A nurse is caring for a client in the second stage of labor who is experiencing shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver.
What action should the nurse take?
Press firmly on the client’s suprapubic area.
Assist the client in pulling their knees toward their abdomen.
Apply pressure to the client’s fundus.
Move the client onto their hands and knees.
The Correct Answer is B
Choice A rationale
Applying firm pressure on the client’s suprapubic area is not part of the McRoberts maneuver. This action is more associated with the suprapubic pressure technique, which is another method used to manage shoulder dystocia.
Choice B rationale
The McRoberts maneuver involves having the client flex her hips against her abdomen. This is achieved by assisting the client in pulling her knees toward her abdomen.
Choice C rationale
Applying pressure to the client’s fundus is not part of the McRoberts maneuver and can be contraindicated as it may cause additional complications.
Choice D rationale
Moving the client onto their hands and knees is not part of the McRoberts maneuver. This position is more associated with the all-fours maneuver, also known as the Gaskin maneuver.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Expecting two to four wet diapers every 24 hours is not accurate for a newborn. Newborns typically have six or more wet diapers per day. This indicates that the baby is getting enough milk.
Choice B rationale
Feeding the newborn 5 to 10 minutes per breast is not sufficient. It is recommended that newborns be breastfed for 15 to 20 minutes on each breast during each feeding. This ensures that the baby gets both the foremilk, which quenches the baby’s thirst, and the hindmilk, which provides the necessary nutrients and helps the baby feel full.
Choice C rationale
Giving the newborn 30 ml (1 oz) of water between feedings is not recommended. Newborns do not need additional water - breast milk or formula provides all the hydration they need. Giving a newborn extra water can lead to water intoxication, which is a serious condition.
Choice D rationale
Allowing the baby to feed at least every 3 hours is correct. Newborns should be fed on demand, typically every 2 to 3 hours. This ensures that the baby gets enough nutrition for growth and development.
Correct Answer is D
Explanation
Choice A rationale
Providing oxygen to the client via a nonrebreather face mask is important if the client shows signs of hypoxia or shock due to blood loss. However, it is not the first action the nurse should take.
Choice B rationale
Administering oxytocin to the client can help contract the uterus and control bleeding, but it is not the first action the nurse should take.
Choice C rationale
Emptying the client’s bladder can help the uterus contract more effectively, but it is not the first action the nurse should take.
Choice D rationale
The first action the nurse should take when noting excessive vaginal bleeding is to massage the client’s fundus. A boggy uterus can lead to excessive bleeding, and massaging the fundus helps the uterus contract and can control the bleeding.
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