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

The correct answer is choice A. A patient who weighed less than 5 lb (2,268 gm) at birth is at risk for having an infant with intrauterine growth retardation (IUGR).This is because low birth weight is a possible indicator of genetic factors or placental insufficiency that can affect fetal growth.

Choice B is wrong because an ectopic pregnancy one year ago does not increase the risk of IUGR.An ectopic pregnancy is when the fertilized egg implants outside the uterus, usually in the fallopian tube.It does not affect the placental function or fetal development in a subsequent pregnancy.

Choice C is wrong because a mitral valve prolapse does not increase the risk of IUGR.

A mitral valve prolapse is when the valve between the left atrium and left ventricle of the heart does not close properly.It usually does not cause any symptoms or complications during pregnancy, unless it is associated with severe regurgitation or arrhythmias.

Choice D is wrong because the father’s age of 42 years old does not increase the risk of IUGR.The father’s age may affect the risk of chromosomal abnormalities or congenital anomalies in the fetus, but not the fetal growth.

Some of the other risk factors for IUGR include maternal smoking, alcohol, or drug use, medical conditions like anemia or lupus, infections such as rubella or syphilis, carrying twins or multiples, high blood pressure, gestational diabetes, and placenta problems.

A. “You don’t need to breastfeed now if you would rather wait for your milk to come in.”. B. “It is good practice for you to breastfeed now so that you will be skilled when your milk comes in.”. C. “The earlier you begin to breastfeed your baby, the closer you and your baby may become.”. D. “The fluid you have in your breasts now is just what the baby needs.”.

Correct Answer is D

Explanation

The correct answer is choice D. The fluid that the mother has in her breasts before the milk comes in is called colostrum, which is rich in antibodies and nutrients that the baby needs.

It also helps to prevent jaundice by stimulating the baby’s bowel movements.

Therefore, the nurse should encourage the mother to breastfeed as soon as possible after birth and explain the benefits of colostrum.

Choice A is wrong because it discourages breastfeeding and may interfere with milk production and bonding.

Choice B is wrong because it implies that breastfeeding is only a skill and not a natural process that benefits both the mother and the baby.

Choice C is wrong because it focuses on the emotional aspect of breastfeeding and not the physiological one.

While breastfeeding may enhance the closeness between the mother and the baby, it is not the only reason to breastfeed.

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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 patient who is 17 weeks pregnant shares several pieces of information with the nurse. Which statement made by the patient would indicate the patient is at risk for having an infant with intrauterine growth retardation (IUGR)?

Correct Answer is A

Explanation

During the first postpartum day, a new mother is breastfeeding her infant.The client asks, “Since I don’t have any milk yet, why am I breastfeeding?” Which response by the nurse is most appropriate?

Correct Answer is D

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?

A patient comes to the antepartal clinic for her visit and provides the nurse with information. What piece of information places this patient at high risk for exposure to teratogenic agents?

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A client who is twO weeks postpartum calls the office and tells a nurse, "l am havinga small amount of brownish discharge from my vagina." Which response is appropriate for the nurse to make?

A 14-year-old patient is 10 weeks pregnant. In order to plan nutritional counseling for this patient, the nurse should have which understanding about adolescents’ nutritional needs during pregnancy?

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?