Nokea
Which of the following is a risk factor for developing a cesarean section?
- A. Fetal malpresentation
- B. Spontaneous labor
- C. Low maternal age
- D. No previous pregnancies
Correct Answer: A
Rationale: The correct answer is A: Fetal malpresentation. This is a risk factor for cesarean section because the baby's position can impact the ability to deliver vaginally. If the baby is in a breech or transverse position, a cesarean section may be necessary to ensure a safe delivery.
Choice B, spontaneous labor, is not a risk factor for cesarean section as it is a natural part of childbirth. Choice C, low maternal age, is also not a risk factor as age alone does not determine the need for a cesarean section. Choice D, no previous pregnancies, is not a risk factor as it does not directly impact the likelihood of needing a cesarean section.
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The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy.
- A. During the third trimester I may experience frequent urination.
- B. During the third trimester I may experience heartburn.
- C. During the third trimester I may experience nagging backaches.
- D. During the third trimester I may experience persistent headache.
Correct Answer: A
Rationale: Frequent urination, heartburn, and backaches are common during the third trimester due to the growing uterus putting pressure on the bladder and digestive system, as well as changes in posture. Persistent headaches are not normal and should be reported.
A pregnant patient at 26 weeks gestation reports pain in the lower abdomen and back. What should the nurse do first?
- A. Encourage the patient to rest and monitor for changes in symptoms.
- B. Perform a pelvic exam to assess for possible cervical dilation.
- C. Administer pain medication to relieve the discomfort.
- D. Assess the patient's blood pressure and check for signs of preeclampsia.
Correct Answer: A
Rationale: The correct answer is A: Encourage the patient to rest and monitor for changes in symptoms. At 26 weeks gestation, lower abdominal and back pain could indicate preterm labor. The first step is to have the patient rest to reduce uterine activity. Monitoring for changes in symptoms is crucial to assess if the pain is worsening and if there are any signs of preterm labor. Performing a pelvic exam (B) could potentially stimulate contractions and should be avoided unless absolutely necessary. Administering pain medication (C) does not address the underlying cause and could mask symptoms. Assessing blood pressure for signs of preeclampsia (D) is important but not the first priority in this scenario.
The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?
- A. Repeat the test in 1 week so that results can be trended based on this baseline result.
- B. Contact the health care provider to discuss birth options for the patient.
- C. Send the patient out for a meal and repeat the test to confirm that the results are valid.
- D. Ask the patient to perform a fetal kick count assessment for the next 30 minutes and then reassess the patient.
Correct Answer: B
Rationale: A positive CST is an abnormal finding that may indicate fetal compromise, requiring immediate discussion of birth options.
The nurse is assessing a 38-week pregnant woman who is experiencing severe abdominal pain and has not felt her baby move for several hours. What is the most appropriate action for the nurse to take?
- A. Encourage the patient to drink water and rest.
- B. Notify the healthcare provider immediately.
- C. Ask the patient to lie on her left side and monitor fetal movements.
- D. Reassure the patient that this is common at the end of pregnancy.
Correct Answer: B
Rationale: The correct answer is B: Notify the healthcare provider immediately. This is the most appropriate action because the pregnant woman is experiencing severe abdominal pain and has not felt her baby move for several hours, which could indicate a potential emergency situation such as placental abruption or fetal distress. Prompt notification of the healthcare provider is crucial for timely evaluation and management to ensure the well-being of both the mother and the baby.
Choice A is incorrect because simply encouraging the patient to drink water and rest may delay necessary medical intervention. Choice C is incorrect as monitoring fetal movements without immediate healthcare provider notification may lead to a critical delay in assessment and treatment. Choice D is incorrect as reassuring the patient without further evaluation could overlook a serious issue.
A nurse is providing discharge instructions to a postpartum person who had a cesarean birth. What is the most important instruction to include?
- A. avoid heavy lifting
- B. encourage deep breathing exercises
- C. encourage early ambulation
- D. avoid sexual activity
Correct Answer: B
Rationale: The correct answer is B: encourage deep breathing exercises. Deep breathing helps prevent complications like pneumonia after surgery, aids in lung expansion, and promotes overall respiratory health. Choice A is important but not the most crucial post-cesarean. Choice C promotes mobility but doesn't address immediate respiratory needs. Choice D is important but not the most vital in the early postpartum period.