Nokea
Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
- A. External fetal monitoring (EFM)
- B. Internal fetal monitoring
- C. Intrauterine pressure catheter (IUP
- D. Maternal comments based on perception
Correct Answer: C
Rationale: The correct answer is C: Intrauterine pressure catheter (IUP). This device directly measures the pressure within the uterus, providing precise data on uterine contraction strength. It is considered the gold standard for assessing uterine activity.
A: External fetal monitoring (EFM) measures fetal heart rate and uterine contractions but doesn't provide direct information on contraction strength.
B: Internal fetal monitoring measures fetal heart rate and uterine contractions internally but focuses on fetal well-being, not contraction strength.
D: Maternal comments based on perception are subjective and not reliable for accurately assessing uterine contraction strength.
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The nurse is assessing the client for the presence of ballottement. Which should the nurse perform to test for the presence of ballottement?
- A. Palpate the uterus for contractions
- B. Assess the skin for increased pigmentation
- C. Initiate a gentle upward tap on the cervix
- D. Palpate the abdomen for fetal outline
Correct Answer: C
Rationale: The correct answer is C. To test for the presence of ballottement, the nurse should initiate a gentle upward tap on the cervix. Ballottement is a technique used in obstetrics to assess for the presence of a floating object in the uterus, such as a fetus. By tapping the cervix gently, the nurse can feel for a rebound effect, indicating the presence of a floating object. This technique helps to confirm the presence of a fetus in the uterus.
Explanation of why other choices are incorrect:
A: Palpating the uterus for contractions is not relevant to testing for ballottement.
B: Assessing the skin for increased pigmentation is not related to assessing for the presence of a floating object in the uterus.
D: Palpating the abdomen for fetal outline does not specifically test for ballottement, which involves tapping the cervix.
What is one potential fetal complication of using the vacuum extractor?
- A. cephalohematoma
- B. face presentation
- C. fetal growth restriction
- D. scalp fracture
Correct Answer: A
Rationale: The correct answer is A: cephalohematoma. When using a vacuum extractor during childbirth, the device applies suction to the baby's head to assist with delivery. This suction can cause a collection of blood between the baby's skull and periosteum, resulting in a cephalohematoma. This complication is due to the pressure exerted on the baby's head during the extraction process. Cephalohematoma is a common side effect of vacuum extraction and typically resolves on its own. Face presentation and fetal growth restriction are not directly related to the use of a vacuum extractor. Scalp fracture is a rare but serious complication that can occur if excessive force is applied during vacuum extraction, leading to bone injury, which is different from the collection of blood in a cephalohematoma.
The nurse is instructing a nursing student on the application of fetal monitoring devices. Which method of assessing the fetal heart rate requires the use of a gel?
- A. Doppler
- B. Fetoscope
- C. Scalp electrode
- D. Tocodynamometer
Correct Answer: A
Rationale: The correct answer is A: Doppler. Doppler requires the use of a gel to enhance the transmission of sound waves for accurate assessment of the fetal heart rate. Gel helps to eliminate air between the Doppler probe and the skin, improving signal quality. Fetoscope (B) is a direct listening device; Scalp electrode (C) and Tocodynamometer (D) do not require gel for fetal heart rate assessment.
A nurse is taking a birth history assessment on a client who is 8 weeks gestation and has one child who was born at 38 weeks. Which is consistent with this birth history?
- A. Primipara
- B. Primigravida
- C. Nulligravida
- D. Multipara
Correct Answer: D
Rationale: The correct answer is D: Multipara. This term refers to a woman who has given birth to two or more children. In this case, the client has one child already, making her a multipara.
A: Primipara refers to a woman who has given birth to one child, which does not match the client's birth history.
B: Primigravida refers to a woman who is pregnant for the first time, which also does not match the client's history.
C: Nulligravida refers to a woman who has never been pregnant, which is not the case for the client.
Therefore, the correct term to describe the client's birth history is Multipara, as she has one child and is currently 8 weeks gestation.
The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.
- A. Fetuses in breech position unable to deliver vaginally
- B. Increased number of elective or maternal request cesareans
- C. Incidences of women of older maternal age getting pregnant
- D. Decreasing rate of malpractice litigation with cesarean birth
Correct Answer: B
Rationale: The correct answer is B: Increased number of elective or maternal request cesareans. This is correct because the rise in elective cesarean births, often due to patient preference or convenience, can contribute to the overall high rates of cesarean births.
A: Fetuses in breech position unable to deliver vaginally - This is a valid reason for cesarean births, but it does not address the question about high rates of cesarean births.
C: Incidences of women of older maternal age getting pregnant - While advanced maternal age can be a factor in cesarean births, it is not directly related to the high rates of cesarean births at the facility.
D: Decreasing rate of malpractice litigation with cesarean birth - This is an irrelevant factor in determining the reasons for high rates of cesarean births at the facility.