice B, Bishop score of 10, indicates favorable conditions for labor progress but does not necessarily affect pain perception. Choice C, Gynecoid pelvis, refers to a common pelvis shape that may facilitate labor but does not directly influence pain tolerance. Choice D, Absence of Ferguson's reflex, is related to the ability to push effectively but is not directly linked to pain perception.
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A patient at 40 weeks' gestation should be instructed to go to a hospital or birth center for evaluation when she experiences
- A. increased fetal movement.
- B. irregular contractions for 1 hour.
- C. a trickle of fluid from the vagin
- D. thick pink or dark red vaginal mucus.
Correct Answer: C
Rationale: The correct answer is C because a trickle of fluid from the vagina at 40 weeks' gestation could indicate the rupture of membranes, which is a sign of impending labor. This warrants immediate evaluation to assess the status of the amniotic sac and the need for monitoring or intervention.
Explanation for other choices:
A: Increased fetal movement is a normal sign of fetal well-being and not a reason for immediate evaluation.
B: Irregular contractions for 1 hour may not necessarily indicate active labor, so immediate evaluation is not needed.
D: Thick pink or dark red vaginal mucus may indicate bloody show, which can be a sign of labor starting, but it is not as urgent as a potential rupture of membranes.
The nurse thoroughly dries the infant immediately after birth primarily to
- A. reduce heat loss from evaporation.
- B. stimulate crying and lung expansion.
- C. increase blood supply to the hands and feet.
- D. remove maternal blood from the skin surfac
Correct Answer: A
Rationale: The correct answer is A because drying the infant helps reduce heat loss through evaporation, preventing hypothermia. Wet skin can lead to rapid heat loss. This is critical for newborns who are at risk of temperature instability.
Choice B is incorrect because drying the infant is not primarily done to stimulate crying and lung expansion. Choice C is incorrect because drying does not increase blood supply to the hands and feet. Choice D is incorrect because maternal blood is typically cleared from the infant's skin through other means, not primarily by drying.
Which assessment would be important for a 6-hour-old infant who has bruising over the cheeks from a forceps birth?
- A. Presence of newborn reflexes
- B. Symmetry of facial movements
- C. Caput and molding of the head
- D. Anterior and posterior fontanels
Correct Answer: B
Rationale: The correct answer is B: Symmetry of facial movements. Bruising over the cheeks can indicate potential nerve damage from the forceps birth. Assessing facial movements helps determine if there is any nerve injury affecting facial muscles. Presence of newborn reflexes (A) is important but not directly related to facial nerve injury. Caput and molding of the head (C) are more related to the birthing process and not specific to facial nerve assessment. Anterior and posterior fontanels (D) are important for assessing fontanelle closure but not specific to facial nerve evaluation.
Immediately following the forceps-assisted birth of an infant, which action should the nurse implement?
- A. Assess the infant for signs of traum
- B. Measure the circumference of the infant's hea
- C. Apply a cold pack to the infant's scalp.
- D. Give the infant prophylactic antibiotics.
Correct Answer: A
Rationale: The correct action is to assess the infant for signs of trauma (Choice A) because forceps-assisted birth can increase the risk of injury to the infant. By assessing for signs of trauma promptly, the nurse can identify any potential issues and initiate necessary interventions.
Choice B is incorrect because measuring the circumference of the infant's head is not necessary immediately after forceps-assisted birth.
Choice C is incorrect as applying a cold pack to the infant's scalp is not indicated unless there is a specific medical reason for it.
Choice D is incorrect because giving prophylactic antibiotics to the infant is not a standard practice following forceps-assisted birth unless there is a specific indication for infection prevention.
The method of anesthesia in labor that is considered the safest for the fetus is
- A. epidural block.
- B. pudendal block.
- C. local infiltration.
- D. spinal (subarachnoi
Correct Answer: A
Rationale: The correct answer is A: epidural block. Epidural anesthesia in labor is considered the safest for the fetus because it does not directly affect the baby's central nervous system. It provides effective pain relief for the mother while minimizing the risk of medication passing to the fetus. It also allows for adjustment of the dose as needed during labor.
Summary of why other choices are incorrect:
B: Pudendal block is a regional anesthesia technique that primarily provides pain relief to the perineum and does not affect the fetus directly.
C: Local infiltration anesthesia is limited in its coverage and may not provide adequate pain relief during labor.
D: Spinal (subarachnoid) anesthesia may lead to a rapid and significant drop in blood pressure, affecting fetal oxygenation and require careful monitoring.