A nurse is discussing probable signs of pregnancy with a newly licensed nurse. Which of the following terms should the nurse use to describe the movement of the fetus felt by the provider after placing upward pressure on the cervix?
Goodell’s sign
Lightening
Ballottement
Chadwick's sign
The Correct Answer is C
A) Goodell’s sign:
Goodell's sign refers to the softening of the cervix that occurs early in pregnancy, typically around 4–6 weeks. It is a probable sign of pregnancy due to increased vascularity and hormonal changes. However, it does not describe the movement of the fetus or the sensation felt by the provider when pressure is applied to the cervix.
B) Lightening:
Lightening refers to the sensation of the fetus dropping or descending into the pelvic cavity, which typically happens in the later stages of pregnancy (around 36 weeks or later). It is not related to the fetal movement felt by the provider through upward pressure on the cervix, but rather to the physical repositioning of the fetus as it prepares for labor.
C) Ballottement:
Ballottement is the correct term for the movement of the fetus that can be felt by the provider when upward pressure is applied to the cervix. This technique involves a gentle tapping or pushing on the cervix, causing the fetus to rise and then "bounce" back. This is a probable sign of pregnancy, typically noticeable between 16 and 18 weeks gestation.
D) Chadwick's sign:
Chadwick’s sign refers to the bluish discoloration of the cervix, vagina, and vulva due to increased blood flow and is often an early sign of pregnancy. It does not relate to the movement of the fetus felt by the provider, but rather to changes in the color of the genital tissues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"},"G":{"answers":"B"},"H":{"answers":"B"},"I":{"answers":"B"}}
Explanation
- Apply petrolatum to penis with each diaper change: Applying petrolatum prevents the healing circumcision site from adhering to the diaper, reducing pain and promoting proper healing.
- Use a diaper barrier cream that contains zinc oxid: Zinc oxide is used for diaper rash treatment but is not routinely necessary. It may interfere with circumcision healing by creating a barrier that retains moisture.
- Use alcohol-based baby wipes on the soiled genital area: Alcohol-based wipes can be too harsh on a newborn’s delicate skin and may cause irritation, especially on the healing circumcision site.
- Fold the diaper below the umbilical cord at all times: Folding the diaper below the umbilical cord keeps the area dry and exposed to air, promoting natural drying and reducing the risk of infection.
- Apply alcohol to the umbilical stump with a diaper change: Alcohol was previously used to dry the cord, but current guidelines recommend keeping it clean and dry, allowing it to fall off naturally.
- Use a soft-bristled brush with mild shampoo to wash the head: A soft-bristled brush helps loosen cradle cap (seborrheic dermatitis), preventing buildup of flaky skin without causing irritation.
- Bathe in a shallow warm tub every other day: Full immersion bathing should be avoided until the umbilical cord stump falls off to prevent moisture retention and infection. Sponge baths are recommended instead.
- Cover the hands with socks or sleeves at all times: While covering hands temporarily can prevent scratches, prolonged covering may interfere with newborn sensory development and exploration.
- Apply mildly scented lotion to face as needed: Newborn skin is sensitive, and scented lotions may cause irritation or allergic reactions. If needed, only fragrance-free moisturizers should be used.
Correct Answer is ["C","E","H","I"]
Explanation
Findings that require follow-up:
Uterus boggy at 24 hr postpartum:
A boggy uterus indicates poor uterine contraction, which can lead to postpartum hemorrhage. Effective uterine contraction is crucial to prevent excessive bleeding after delivery, and this finding warrants immediate intervention, such as fundal massage or administering uterotonic medications.
Lochia rubra with foul odor:
Foul-smelling lochia is a sign of potential infection, often indicative of endometritis, which is an infection of the uterine lining. The presence of this odor requires prompt follow-up and possibly antibiotic treatment to prevent further complications.
Elevated temperature (38.3°C/100.9°F) at 24 hr postpartum:
A postpartum fever may indicate infection, such as endometritis or a urinary tract infection (UTI). This fever should be investigated further to determine the cause and appropriate treatment, as untreated infections can lead to serious complications.
Increased heart rate (105/min) at 24 hr postpartum:
Tachycardia in the postpartum period can be a sign of infection or early signs of hemodynamic instability, possibly due to blood loss or infection. Close monitoring is necessary, and the healthcare provider should be notified to evaluate the cause and initiate treatment if necessary.
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