Question

A nurse is reviewing the medical record of a client who desires to conceive. Which of the following findings increases the client's risk for a vitamin D deficiency?

Answer 1

Correct Answers:

The client has a high level of melanin in the skin.

Rationale :

✳️ A high level of melanin increases the risk for vitamin D deficiency because melanin reduces the skin's ability to produce vitamin D following exposure to ultraviolet B radiation.

✳️Individuals with darker skin pigmentation generally require greater sunlight exposure to synthesize an equivalent amount of vitamin D compared with individuals who have less melanin.

✳️Vitamin D is important before and during pregnancy because it contributes to calcium absorption, bone mineralization, and fetal skeletal development.

✳️Inadequate vitamin D stores before conception can therefore increase the likelihood of deficiency during pregnancy.

✳️The client's high level of skin melanin is the finding most directly associated with reduced cutaneous vitamin D synthesis.

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Answer 2

Correct Answers:

Apply pressure to the client's suprapubic area.

Rationale :

🖊️ Retraction of the fetal head against the perineum after emergence is the classic turtle sign, which indicates shoulder dystocia.

🖊️ Shoulder dystocia occurs when the fetal anterior shoulder becomes impacted behind the maternal pubic symphysis after delivery of the head.

🖊️ Suprapubic pressure helps dislodge the impacted anterior shoulder by pushing it into a more favorable position for delivery.

🖊️ This intervention is commonly performed together with maneuvers such as the McRoberts maneuver while avoiding fundal pressure.

🖊️ Rapid intervention is essential because prolonged shoulder dystocia can result in fetal hypoxia, brachial plexus injury, and maternal trauma.

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Answer 3

Correct Answers:

9

Rationale :

👉 Formula

👉 mL/hr = Ordered dose ÷ Concentration × 60 min/hr

👉 Available concentration:

👉10 units = 10,000 milliunits

👉 10,000 milliunits ÷ 1,000 mL = 10 milliunits/mL

👉1.5 milliunits/min ÷ 10 milliunits/mL × 60 min/hr

📌 9 mL/hr

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Answer 4

Correct Answers:

Assess abdominal rigidity.

Rationale :

✍️ Abruptio placentae is premature separation of the placenta from the uterine wall and can cause significant maternal and fetal compromise.

✍️ A characteristic finding is a firm, rigid, boardlike abdomen resulting from uterine irritability and concealed bleeding behind the placenta.

✍️ The nurse should assess abdominal tone and rigidity because increasing firmness may indicate worsening placental separation and hemorrhage.

✍️ Other expected manifestations can include painful vaginal bleeding, uterine tenderness, frequent contractions, and fetal distress.

✍️ Prompt recognition is essential because severe abruption can lead to maternal shock, disseminated intravascular coagulation, and fetal hypoxia or death.

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Answer 5

Correct Answers:

A uterine resting tone of 45 mm Hg during the infusion

Rationale :

♦️ During an amnioinfusion, fluid is infused into the uterine cavity to increase amniotic fluid volume, commonly to relieve recurrent variable decelerations caused by cord compression.

♦️ A uterine resting tone of 45 mm Hg is abnormally elevated and may indicate excessive intrauterine pressure or uterine overdistention.

♦️ Normal resting tone measured with an intrauterine pressure catheter is generally much lower between contractions.

♦️ Excessive uterine pressure during amnioinfusion increases the risk for complications such as uterine hypertonicity, impaired placental perfusion, and uterine rupture.

♦️ The nurse should stop or reduce the infusion according to protocol and immediately evaluate the client and fetus when an abnormally elevated resting tone occurs.

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Answer 6

Correct Answers:

Station of the presenting part
Cervical dilation
Cervical effacement

Rationale :

Station of the presenting part

🔅 Fetal station is one of the five components used to calculate the Bishop score before labor induction.

🔅 Station describes the relationship of the presenting fetal part to the maternal ischial spines.

🔅 A presenting part at the ischial spines is documented as 0 station, while negative and positive numbers indicate positions above or below the spines.

