Question

A nurse in a prenatal clinic is caring for a client who is 39 weeks gestation. The nurse educates the client on signs of impending labor. What sign should the nurse include in the education?

Answer 1

Correct Answers:

Lightening

Rationale :

🍼Lightening is the descent of the fetal presenting part into the pelvis at term, producing a sense that the baby has “dropped.”

🚶‍♀️This descent often relieves diaphragmatic pressure (less dyspnea) but increases pelvic pressure, signaling impending labor.

🚽Clients frequently report urinary frequency, not urinary retention, because the fetal head compresses the bladder after lightening.

📆Lightening typically occurs weeks before labor in primigravidas and closer to onset in multigravidas, marking a pre-labor change rather than a general discomfort like fatigue or constipation.

📌Core Message

Lightening reflects fetal descent causing pelvic pressure and urinary frequency, making it a classic impending labor sign.

Answer 2

Correct Answers:

"A suction cup will be applied to the newborn's head during delivery."

Rationale :

🛠️A suction cup device refers to vacuum extraction, not forceps, so equating it with forceps indicates a misunderstanding.

👶Forceps are bladed instruments applied to the fetal head to assist traction and rotation when criteria are met.

✂️Episiotomy may be used with operative vaginal birth to expand the outlet, which aligns with accurate knowledge of forceps use.

🕘Full cervical dilation is a required precondition for safe forceps application, underscoring why the suction-cup statement is the incorrect one.

📌Core Message

Confusing vacuum extraction with forceps reveals an error; forceps ≠ suction cup and require full dilation.

Answer 3

Correct Answers:

The fetus is in a breech position

Rationale :

🎯Feeling a hard, round part in the fundus during Leopold’s first maneuver suggests the head is up, pointing to breech.

🦶Conversely, the softer, irregular buttocks in the fundus would support a vertex conclusion, which is not the palpated finding here.

🧭Leopold’s maneuvers differentiate presentation by locating head vs buttocks and mapping fetal lie and position.

🔎Thus, a hard, ballotable structure at the fundus indicates the cephalic pole is superior, confirming breech.

📌Core Message

A hard, round fundal mass on Leopold’s indicates the head is in the fundus, consistent with breech.

Answer 4

Correct Answers:

A client who is 34 weeks pregnant with twins.

Rationale :

👶Multiple gestation is a leading risk factor for preterm labor due to uterine overdistention and increased prostaglandin activity.

📉At 34 weeks, the baseline risk is already elevated, and twins further amplify uterine stretch, promoting contractions.

🧪Other listed histories (e.g., depression or prior post-term delivery) lack the same direct pathophysiologic link to preterm labor.

🧭Risk assessment prioritizes conditions that increase uterine activity, making twins at 34 weeks the highest risk profile.

📌Core Message

Twin gestation at 34 weeks most heightens preterm labor risk due to uterine overdistention.

Answer 5

Correct Answers:

Cervical dilation
Blood pressure
Fetal heart rate variability
Contraction frequency

Rationale :

🩺Cervical dilation directly measures labor progress, making it essential for triage decision-making.

🧯Blood pressure is a vital sign that screens for hypertensive disorders and hemodynamic stability during labor evaluation.

📈Fetal heart rate variability reflects fetal autonomic status and oxygenation, a key fetal well-being indicator on triage.

⏱️Contraction frequency informs the labor pattern and helps differentiate true vs false labor during the initial assessment.

📌Core Message

Triage centers on maternal vitals, cervical status, FHR assessment, and contraction pattern to gauge labor and safety.

Answer 6

Correct Answers:

Variable decelerations

Rationale :

📉Variable decelerations are abrupt drops in FHR with variable timing relative to contractions, typically due to cord compression.

🪢They often show sharp V- or U-shapes and rapid onset/return, distinguishing them from gradual, late patterns.

🧪Management targets relieving cord compression (e.g., repositioning, amnioinfusion if ordered), consistent with recognizing this pattern.

🧭Accurate strip documentation uses the precise deceleration category, guiding timely interventions for fetal well-being.

