A patient is scheduled for an amniocentesis when she is 18 weeks pregnant. Which instruction concerning amniocentesis should the nurse give to the patient?

Plan to remain flat in bed for six hours after the test.

Expect some vaginal bleeding after the test.

Empty your bladder prior to the test.

Do not consume any solid foods for sixteen hours prior to the test.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Empty your bladder prior to the test. This is because a full bladder can interfere with the insertion of the needle and increase the risk of complications. Amniocentesis is a test that involves removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the baby in the womb. It is done to check for genetic or chromosomal conditions, such as Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.

Choice A is wrong because there is no need to remain flat in bed for six hours after the test. You can resume your normal activities after a few hours of rest.

Choice B is wrong because vaginal bleeding is not a normal outcome of amniocentesis. If you experience any bleeding, leaking of fluid, fever or severe pain after the test, you should contact your doctor immediately.

Choice D is wrong because there is no restriction on eating before the test. You can have your normal meals and drinks before amniocentesis.

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Correct Answer is B

Explanation

The correct answer is choice B. Apply ice to her perineal area.This is because ice can help reduce swelling and pain in the episiotomy wound, which is a cut made in the tissue between the vagina and anus during childbirth.Ice should be applied for the first 24 to 48 hours after delivery.

Choice A is wrong because Kegel exercises, which involve contracting and relaxing the pelvic floor muscles, are not recommended for the first 12 hours after an episiotomy.They can increase blood flow and inflammation in the area, and may interfere with healing.

Choice C is wrong because keeping her hips slightly elevated can cause pressure on the episiotomy wound and increase discomfort.It can also affect blood circulation and drainage in the area.

Choice D is wrong because observing her perineal area for signs of infection is not a nursing action that should be included in her plan of care for the first 12 hours.Infection is rare in episiotomy wounds, and signs of infection usually appear after 24 hours or later.However, the nurse should teach the patient how to keep the area clean and dry, and when to report any signs of infection, such as fever, pus, or foul-smelling discharge.

Normal ranges for episiotomy healing are:

• Stitches dissolve within 2 to 4 weeks

• Pain and swelling subside within a few days to a week

• Wound heals completely within 4 to 6 weeks

A. The fetal heart rate decreases after the start of a contraction and returns to the baseline 60 seconds after the end of the contraction. B. There is a six to ten beat-to-beat variability in the fetal heart rate. C. The fetal heart rate accelerates five to seven beats just prior to the beginning of a contraction. D. The fetal heart rate decreases at the start of the contraction and returns to baseline by the end of the contraction.

Correct Answer is A

Explanation

The correct answer is choice A and it indicates fetal distress because it is a sign oflate deceleration.Late decelerations are due touteroplacental insufficiencyas the result of decreased blood flow and oxygen to the fetus during the uterine contractions.This causeshypoxemiaand can lead to fetal acidosis and neurological damage.

Choice B is wrong because it indicates anormal variabilityin the fetal heart rate, which reflects a healthy autonomic nervous system.A normal fetal heart rate is 120-160 beats per minute.

Choice C is wrong because it indicates anearly accelerationin the fetal heart rate, which is a benign finding that may occur with fetal movement or stimulation.

Choice D is wrong because it indicates anearly decelerationin the fetal heart rate, which is a normal response to fetal head compression during contractions.

It does not indicate fetal distress.

Normal ranges for fetal heart rate patterns are:

• Baseline: 120-160 beats per minute

• Variability: 6-25 beats per minute

• Accelerations: at least 15 beats per minute above baseline for at least 15 seconds

• Decelerations: none or early (mirror contractions)

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A patient is scheduled for an amniocentesis when she is 18 weeks pregnant. Which instruction concerning amniocentesis should the nurse give to the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient had an episiotomy during her delivery. Which nursing action should be included in her plan of care for the first 12 hours?

Correct Answer is B

Explanation

A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?

Correct Answer is A

Explanation

A 14-year-old patient visits the antepartal clinic because she has missed three menstrual periods.The patient is to have a pelvic examination. In addition to explaining the procedure, which measure would best help reduce the patient’s anxiety?

A nurse is caring for a patient who is 40 weeks pregnant. Which finding would indicate the need for a cesarean delivery?

The nurse at the antepartal clinic reviews four patients’ charts. Which patient is at increased risk for an ectopic pregnancy?

A patient comes to the family planning clinic requesting information.Which information should the nurse obtain initially to determine the patient’s knowledge base?.

A nurse is caring for a client with gestational diabetes.Which guideline should the nurse use when providing nutritional counseling to this client?

A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun. A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

During the postpartal admission assessment, the nurse notes that a patient’s perineum appears edematous and ecchymotic. Based on this finding, which action should the nurse take?

The nurse instructs a class of postpartum women on methods to avoid nipple soreness while breastfeeding. Which comment by a class participant indicates the need for further instruction?