A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client's umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?
- A. Cephalic
- B. Transverse
- C. Posterior
- D. Frank breech
Correct Answer: A
Rationale: When the nurse locates the fetal heart tones above the client's umbilicus at midline, it indicates that the fetus is in a cephalic position. In this position, the baby's head is facing downward towards the birth canal, which is the optimal position for a vaginal delivery. This positioning is considered normal and favorable for childbirth.
You may also like to solve these questions
Which newborn is at higher risk for developing hypoglycemia? SATA
- A. SGA
- B. Post term newborn
- C. LGA
- D. 38 week gestation (term newborn)
Correct Answer: A
Rationale: - Small for gestational age (SGA) newborns are at higher risk for developing hypoglycemia due to limited glycogen stores and decreased adipose tissue for energy reserve.
Teratogens are substances or agents that can cause congenital abnormalities or birth defects in a developing embryo or fetus during pregnancy. What is a true statement about teratogens?
- A. Vitamins can help prevent abnormalities due to teratogens.
- B. Their impact on the fetus depends on factors such as timing and duration of exposure during pregnancy.
- C. They include only medications that a pregnant person may take.
- D. They can be avoided by immunizations.
Correct Answer: B
Rationale:
What education should a nurse provide for safe sleeping practices for a newborn?
- A. Place the newborn in the prone position
- B. Use a firm mattress and avoid loose bedding
- C. Use a soft mattress and co-sleep with the baby
- D. Encourage side-lying sleeping position
Correct Answer: B
Rationale: Using a firm mattress and avoiding loose bedding reduces the risk of SIDS.
Which of the following is true about the three layers juries, and parents are concerned about the long-term of involuntary smooth muscles of the uterus?
- A. Designed to provide expansion of the growing fetus.
- B. Meant to inhibit the contraction of the uterus
- C. These injuries require immediate surgery. prior to the onset of labor.
- D. Your child will have permanent paralysis.
Correct Answer: A
Rationale: The correct statement about the three layers juries, and parents are concerned about the long-term of involuntary smooth muscles of the uterus is that they are designed to provide expansion of the growing fetus. The three layers of the uterus, consisting of the perimetrium, myometrium, and endometrium, play essential roles during pregnancy. The myometrium, which is the middle layer of the uterus, contains involuntary smooth muscle fibers that contract during labor to help expel the fetus. These muscles are designed to expand and contract to accommodate the growing fetus during pregnancy and aid in the birthing process.
A nurse is caring for a client who is gravida 3, para 2, and is in active labor. The fetal head is at 3+ station after a vaginal examination. Which of the following actions should the nurse take
- A. Apply fundal pressure.
- B. Observe for the presence of a nuchal cord.
- C. Observe for crowning.
- D. Prepare to administer oxytocin.
Correct Answer: C
Rationale: Observing for crowning is the appropriate action for the nurse to take when the fetal head is at 3+ station after a vaginal examination. Crowning refers to the appearance of the baby's head at the vaginal opening during delivery. This indicates that the baby is descending and will be born soon. It is important for the nurse to be prepared for the actual birth once crowning is observed, as it signifies that the second stage of labor is progressing and delivery is imminent. Applying fundal pressure, observing for a nuchal cord, or preparing to administer oxytocin are not appropriate actions at this stage of labor when crowning has been observed.