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Which of the following is a potential complication of a vaginal delivery?
- A. Shoulder dystocia
- B. Placenta previa
- C. Umbilical cord prolapse
- D. Cephalopelvic disproportion
Correct Answer: A
Rationale: The correct answer is A: Shoulder dystocia. This is a potential complication of vaginal delivery where the baby's shoulder gets stuck behind the mother's pubic bone. It can lead to serious complications for both the mother and the baby, such as brachial plexus injury or fetal hypoxia. Shoulder dystocia requires immediate intervention to prevent harm. Placenta previa (B) and umbilical cord prolapse (C) are complications related to the placenta and umbilical cord, not the delivery process itself. Cephalopelvic disproportion (D) refers to the mismatch between the size of the baby's head and the mother's pelvis, which may lead to difficulties in labor but is not a direct complication of vaginal delivery.
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What is the recommended method of screening for group B streptococcus during pregnancy?
- A. Culture of a vaginal swab
- B. Rapid antigen test of a vaginal swab
- C. PCR test of a vaginal swab
- D. All of the above
Correct Answer: A
Rationale: Culture of a vaginal swab is the recommended method for screening for group B streptococcus during pregnancy.
A nurse is providing discharge instructions about newborn safety to a client who is 2 days postpartum. Which of the following instructions should the nurse include?
- A. Lay the baby on his stomach to nap during the daytime.
- B. Change smoke detector batteries every other year.
- C. Use a car seat when traveling by airplane
- D. Place a plastic waterproof sheet over the crib bedding
Correct Answer: C
Rationale: Using a car seat during air travel ensures the newborn's safety during takeoff, landing, and turbulence.
A nurse is assessing a client who is 1 hr postpartum following a vaginal birth. The nurse notes that the client has excessive vaginal bleeding. Which of the following actions should the nurse take first?
- A. Massage the client's fundus.
- B. Administer oxytocin to the client.
- C. Empty the client’s bladder.
- D. Provide oxygen to the client via nonrebreather face mask.
Correct Answer: A
Rationale: The correct action is to massage the client's fundus first. This helps to stimulate uterine contractions and control excessive bleeding, preventing postpartum hemorrhage. Massaging the fundus promotes the expulsion of clots and helps the uterus contract, decreasing the risk of further bleeding. Administering oxytocin (choice B) can be done after fundal massage to enhance uterine contractions. Emptying the client's bladder (choice C) can also aid in reducing uterine atony but is not the priority in this situation. Providing oxygen (choice D) is not directly related to controlling postpartum bleeding.
A nurse is developing a plan of care for a newborn whose mother tested positive for heroin during pregnancy. The newborn is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse include in the plan?
- A. Administer naloxone to the newborn.
- B. Swaddle the newborn with his legs extended.
- C. Maintain eye contact with the newborn during feedings
- D. Minimize noise in the newborn's environment.
Correct Answer: D
Rationale: Minimizing noise in the newborn's environment helps reduce overstimulation, which can exacerbate symptoms of neonatal abstinence syndrome. Naloxone is not used for this condition, and swaddling with legs extended is incorrect as it should be snug to provide comfort.
A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client’s history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply.)
- A. Cholecystitis
- B. Hypertension
- C. Human papillomavirus
- D. Migraine headaches
Correct Answer: A, B, D
Rationale: The correct answer is A, B, D. Cholecystitis is a contraindication due to increased risk of gallbladder disease. Hypertension is a contraindication as estrogen in oral contraceptives can elevate blood pressure. Migraine headaches with aura are contraindicated due to increased risk of stroke. Human papillomavirus is not a contraindication. It's important to consider individual health factors for each client when prescribing oral contraceptives.