🔅 A lower fetal station generally indicates greater descent and may contribute to a more favorable Bishop score.

🔅 Assessing station helps determine how ready the maternal cervix and pelvis are for a successful labor induction.

Cervical dilation

🔅 Cervical dilation is another major component of the Bishop scoring system.

🔅 Dilation measures how widely the cervix has opened and is recorded in centimeters from 0 to 10 cm.

🔅 Greater dilation before induction indicates a more favorable cervix and a higher likelihood of successful induction.

🔅 Cervical dilation is evaluated together with effacement, consistency, position, and fetal station.

🔅 A higher total Bishop score indicates that the cervix is more ripe and responsive to induction methods.

Cervical effacement

🔅 Cervical effacement is included in the Bishop score because it reflects thinning and shortening of the cervix before and during labor.

🔅 Effacement is commonly documented as a percentage from 0% to 100%.

🔅 Greater effacement indicates more advanced cervical ripening and contributes to a higher Bishop score.

🔅 Cervical thinning facilitates fetal descent and eventual cervical dilation during labor.

🔅 Assessing effacement helps predict the probability that labor induction will be successful.

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Answer 7

Correct Answers:

Insert the diaphragm up to 6 hr before intercourse.

Rationale :

🖍️ A diaphragm is a barrier contraceptive device that covers the cervix and should be used with spermicide to improve effectiveness.

🖍️ The diaphragm may generally be inserted up to 6 hours before intercourse, which allows the client some flexibility in timing.

🖍️ Additional spermicide should be inserted for repeated intercourse according to product instructions without removing the diaphragm.

🖍️ The diaphragm should remain in place for at least 6 hours after the last episode of intercourse to allow the spermicide to remain effective.

🖍️ Correct insertion, use of spermicide, and appropriate timing are essential to maximize contraceptive effectiveness.

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Answer 8

Correct Answers:

"This medication might cause an increase in your blood glucose level."

Rationale :

✏️ Betamethasone is a corticosteroid administered to clients at risk for preterm birth to accelerate fetal lung maturation.

✏️ Corticosteroids can increase maternal blood glucose levels by promoting hepatic glucose production and decreasing peripheral glucose utilization.

✏️ This effect is especially important for a client with gestational diabetes mellitus, because significant hyperglycemia may occur after treatment.

✏️ The nurse should anticipate closer blood glucose monitoring and possible temporary adjustments to diabetes therapy after betamethasone administration.

✏️ Teaching the client about the possibility of elevated glucose promotes safe management while still providing the fetus the important pulmonary benefits of antenatal corticosteroids.

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Answer 9

Correct Answers:

"I will call if the temperature under my baby's arm is less than 36.5° C (97.7° F)."

Rationale :

🔆 An axillary temperature below 36.5°C (97.7°F) indicates that a newborn may be experiencing hypothermia or inadequate thermoregulation.

🔆 Newborns lose heat rapidly because they have a large surface-area-to-body-mass ratio, limited subcutaneous fat, and immature temperature-regulating mechanisms.

🔆 Hypothermia increases oxygen and glucose consumption and can lead to respiratory distress, hypoglycemia, metabolic acidosis, and other complications.

🔆 A persistently low temperature can also be an early manifestation of infection or neonatal illness, even when fever is absent.

🔆 The parent should therefore contact the pediatric provider when the newborn's temperature falls below the recommended normal range.

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Answer 10

Correct Answers:

Fentanyl

Rationale :

✓ Fentanyl is an opioid analgesic that can be administered during active labor to provide relief from moderate to severe contraction pain.

✓ It has a relatively rapid onset and short duration of action, making it useful for carefully controlled intrapartum analgesia.

✓ The nurse should monitor maternal respiratory rate, sedation level, blood pressure, and fetal heart rate because opioids can cause respiratory and central nervous system depression.

✓ Administration should be timed appropriately because giving systemic opioids too close to birth can increase the risk of neonatal respiratory depression.

✓ Fentanyl is therefore the most appropriate medication among the choices for a laboring client requesting pharmacologic relief of intense contraction pain.

