A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station.
The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?

“Your labor may slow down if you receive an epidural now.”.

“You need to be at least eight centimeters dilated prior to receiving an epidural.”.

“You will need to be catheterized prior to receiving an epidural.”.

“Your baby needs to be at zero station before you can have an epidural.”.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. “Your labor may slow down if you receive an epidural now.” An epidural is a type of regional anesthesia that blocks pain in a specific area of the body.

It can be used to reduce pain during labor and delivery.

However, an epidural can also have some side effects, such as lowering blood pressure, causing fever, and slowing down labor progress.

Therefore, it is usually recommended to wait until the cervix is at least 4 to 5 cm dilated and the contractions are strong and regular before receiving an epidural.

Choice B is wrong because there is no fixed rule about how dilated the cervix needs to be before receiving an epidural.

Some women may receive an epidural earlier or later than others, depending on their pain level, medical history, and preferences.

Choice C is wrong because catheterization is not a prerequisite for receiving an epidural.

Catheterization is the insertion of a tube into the bladder to drain urine.

It may be done after receiving an epidural because the anesthesia can affect the ability to urinate.

However, it is not required before receiving an epidural.

Choice D is wrong because the station of the baby does not determine when a woman can have an epidural.

The station of the baby refers to how far the baby has descended into the pelvis.

It is measured in relation to the ischial spines, which are bony landmarks in the pelvis.

A positive station means that the baby is below the spines, while a negative station means that the baby is above the spines.

Zero station means that the baby is at the level of the spines.

The station of the baby does not affect the administration of an epidural, as long as there are no other complications or contraindications.

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Correct Answer is A

Explanation

Choice A reason:
At 37 weeks, especially in gestational diabetes, fetal lungs may still be immature. Amniocentesis checks lung maturity to ensure the baby can breathe effectively if early delivery is needed due to fetal compromise.

Choice B reason:
Fetal renal function is not typically assessed through amniocentesis at term. Kidney function is monitored via ultrasound, not by analyzing amniotic fluid at 37 weeks.

Choice C reason:
Amniotic fluid glucose levels are not used to manage gestational diabetes. Maternal blood glucose is the standard for monitoring and treatment.

Choice D reason:
Congenital anomalies are usually detected earlier in pregnancy. By 37 weeks, the focus of amniocentesis is on delivery planning, not anomaly detection.

A. breast care teaching because she is predisposed to mastitis. B. frequent uterine fundal assessments because she is at risk for developing a prolapsed uterus. C. a strict toileting schedule because she is prone to developing a urinary tract infection. D. an “as needed” order for an analgesic because she is likely to have pain.

Correct Answer is B

Explanation

The correct answer is choice B. A multipara is a woman who has given birth more than once.

After delivery, the uterus contracts to return to its normal size and position.

However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.

This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.

Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.

Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.

Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.

Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.

It is not more common in multiparas.

Choice C is wrong because a strict toileting schedule is not necessary for multiparas.

Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.

UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.

Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.

Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.

Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.

Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.

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A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station. The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has gestational diabetes and is scheduled for an amniocentesis at 37 weeks of gestation due to suspected fetal compromise. What is the nurse’s best response to the client’s question as to why the amniocentesis test is being done?

Correct Answer is A

Explanation

In planning the postpartum care of a multipara who had a normal pregnancy, labor, and delivery, which factor should be considered? The client needs to have:

Correct Answer is B

Explanation

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A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station.
The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?