Nokea
With what has maternal hypertension been associated?
- A. anorexia
- B. low birth weight
- C. macrosomia
- D. symphysis pubis dysfunction
Correct Answer: B
Rationale: Maternal hypertension can lead to decreased blood flow to the placenta, resulting in restricted growth and low birth weight in the baby. This association is well-documented in research and clinical practice. Low birth weight is a common consequence of maternal hypertension due to inadequate nutrient and oxygen supply to the fetus. Therefore, choice B is the correct answer. Choices A, C, and D are not directly associated with maternal hypertension. Anorexia is a psychological disorder related to eating habits, macrosomia refers to excessive birth weight, and symphysis pubis dysfunction is a musculoskeletal issue during pregnancy.
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Which method of intrapartum fetal monitoring is the most appropriate when a woman has a history of hypertension during pregnancy?
- A. Continuous auscultation with a fetoscope
- B. Continuous electronic fetal monitoring
- C. Intermittent assessment with a Doppler transducer
- D. Intermittent electronic fetal monitoring for 15 minutes each hour
Correct Answer: B
Rationale: The correct answer is B: Continuous electronic fetal monitoring. This method is most appropriate for a woman with a history of hypertension during pregnancy because it allows continuous monitoring of fetal heart rate patterns and uterine contractions, providing real-time data to detect any signs of fetal distress promptly. Continuous monitoring is crucial in high-risk pregnancies to ensure timely intervention if any issues arise.
A: Continuous auscultation with a fetoscope is not ideal for a woman with a history of hypertension as it does not provide continuous monitoring and may miss subtle changes in fetal well-being.
C: Intermittent assessment with a Doppler transducer does not offer continuous monitoring, which is essential in high-risk pregnancies like hypertension.
D: Intermittent electronic fetal monitoring for 15 minutes each hour is not as effective as continuous monitoring in detecting changes in fetal well-being promptly, which is crucial in cases of hypertension during pregnancy.
What is a possible complication of uterine tachysystole?
- A. Category I fetal heart rate tracing
- B. placenta previa
- C. fetal hypoxia
- D. prolapsed cord
Correct Answer: C
Rationale: Uterine tachysystole is excessive uterine contractions, reducing placental perfusion and causing fetal hypoxia. This can lead to potential complications such as fetal distress and hypoxia. Category I fetal heart rate tracing is typically associated with normal fetal heart rate. Placenta previa is unrelated to uterine tachysystole. Prolapsed cord is a potential complication of uterine hyperstimulation, not tachysystole.
A nurse is reviewing the record of a woman who has just been told that she is pregnant. The physician has documented the presence of Goodell’s sign. The nurse determines this sign refers to which of the following?
- A. A softening of the tip of the cervix
- B. A soft blowing sound that corresponds to the maternal pulse
- C. Enlargement of the uterus
- D. A softening of the lower uterine segment
Correct Answer: A
Rationale: The correct answer is A: A softening of the tip of the cervix. Goodell's sign is a softening of the tip of the cervix, which is one of the early signs of pregnancy due to increased vascularity and edema. This sign is often used by healthcare providers to confirm pregnancy.
Rationale:
1. Goodell's sign specifically refers to the softening of the cervix, not any other part of the reproductive system.
2. It is an important early sign of pregnancy due to hormonal changes.
3. Enlargement of the uterus (Choice C) typically occurs later in pregnancy, not as an early sign.
4. A blowing sound corresponding to maternal pulse (Choice B) and softening of the lower uterine segment (Choice D) are not associated with Goodell's sign.
The nurse evaluates a pattern on the fetal monitor that appears similar to early decelerations. The deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?
- A. This pattern reflects variable decelerations. No interventions are necessary at this time
- B. Document this Category I fetal heart rate pattern and decrease the rate of the
- C. Continue to monitor these early decelerations, which occur as the fetal head is
compressed during a contraction - D. This deceleration pattern is associated with uteroplacental insufficiency. The nurse
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. The deceleration pattern described, beginning near the acme of the contraction and extending beyond, is associated with uteroplacental insufficiency.
2. Uteroplacental insufficiency indicates a potential problem with oxygen and nutrient delivery to the fetus.
3. This situation requires immediate intervention to improve oxygenation to the fetus.
4. Monitoring alone is not sufficient; action is needed to address the underlying issue.
5. Therefore, the correct nursing action in this situation is to recognize the potential uteroplacental insufficiency and take appropriate measures to address it.
Summary of why other choices are incorrect:
A: This pattern reflects variable decelerations - Incorrect because the described pattern is not characteristic of variable decelerations.
B: Document this Category I fetal heart rate pattern and decrease the rate of the - Incorrect because immediate action is needed in the presence of potential uteroplacental insufficiency.
Why is multiple gestation is a risk factor for cesarean delivery?
- A. cord prolapse
- B. increased pain in labor
- C. inability to push
- D. twins in cephalic-cephalic presentation
Correct Answer: A
Rationale: The correct answer is A: cord prolapse. In multiple gestation, there is a higher chance of cord prolapse due to the presence of more than one fetus in the uterus. This can lead to fetal distress and necessitate an emergency cesarean delivery to prevent complications. The other choices are incorrect because increased pain in labor, inability to push, and twins in cephalic-cephalic presentation are not direct risk factors for cesarean delivery in the context of multiple gestation.