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 D

Explanation

The correct answer is choice D. “Have you noticed any tenderness in your breasts?”

Breast tenderness is one of the early signs of pregnancy that may occur as early as one to two weeks after conception.It is caused by hormonal changes that prepare the breasts for lactation.

Choice A is wrong because shortness of breath is not a sign of early pregnancy.It may occur later in pregnancy due to the growing uterus pressing on the diaphragm.

Choice B is wrong because episodes of loss of consciousness are not a sign of early pregnancy.They may indicate a serious condition such as anemia, dehydration, or hypoglycemia that requires medical attention.

Choice C is wrong because spotting is not a sign of early pregnancy.

It may be a sign of implantation bleeding, which occurs when the fertilized egg attaches to the lining of the uterus.However, implantation bleeding is usually much lighter and shorter than a normal period.

A. The patient’s cervix is dilated. B. The patient’s uterine contraction pattern is enhanced. C. The patient’s cervix is softened. D. The patient’s uterus is softened.

Correct Answer is B

Explanation

The correct answer is choice B. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.

A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.

Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.

Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.

Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a female client who suspects she is pregnant. Which question, if asked by the nurse, is consistent with signs of early pregnancy?

Correct Answer is D

Explanation

The physician prescribes prostaglandin (PGE2) gel for a patient being admitted for induction of labor. Which finding would best indicate that the prostaglandin gel is effective?

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?