📌Core Message

Abrupt FHR drops with V-shapes signify variable decelerations from cord compression, guiding repositioning-focused care.

Answer 7

Correct Answers:

Moderate amount of rubra lochia
Fundus is firm and midline
Small clots expressed with fundal check

Rationale :

🩸Within the first hour postpartum, a moderate rubra lochia amount is expected as the uterus involutes.

🎯A firm, midline fundus indicates effective uterine contraction, helping prevent postpartum hemorrhage.

🧊Small clots may be expressed during fundal checks as the uterus clears residual blood from the cavity.

🛑Uterine atony and hypotension are not expected findings; their presence would suggest complications requiring urgent action, hence their exclusion.

📌Core Message

Early postpartum norms include rubra lochia, a firm midline fundus, and occasional small clots—signs of effective involution.

Answer 8

Correct Answers

The plastic rim will fall off in approximately 10 days. [ Plastibell ]
Clean the area by squeezing warm water over the circumcision site. [ Gomco Clamp ; Plastibell ]
Skin-to-skin contact is encouraged after completion of the circumcision. [ Gomco Clamp ; Plastibell ]
Call the pediatrician if there is purulent drainage from the circumcision site. [ Gomco Clamp ; Plastibell ]
Apply petroleum jelly to the penis during each diaper change [ Gomco Clamp ]

Rationale :

🧰Plastibell leaves a plastic ring that separates and falls off spontaneously in about 7–10 days, unlike Gomco, which has no ring post-procedure.

🚿Both methods require gentle cleansing by pouring warm water over the site to maintain hygiene and prevent irritation without disrupting healing tissue.

🤱Skin-to-skin is broadly beneficial for thermoregulation, bonding, and analgesia, and is appropriate after either Plastibell or Gomco once the procedure is completed.

🩹Purulent drainage signals possible infection in any technique and warrants provider notification, aligning with universal post-procedure precautions.

🧴After Gomco, petroleum jelly prevents the glans from adhering to the diaper, whereas with Plastibell it is avoided to prevent ring displacement.

📌Core Message

Match Plastibell with the plastic ring and no petroleum, and apply universal hygiene/monitoring and skin-to-skin to both methods, reserving petroleum jelly for Gomco.

Answer 9

Correct Answers:

Notify the healthcare provider
Change the client's position
Perform a sterile vaginal exam
Administer IV fluids

Rationale :

🪢Variable decelerations reflect umbilical cord compression, so immediate maternal position change helps relieve pressure on the cord.

💧Administering IV fluids supports placental perfusion, addressing potential fetal hypoxemia associated with recurrent variables.

🧤A sterile vaginal exam evaluates for cord prolapse or rapid cervical change, informing urgent next steps.

📞Notifying the provider is appropriate with recurrent patterns after initial measures, ensuring timely collaboration for escalation if needed.

📌Core Message

Manage recurrent variables by repositioning, bolusing IV fluids, and assessing vaginally, while alerting the provider for coordinated escalation.

Answer 10

Correct Answers:

An IUD is contraindicated in clients with active pelvic infections.
An IUD can increase the likelihood of an ectopic pregnancy.
An IUD is considered a highly effective form of birth control.

Rationale :

🦠Active pelvic infection increases the risk of ascending infection, making IUDs contraindicated until infection is treated.

🫀If a pregnancy occurs with an IUD, the relative risk of ectopic implantation is higher than in pregnancies without an IUD, necessitating early evaluation.

✅IUDs (copper or hormonal) are highly effective long-acting reversible contraceptives with very low failure rates.

🍼Breastfeeding is not a contraindication; progestin IUDs and copper IUDs can be used safely postpartum per standard guidance.

📌Core Message

IUDs are highly effective LARC, avoid during active PID, and if pregnancy occurs, assess for ectopic promptly.

Education	Gomco Clamp	Plastibell
The plastic rim will fall off in approximately 10 days.
Clean the area by squeezing warm water over the circumcision site.
Skin-to-skin contact is encouraged after completion of the circumcision.
Call the pediatrician if there is purulent drainage from the circumcision site.
Apply petroleum jelly to the penis during each diaper change

1 :
A nurse in a prenatal clinic is caring for a client who is 39 weeks gestation. The nurse educates the client on signs of impending labor. What sign should the nurse include in the education?

