The nurse notes a pattern of late decelerations on the fetal monitor. The most appropriate action is to
a. Continue observation of this reassuring pattern.
b. Notify the physician or nurse-midwife.
c. Give the woman oxygen by face mask.
d. Place the woman in a Trendelenburg position.
C
Feedback
A This is not a reassuring pattern; interventions are needed.
B Nursing interventions should be initiated before notifying the health care
provider.
C Late decelerations are associated with reduced placental perfusion. Giving the
laboring woman oxygen increases the oxygen saturation in her blood, making
more oxygen available to the fetus.
D The Trendelenburg position will not increase the placental perfusion.
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Which acculturation behavior will the nurse observe in a client who has emigrated from Mexico to the United States?
A) The client buys all needed products from the local store owned by people from Mexico. B) The client lives in a neighborhood that is populated predominantly with people from Mexico. C) The client speaks Spanish only. D) The client attends church in the neighboring community to meet new people.
The nurse is developing a genogram. Which of the following pieces of information can be used to help identify the widowed female? Standard Text: Select all that apply
1. A square is used to denote the female. 2. A circle is used to denote the male. 3. A horizontal line connects the circle and the square in the middle. 4. A line above the circle and square that is linked on the top of each shape. 5. The square has a diagonal line through the square from bottom left to upper right corner.
The perinatal nurse observed the pediatrician completing the Ballard Gestational Age by Maturity Rating tool. The maturity components used with this assessment tool are:
Select all answers that apply. A) physical. B) behavioral. C) reflexive. D) neuromuscular.
Following surgery for hyperpitutarism, a client complains of a supra-orbital headache. The nurse suspects a possible CSF leak and would: Select all that apply
1. Maintain bed rest. 2. Keep HOB elevated 30 degrees. 3. Administer antibiotics. 4. Medicate for pain. 5. Inform the client that headaches are expected.