Nokea
Which type of anesthesia, used with a client in labor, produces a loss of sensation only to the vagina and perineum?
- A. Epidural block
- B. Saddle block
- C. Paracervical block.
- D. Pudendal block
Correct Answer: D
Rationale: A pudendal block targets the pudendal nerve, numbing only the vagina and perineum, making it ideal for the second stage of labor.
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A client is admitted to the postpartum unit and tells the nurse she had rheumatic fever as a child, which resulted in some 'heart damage.' The nurse knows that this client is at particular risk for developing heart failure during the immediate postpartum period. Based on this client's history, which nursing problem has the highest priority?
- A. Sleep deprivation.
- B. Fluid volume excess
- C. Nausea and vomiting
- D. Risk for infection.
Correct Answer: B
Rationale: Heart damage from rheumatic fever increases the risk of heart failure, particularly postpartum due to fluid shifts. Managing fluid volume excess is the priority.
After breast-feeding 10 minutes at each breast, a new mother calls the nurse to the postpartum room to help change the newborn's diaper. As the mother begins the diaper change, the newborn spits up the breast milk. What action should the nurse implement first?
- A. Place the newborn in a position with the head lower than the feet.
- B. Turn the newborn to the side and bulb suction the mouth and nares.
- C. Wipe away the spit-up and assist the mother with the diaper change
- D. Sit the newborn upright and burp by rubbing or patting the upper back
Correct Answer: D
Rationale: Sitting the newborn upright and burping helps release trapped air, which is a common cause of spitting up after feeding.
A primipara at 20-weeks gestation is scheduled for an ultrasound. In preparing the client for the procedure, the nurse should explain that the primary reason for conducting this diagnostic study is to obtain which information?
- A. Chromosomal abnormalities
- B. Sex and size of the infant
- C. Lecithin-sphingomyelin ratio
- D. Fetal growth and gestational age.
Correct Answer: D
Rationale: A routine ultrasound at 20 weeks primarily assesses fetal growth and gestational age to ensure proper development.
The nurse is caring for a postpartum client who is complaining of severe pain and a feeling of pressure in her perineum. Her fundus is firm and she has a moderate lochial flow. On inspection, the nurse finds that a perineal hematoma is beginning to form. Which assessment finding should the nurse obtain first?
- A. Hemoglobin and hematocrit
- B. Abdominal contour and bowel sounds
- C. Heart rate and blood pressure
- D. Urinary output and IV fluid intake
Correct Answer: C
Rationale: A perineal hematoma can cause significant pain and pressure, potentially leading to hemodynamic instability. Assessing heart rate and blood pressure first is crucial to detect signs of shock or circulatory compromise.
The healthcare provider prescribes magnesium sulfate 6 grams intravenously (IV) to be infused over 20 minutes for client with preterm labor. The IV bag contains magnesium sulfate 20 grams in dextrose 5% in water 500 mL. How many mL/hour should the nurse set the infusion pump? (Enter numerical value only.)
Correct Answer: 450
Rationale: To deliver 6 grams over 20 minutes from a solution of 20 grams in 500 mL, the concentration is 25 mL/g. Thus, 6 grams requires 150 mL over 20 min, which is (150 mL / 20 min) x 60 = 450 mL/hour.