A nurse in the emergency department is admitting a client who is experiencing an especially rapid labor (precipitous labor). She is at 40 weeks of gestation, has ruptured membranes, and the nurse observes the newborn's head crowning. The client tells the nurse she feels a strong urge to push. Which of the following instructions should the nurse make to help the mother have a more controlled birth?

"You should take a deep, cleansing breath and breathe naturally."

"You should go ahead and push as hard as you can to assist the delivery."

"You should try to blow or pant as the baby is being born to help avoid a toorapid birth."

"You should try to perform slowpaced breathing patterns."

Answer and Explanation

The Correct Answer is C

A: Taking deep, cleansing breaths and breathing naturally is not the appropriate technique during the crowning phase of labor, as it can increase the risk of rapid birth and potential perineal trauma.

C: During a precipitous labor with the baby's head crowning, the nurse should encourage the mother to perform blowing or panting breaths during contractions. This technique helps to slow down the delivery process and allows the perineum to stretch gradually, reducing the risk of tearing or other trauma.

B: In the case of precipitous labor, actively pushing as hard as possible can increase the risk of rapid birth and potential complications for both the mother and the baby.

D: Slowpaced breathing patterns are not recommended during the crowning phase of labor, as they may not effectively control the birth process.

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Correct Answer is C

Explanation

A: Administering a 500 mL bolus of 5% dextrose in water is not necessary before the epidural administration, and it may not be recommended in active labor as it can increase the risk of fluid overload.

B: The duration of the anesthetic effect of the epidural can vary depending on the medication used, and it is not the nurse's priority during the preparation process.

C: Prior to administering epidural analgesia, the nurse should obtain a 30minute electronic fetal monitoring (EFM) strip to assess the fetal heart rate and monitor for any signs of fetal distress during the procedure.

D: Having the client stand very still with her arms at her side is not practical or necessary for epidural administration and could be uncomfortable for the client during labor.

A. "All you need to do is relax." B. "A pelvic exam is required if you want birth control pills." C. "What part of the exam makes you most nervous?" D. "Don't worry, I will be with you during the exam."

Correct Answer is C

Explanation

Choice A: While relaxation can be helpful during a pelvic examination, it is not the most comprehensive response to address the client's concerns.

Choice B: A pelvic examination is not always required for prescribing birth control pills. In many cases, a healthcare provider can prescribe oral contraceptives based on the client's medical history and other factors without a pelvic exam.

Choice C: This response encourages the client to express her specific concerns and fears related to the examination, allowing the nurse to address them directly and provide appropriate support and reassurance.

Choice D: Although offering support during the exam is important, it does not address the client's nervousness and concerns about the examination itself.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a client who is in active labor for epidural analgesia. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse in a family planning clinic is caring for a 17 year old female client who is requesting oral contraceptives. The client states that she is nervous because she has never had a pelvic examination. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A nurse is caring for a client who is scheduled for a maternal serum alphafetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the teaching?

A nurse in a prenatal clinic is caring for a client who is at 12 weeks gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make?

A nurse is caring for a client who is in the first stage of labor and is using patternpaced breathing. The client says she feels lightheaded, and her fingers are tingling. Which of the following actions should the nurse take?

A nurse is caring for a client who is 42 weeks of gestation. Based on the assessment findings, which of the following actions should the nurse plan to take? (Select all that apply.)

A nurse is providing teaching to a client who is at 30 weeks of gestation and is to have a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?

A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?

A nurse is caring for a client following an amniotomy who is now in the active phase of the first stage of labor. Which of the following actions should the nurse implement with this client?