Nokea
Which of the following is the most accurate description of fetal station during labor?
- A. The distance from the cervix to the fetal head
- B. The level of the presenting part in relation to the ischial spines
- C. The degree of fetal flexion during contractions
- D. The amount of cervical dilation during labor
Correct Answer: B
Rationale: The correct answer is B: The level of the presenting part in relation to the ischial spines. Fetal station refers to the position of the baby's head in the mother's pelvis during labor. It is measured in centimeters above or below the ischial spines. This measurement helps determine the progress of labor and the descent of the baby through the birth canal. Choices A, C, and D do not accurately describe fetal station and are therefore incorrect. Choice A refers to the cervical length, choice C refers to fetal position, and choice D refers to cervical dilation, which are not related to fetal station.
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A nurse is advising a pregnant woman about the danger signs of pregnancy. The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? Select all that apply.
- A. Convulsions.
- B. Double vision.
- C. Epigastric pain.
- D. Persistent vomiting.
Correct Answer: D
Rationale: These symptoms may indicate severe complications such as preeclampsia, eclampsia, or hyperemesis gravidarum, requiring immediate medical attention. Polyuria is generally not a danger sign.
A pregnant patient is at 30 weeks gestation and is experiencing dizziness and lightheadedness when standing. What is the nurse's first priority action?
- A. Encourage the patient to drink fluids and rest for 10 minutes.
- B. Instruct the patient to lie flat on her back to restore circulation.
- C. Monitor the patient's blood pressure and check for signs of anemia.
- D. Administer oxygen and prepare for immediate delivery.
Correct Answer: A
Rationale: The correct answer is A: Encourage the patient to drink fluids and rest for 10 minutes. This is the first priority action because dizziness and lightheadedness in a pregnant patient at 30 weeks gestation could be due to orthostatic hypotension, a common issue in pregnancy. Encouraging the patient to drink fluids and rest will help increase blood volume and alleviate symptoms.
Choice B is incorrect because lying flat on her back can worsen symptoms due to supine hypotensive syndrome. Choice C is not the first priority as checking for anemia or monitoring blood pressure should come after addressing immediate symptoms. Choice D is incorrect because immediate delivery is not warranted based on the symptoms described.
The nurse explains that the birth weight of monozygotic twins is frequently below average. What is the most likely cause?
- A. Inadequate space in the uterus
- B. Inadequate blood supply
- C. Inadequate maternal health
- D. Inadequate placental nutrition
Correct Answer: D
Rationale: The single placenta may not be able to provide adequate nutrition to two fetuses.
A gravid woman who recently emigrated from mainland China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following communicable diseases should be administered to the woman during her pregnancy?
- A. Influenza.
- B. Mumps.
- C. Rubella.
- D. Varicella.
Correct Answer: A
Rationale: Influenza vaccination is safe and recommended during pregnancy to protect both the mother and fetus. Vaccines for Mumps, Rubella, and Varicella are live attenuated vaccines and are contraindicated during pregnancy.
A nurse is assessing a laboring person for signs of uterine rupture. What is the most common sign of uterine rupture?
- A. abdominal pain
- B. vaginal bleeding
- C. decreased fetal movement
- D. increased fetal heart rate
Correct Answer: C
Rationale: The correct answer is C: decreased fetal movement. Uterine rupture can lead to decreased blood flow to the fetus, resulting in reduced fetal movement. This sign is crucial as it indicates fetal distress and the need for immediate medical intervention. Abdominal pain (A) can be present but is not specific to uterine rupture. Vaginal bleeding (B) is a sign of placental abruption, not uterine rupture. Increased fetal heart rate (D) can occur due to fetal distress, but decreased fetal movement is a more direct sign of uterine rupture.