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QLexNursing

1 :
A nurse is reviewing the medical record of a client who desires to conceive. Which of the following findings increases the client's risk for a vitamin D deficiency?

2 :
A nurse is caring for a client who is in the second stage of labor. The nurse observes the fetal head retract against the client's perineum immediately following emergence. Which of the following actions should the nurse take?

4 :
A nurse is caring for a client who is at 35 weeks of gestation and has abruptio placenta. Which of the following actions should the nurse take?

5 :
A nurse is caring for a client who is receiving an amnioinfusion. Which of the following manifestations is an indication of a potential complication of this procedure?

6 :
A nurse is determining a Bishop score for a client who is scheduled for labor induction. Which of the following findings should the nurse assess? (Select all that apply.)

7 :
A nurse is providing instructions to a client who has chosen a diaphragm for birth control. Which of the following instructions should the nurse include?

8 :
A nurse is preparing to administer betamethasone to a client who is at 30 weeks of gestation and has gestational diabetes mellitus. Which of the following statements should the nurse make to the client?

9 :
A nurse is teaching a parent of a newborn about reasons to call a pediatrician. Which of the following statements by the parent indicates an understanding of the teaching?

10 :
A nurse is caring for a client who is in active labor. The client reports intense pain with contractions and requests pain medication. Which of the following medications should the nurse plan to administer?

QLexNursing

1 : A nurse is reviewing the medical record of a client who desires to conceive. Which of the following findings increases the client's risk for a vitamin D deficiency?

2 : A nurse is caring for a client who is in the second stage of labor. The nurse observes the fetal head retract against the client's perineum immediately following emergence. Which of the following actions should the nurse take?

4 : A nurse is caring for a client who is at 35 weeks of gestation and has abruptio placenta. Which of the following actions should the nurse take?

5 : A nurse is caring for a client who is receiving an amnioinfusion. Which of the following manifestations is an indication of a potential complication of this procedure?

6 : A nurse is determining a Bishop score for a client who is scheduled for labor induction. Which of the following findings should the nurse assess? (Select all that apply.)

7 : A nurse is providing instructions to a client who has chosen a diaphragm for birth control. Which of the following instructions should the nurse include?

8 : A nurse is preparing to administer betamethasone to a client who is at 30 weeks of gestation and has gestational diabetes mellitus. Which of the following statements should the nurse make to the client?

9 : A nurse is teaching a parent of a newborn about reasons to call a pediatrician. Which of the following statements by the parent indicates an understanding of the teaching?

10 : A nurse is caring for a client who is in active labor. The client reports intense pain with contractions and requests pain medication. Which of the following medications should the nurse plan to administer?

1 :
A nurse is reviewing the medical record of a client who desires to conceive. Which of the following findings increases the client's risk for a vitamin D deficiency?

2 :
A nurse is caring for a client who is in the second stage of labor. The nurse observes the fetal head retract against the client's perineum immediately following emergence. Which of the following actions should the nurse take?

4 :
A nurse is caring for a client who is at 35 weeks of gestation and has abruptio placenta. Which of the following actions should the nurse take?

5 :
A nurse is caring for a client who is receiving an amnioinfusion. Which of the following manifestations is an indication of a potential complication of this procedure?

6 :
A nurse is determining a Bishop score for a client who is scheduled for labor induction. Which of the following findings should the nurse assess? (Select all that apply.)

7 :
A nurse is providing instructions to a client who has chosen a diaphragm for birth control. Which of the following instructions should the nurse include?

8 :
A nurse is preparing to administer betamethasone to a client who is at 30 weeks of gestation and has gestational diabetes mellitus. Which of the following statements should the nurse make to the client?

9 :
A nurse is teaching a parent of a newborn about reasons to call a pediatrician. Which of the following statements by the parent indicates an understanding of the teaching?

10 :
A nurse is caring for a client who is in active labor. The client reports intense pain with contractions and requests pain medication. Which of the following medications should the nurse plan to administer?