Nokea
Which of the following is a potential complication of a forceps-assisted delivery?
- A. Fetal distress
- B. Maternal hemorrhage
- C. Neonatal brachial plexus injury
- D. All of the above
Correct Answer: C
Rationale: Forceps-assisted delivery can sometimes result in neonatal brachial plexus injury due to the pressure applied during delivery.
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A nurse on an antepartum unit is caring for four clients. Which of the following clients should the nurse identify as the priority?
- A. A client who has gestational diabetes and a fasting blood glucose level of 120 mg/dL (less than 95 mg/dL).
- B. A client who is at 34 weeks of gestation and reports epigastric pain.
- C. A client who is at 28 weeks of gestation and has an Hgb of 10.4 g/dL (11 to 16 g/dL).
- D. A client who is at 39 weeks of gestation and reports urinary frequency and dysuria.
Correct Answer: B
Rationale: Epigastric pain in a pregnant client can be a sign of preeclampsia or HELLP syndrome, both of which are serious conditions that require immediate medical attention.
Which of the following is a potential complication of neonatal hypothermia?
- A. Hypoglycemia
- B. Respiratory distress syndrome
- C. Jaundice
- D. All of the above
Correct Answer: D
Rationale: All of the above are potential complications of neonatal hypothermia. Hypothermia can lead to hypoglycemia, respiratory distress, and jaundice due to the infant's inability to regulate body temperature.
What is the function of the umbilical cord during pregnancy?
- A. To transport oxygen and nutrients from the mother to the fetus
- B. To remove waste products from the fetus
- C. To regulate fetal temperature
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A. The umbilical cord functions to transport oxygen and nutrients from the mother to the fetus. This is crucial for the fetus's growth and development. B is incorrect because waste products are removed through the placenta, not the umbilical cord. C is incorrect as the umbilical cord does not regulate fetal temperature. Choice D is incorrect as it includes all options, but only A is accurate.
A nurse is caring for a client who is at 33 weeks of gestation following an amniocentesis. The nurse should monitor the client for which of the following complications?
- A. Vomiting
- B. Hypertension
- C. Epigastric pain
- D. Contractions
Correct Answer: D
Rationale: Contractions can indicate preterm labor, a potential complication following amniocentesis. Vomiting, hypertension, and epigastric pain are less directly related to the procedure.
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
- A. Perform a vaginal examination by applying upward pressure on the presenting part.
- B. Cover the umbilical cord with a sterile saline-saturated towel.
- C. Administer oxygen via nonrebreather mask at 8 L/min.
- D. Initiate an infusion of IV fluids for the client.
Correct Answer: B
Rationale: The correct answer is B: Cover the umbilical cord with a sterile saline-saturated towel. This action is crucial in preventing compression and desiccation of the umbilical cord, which could lead to decreased blood flow and oxygen delivery to the fetus. By covering the cord, the nurse can protect it from further damage while waiting for emergency intervention. Performing a vaginal examination (choice A) could worsen the situation by causing more pressure on the cord. Administering oxygen (choice C) may be important later but is not the immediate priority. Initiating IV fluids (choice D) is not the most urgent action in this scenario.