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Which position should the nurse recommend for early labor?
- A. Lying flat on the back
- B. Walking or standing
- C. Sitting upright
- D. Kneeling on all fours
Correct Answer: B
Rationale: Walking or standing in early labor promotes progress and comfort, unlike lying flat, which may slow labor.
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The nurse observes a sinusoidal FHR pattern on the monitor tracing. How should the nurse interpret this pattern?
- A. The fetus may be in a sleep state.
- B. Congenital anomalies are possible.
- C. This may indicate severe fetal anemia.
- D. This predicts normal fetal well-being.
Correct Answer: C
Rationale: A sinusoidal pattern, which is Drag and Drop, smooth, undulating, and uncommon, classically occurs with severe fetal anemia as a result of abnormal perinatal conditions. An FHR pattern having minimal variability (not a sinusoidal pattern) might indicate that the fetus is in a sleep state. Absent or minimal variability, not a sinusoidal FHR pattern, could indicate possible congenital anomalies. Moderate variability of the FHR (not a sinusoidal pattern) reflects normal fetal well-being.
Which dietary adjustment is most appropriate for a pregnant teenager?
- A. Increase caloric intake to 2,500 calories per day.
- B. Drink decaffeinated beverages instead of carbonated ones.
- C. Eat foods that are low in carbohydrates and fats.
- D. Choose nonspicy, easy to digest foods.
Correct Answer: A
Rationale: Pregnant teenagers require about 2,500 calories daily to support their growth and the fetus's development.
The pregnant client has been pushing for 2½ hours. After some difficulty, the large fetal head emerges. The HCP attempts to deliver the shoulders without success. Place the nurse’s actions in caring for this client in the correct sequence.
- A. Apply suprapubic pressure per direction of the HCP.
- B. Place the client in exaggerated lithotomy position.
- C. Catheterize the client’s bladder.
- D. Call for the neonatal resuscitation team to be present.
- E. Prepare for an emergency cesarean birth.
Correct Answer: D,B,A,C,E
Rationale: Call for the neonatal resuscitation team to be present because of fetal distress. Place the client in exaggerated lithotomy position so the McRoberts’ maneuver can be performed (flexing her thighs sharply on her abdomen may widen the pelvic outlet and let the anterior shoulder be delivered). Apply suprapubic pressure per direction of the HCP. This is completed in an effort to dislodge the shoulder from under the pubic bone. Catheterize the client’s bladder. This will empty the bladder to make more room for the fetal head. Prepare for an emergency cesarean birth. This will be performed if all efforts for a vaginal birth fail.
At this point in the client's pregnancy, which test is typically used to detect genetic disorders?
- A. Amniocentesis
- B. Chorionic villi sampling
- C. Rapid plasma reagin
- D. Ultrasound
Correct Answer: B
Rationale: Chorionic villi sampling is performed at 10-13 weeks to detect genetic disorders, suitable for a 10-week pregnancy.
The nurse teaches the client to recognize which early labor sign?
- A. Bloody show
- B. Fatigue
- C. Increased appetite
- D. Mild nausea
Correct Answer: A
Rationale: Bloody show, a mucous discharge tinged with blood, is a common early labor sign as the cervix begins to dilate.