2 :
A nurse is educating a new graduate nurse about forceps-assisted deliveries. What statement by the new graduate indicates a need for further education?

3 :
The nurse is performing Leopold's maneuver on a 39-week pregnant client. When palpating the fundus, the nurse feels a hard, round fetal part. What should the nurse conclude?

4 :
The nurse is working in an obstetric clinic. Which client is at greatest risk for preterm labor?

5 :
The nurse is triaging a 38-week pregnant client who arrived at the labor and delivery unit with contractions. What should the nurse include in the triage assessment of the client? Select all that apply.

6 :
The nurse is caring for a laboring client. What should the nurse include in the documentation of this fetal monitoring strip below?

7 :
A client delivered a healthy B-pound 3-ounce infant one hour ago. Which assessment finding(s) should the nurse expect? Select all that apply.

8 :
The nurse is planning education for the caregivers of a newborn who is having a circumcision.

Correct Answers

9 :
The nurse is caring for a client in labor and notes recurrent variable decelerations on the fetal monitor. What action(s) should the nurse take at this time? Select all that apply.

10 :
The nurse is planning education for a client who desires to have an intrauterine device (IUD) inserted. Which information should the nurse plan to include? Select all that apply.

1 : A nurse in a prenatal clinic is caring for a client who is 39 weeks gestation. The nurse educates the client on signs of impending labor. What sign should the nurse include in the education?

2 : A nurse is educating a new graduate nurse about forceps-assisted deliveries. What statement by the new graduate indicates a need for further education?

3 : The nurse is performing Leopold's maneuver on a 39-week pregnant client. When palpating the fundus, the nurse feels a hard, round fetal part. What should the nurse conclude?

4 : The nurse is working in an obstetric clinic. Which client is at greatest risk for preterm labor?

5 : The nurse is triaging a 38-week pregnant client who arrived at the labor and delivery unit with contractions. What should the nurse include in the triage assessment of the client? Select all that apply.

6 : The nurse is caring for a laboring client. What should the nurse include in the documentation of this fetal monitoring strip below?

7 : A client delivered a healthy B-pound 3-ounce infant one hour ago. Which assessment finding(s) should the nurse expect? Select all that apply.

8 : The nurse is planning education for the caregivers of a newborn who is having a circumcision.

Correct Answers

9 : The nurse is caring for a client in labor and notes recurrent variable decelerations on the fetal monitor. What action(s) should the nurse take at this time? Select all that apply.

10 : The nurse is planning education for a client who desires to have an intrauterine device (IUD) inserted. Which information should the nurse plan to include? Select all that apply.

1 :
A nurse in a prenatal clinic is caring for a client who is 39 weeks gestation. The nurse educates the client on signs of impending labor. What sign should the nurse include in the education?

2 :
A nurse is educating a new graduate nurse about forceps-assisted deliveries. What statement by the new graduate indicates a need for further education?

3 :
The nurse is performing Leopold's maneuver on a 39-week pregnant client. When palpating the fundus, the nurse feels a hard, round fetal part. What should the nurse conclude?

4 :
The nurse is working in an obstetric clinic. Which client is at greatest risk for preterm labor?

5 :
The nurse is triaging a 38-week pregnant client who arrived at the labor and delivery unit with contractions. What should the nurse include in the triage assessment of the client? Select all that apply.

6 :
The nurse is caring for a laboring client. What should the nurse include in the documentation of this fetal monitoring strip below?

7 :
A client delivered a healthy B-pound 3-ounce infant one hour ago. Which assessment finding(s) should the nurse expect? Select all that apply.

8 :
The nurse is planning education for the caregivers of a newborn who is having a circumcision.

9 :
The nurse is caring for a client in labor and notes recurrent variable decelerations on the fetal monitor. What action(s) should the nurse take at this time? Select all that apply.

10 :
The nurse is planning education for a client who desires to have an intrauterine device (IUD) inserted. Which information should the nurse plan to include? Select all that apply.