Nokea
Which technique would the nurse employ for an obstetrical client with a foreign body airway obstruction?
- A. Back blows
- B. Chest thrusts
- C. Suprapubic thrusts
- D. Abdominal thrusts
Correct Answer: B
Rationale: The correct technique for an obstetrical client with a foreign body airway obstruction is chest thrusts. This is because back blows, suprapubic thrusts, and abdominal thrusts can potentially harm the fetus. Chest thrusts are safer as they target the area above the uterus, avoiding direct pressure on the abdomen. The forceful thrusts to the chest can help dislodge the foreign body without putting the fetus at risk. It is important to prioritize the safety of both the mother and the unborn child in this situation.
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Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
- A. direct Coombs test of twin A.
- B. direct Coombs test of twin B.
- C. indirect Coombs test of the mother.
- D. transcutaneous bilirubin level for both twins.
Correct Answer: C
Rationale: The correct answer is C, indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A. If the test is positive, it indicates sensitization has occurred, making RhoGAM necessary to prevent hemolytic disease in future pregnancies. Direct Coombs tests of the twins (choices A and B) are not relevant in this scenario as they assess for antibodies already attached to the red blood cells. Transcutaneous bilirubin levels (choice D) are used to monitor jaundice, not Rh incompatibility.
Which maternal condition always necessitates delivery by cesarean birth?
- A. Partial abruptio placentae
- B. Total placenta previa
- C. Ectopic pregnancy
- D. Eclampsia
Correct Answer: B
Rationale: The correct answer is B: Total placenta previa. In total placenta previa, the placenta completely covers the opening of the cervix, posing a risk of severe bleeding during vaginal delivery. Cesarean birth is necessary to prevent maternal hemorrhage and ensure a safe delivery.
Partial abruptio placentae (A) may require cesarean birth if there is significant bleeding or fetal distress, but it's not an absolute indication for cesarean section. Ectopic pregnancy (C) and eclampsia (D) do not always necessitate cesarean birth unless there are other obstetric indications.
Which condition is most commonly associated with late decelerations of the fetal heart rate?
- A. Head compression
- B. Maternal hypothyroidism
- C. Uteroplacental insufficiency
- D. Umbilical cord compression
Correct Answer: C
Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.
A patient at 25 weeks' gestation has just been diagnosed with gestational diabetes. What is the most important education for the nurse to provide the patient at this time?
- A. induction of labor
- B. nutrition
- C. potential fetal complications
- D. potential maternal complications
Correct Answer: B
Rationale: The correct answer is B: nutrition. At 25 weeks' gestation with gestational diabetes, nutrition education is crucial to manage blood sugar levels and prevent complications. Proper diet control can help regulate blood glucose levels, ensuring optimal fetal growth and reducing the risk of macrosomia. Educating the patient on a balanced diet, monitoring carbohydrate intake, and understanding the glycemic index are essential. Induction of labor (choice A) is not indicated at this stage and may lead to potential complications. While discussing potential fetal (choice C) and maternal (choice D) complications is important, addressing nutrition takes precedence as it directly impacts the health of both the mother and the fetus.
The nurse is caring for a patient admitted with vaginal bleeding and cramping who delivered a stillborn infant at 22 weeks' gestation. What data in the patient's health history are associated with this complication of pregnancy?
- A. motor vehicle accident 1 year ago
- B. hypertension times 4 years
- C. appendectomy 2 years ago
- D. nausea every day for the past 16 weeks
Correct Answer: B
Rationale: The correct answer is B: hypertension times 4 years. Hypertension is a risk factor for complications during pregnancy, such as preterm birth and stillbirth. The patient's history of chronic hypertension increases the likelihood of developing conditions like preeclampsia, which can lead to fetal complications like stillbirth. The other choices (A, C, and D) are not directly associated with the complication of pregnancy described in the scenario. A motor vehicle accident, appendectomy, and nausea do not have a direct causal relationship with the patient's current condition of vaginal bleeding and cramping after delivering a stillborn infant at 22 weeks' gestation.