Nokea
A relaxation technique that can be used during the childbirth experience to decrease maternal pain perception is
- A. using increased environmental stimulation as a method of distraction.
- B. restricting family and friends from visiting during the labor period to keep the patient focused on breathing techniques.
- C. medicating the patient frequently to reduce pain perception.
- D. assisting the patient in breathing methods aimed at taking control of pain perception based on the contraction pattern.
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. Breathing techniques help in managing pain perception during labor.
2. By assisting the patient in breathing methods, she gains control over her pain perception.
3. Controlled breathing can help distract from the intensity of contractions.
4. By focusing on breathing patterns, the patient can stay calm and manage pain effectively.
Summary:
A, B, and C are incorrect because they do not address pain management directly through breathing techniques. Option A relies on distraction, B focuses on isolation rather than coping mechanisms, and C suggests heavy reliance on medication rather than self-control.
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During a vaginal delivery of a macrosomic baby, the nurse midwife requests nursing assistance. Which of the following actions by the nurse would be appropriate?
- A. Estimate fetal length and weight.
- B. Assess intensity of contractions.
- C. Provide suprapubic pressure.
- D. Assist woman with breathing.
Correct Answer: C
Rationale: Suprapubic pressure helps guide the baby’s shoulders during delivery, reducing the risk of shoulder dystocia.
The nurse is caring for a client who is scheduled to have an amniocentesis. Which intervention is most important for the nurse to perform after the procedure?
- A. Evaluate need for Rh0D immunoglobulin
- B. Clean site
- C. Administer pain medication
- D. Perform vital signs
Correct Answer: A
Rationale: The correct answer is A: Evaluate need for Rh0D immunoglobulin. After an amniocentesis, it is crucial to assess if the client is Rh-negative and the fetus is Rh-positive. If this is the case, Rh0D immunoglobulin should be administered to prevent Rh incompatibility issues in future pregnancies. This intervention is critical to prevent hemolytic disease in the newborn.
Cleaning the site (B) is important for infection prevention but not the most critical post-procedure intervention. Administering pain medication (C) can be done based on client's discomfort level but not the top priority. Performing vital signs (D) is important but assessing Rh status and administering Rh0D immunoglobulin take precedence.
The nurse is discussing the methods of confirming the pregnancy with a patient at the first prenatal visit. What method is used to confirm cardiac activity of the fetus?
- A. bimanual exam
- B. pelvic ultrasound
- C. serum pregnancy test
- D. urine pregnancy test
Correct Answer: B
Rationale: The correct answer is B: pelvic ultrasound. Pelvic ultrasound is used to confirm the presence of cardiac activity in the fetus by visualizing the fetal heartbeat. This method is the most accurate and reliable way to confirm the viability of the pregnancy. A bimanual exam (choice A) is a physical examination technique that assesses the size and shape of the uterus but does not confirm fetal cardiac activity. Serum pregnancy test (choice C) and urine pregnancy test (choice D) detect the presence of human chorionic gonadotropin (hCG) hormone in the blood or urine, indicating pregnancy, but do not confirm fetal cardiac activity.
The nurse in the obstetrician’s office is caring for four 25-week-gestation prenatal clients who are carrying singleton pregnancies. With which of the following clients should the nurse carefully review the signs and symptoms of preterm labor?
- A. African American, 15 years old, with newly diagnosed gestational diabetes.
- B. Asian American, 23 years old, with five-year-old twins who were born at term.
- C. Jewish, 25 years old, working as a certified public accountant.
- D. Mormon, 33 years old, who recently moved into a new apartment.
Correct Answer: A
Rationale: Young age and gestational diabetes are risk factors for preterm labor, making it important to educate this client.
In preparing a pregnant patient for a nonstress test (NST), which of the following should be included in the plan of care?
- A. Have the patient void prior to being placed on the fetal monitor because a full bladder will interfere with results.
- B. Maintain NPO status prior to testing.
- C. Position the patient for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
- D. Have an infusion pump prepared with oxytocin per protocol for evaluation.
Correct Answer: C
Rationale: The correct answer is C because positioning the patient for comfort and adjusting the tocotransducer belt to locate fetal heart rate are essential steps in preparing a pregnant patient for a nonstress test (NST). This allows for proper monitoring of fetal heart rate without interference.
A: Having the patient void prior to the test is not necessary for an NST as a full bladder does not interfere with the results.
B: Maintaining NPO status is not required for an NST, as it does not involve any invasive procedures that would necessitate fasting.
D: Preparing an infusion pump with oxytocin is not part of the standard preparation for an NST and is not needed for evaluation.