Before applying a cord clamp, the nurse assesses the umbilical cord for vessels. The nurse expects to find: Select one:

Two arteries, one vein.

Two veins, one artery.

Two veins, two arteries.

One artery, one vein.

Answer and Explanation

The Correct Answer is A

Choice A Reason: Two arteries, one vein. This is because two arteries and one vein are the normal components of the umbilical cord, which is a structure that connects the fetus to the placenta and provides blood circulation between them. The umbilical cord carries oxygenated blood from the placenta to the fetus through the umbilical vein, and deoxygenated blood from the fetus to the placenta through the umbilical arteries.

Choice B Reason: Two veins, one artery. This is an incorrect answer that indicates an abnormal anatomy of the umbilical cord, which is known as single umbilical artery (SUA). SUA is a condition where there is only one umbilical artery instead of two, which can reduce blood ﬂow and oxygen delivery to the fetus. SUA can be associated with congenital anomalies or growth restriction in some cases.

Choice C Reason: Two veins, two arteries. This is an incorrect answer that indicates an abnormal anatomy of the umbilical cord, which is known as double umbilical vein (DUV). DUV is a condition where there are two umbilical veins instead of one, which can increase blood ﬂow and oxygen delivery to the fetus. DUV can be associated with fetal overgrowth or polycythemia in some cases.

Choice D Reason: One artery, one vein. This is an incorrect answer that indicates an abnormal anatomy of the umbilical cord, which is also known as single umbilical artery (SUA). SUA is a condition where there is only one umbilical artery instead of two, which can reduce blood ﬂow and oxygen delivery to the fetus. SUA can be associated with congenital anomalies or growth restriction in some cases.

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Correct Answer is B

Explanation

Choice A Reason: Prepare for IV dextrose administration. This is an incorrect answer that indicates an unnecessary and invasive intervention for an IDM with normal blood glucose. IV dextrose administration is indicated for an IDM with severe or persistent hypoglycemia, which is defined as a blood glucose below 40 mg/dL or below 60 mg/dL after two feedings.

Choice B Reason: Provide routine care, per hospital IDM protocol. This is because a blood glucose of 60 is within the normal range for an IDM, which is 40 to 80 mg/dL. An IDM is a newborn whose mother has pre-existing or gestational diabetes, which can aﬀect the fetal and neonatal glucose metabolism and regulation. An IDM may have hypoglycemia (low blood glucose), hyperglycemia (high blood glucose), or other complications such as macrosomia, polycythemia, or congenital anomalies. An IDM requires routine care and monitoring according to the hospital IDM protocol, which may include blood glucose testing, feeding, temperature regulation, and observation for signs of distress.

Choice C Reason: Place the infant in a warmed incubator. This is an incorrect answer that suggests an irrelevant and potentially harmful action for an IDM with normal blood glucose. Placing the infant in a warmed incubator is indicated for an IDM with hypothermia, which is a low body temperature that can impair glucose utilization and increase oxygen consumption. However, placing the infant in a warmed incubator without proper indication can cause hyperthermia, which is a high body temperature that can lead to dehydration, electrolyte imbalance, or brain damage.

Choice D Reason: Alert the clinician immediately for orders. This is an incorrect answer that implies an urgent and unwarranted situation for an IDM with normal blood glucose. Alerting the clinician immediately for orders is indicated for an IDM with signs of distress or complications, such as apnea, cyanosis, seizures, or jaundice.

A. Enhance uterine contractions. B. Be used in place of preoperative sedation. C. Result in neonatal respiratory depression. D. Prevent the need for anesthesia with an episiotomy.

Correct Answer is C

Explanation

Choice A Reason: Enhance uterine contractions. This is an incorrect answer that contradicts the eﬀect of narcotic analgesia on uterine activity. Narcotic analgesia can reduce uterine contractions by decreasing maternal catecholamine levels, which can prolong labor or increase bleeding.

Choice B Reason: Be used in place of preoperative sedation. This is an irrelevant answer that does not apply to this scenario. Preoperative sedation is a medication given before surgery to reduce anxiety, pain, or nausea. Narcotic analgesia can be used as a preoperative sedative, but it is not related to labor or delivery.

Choice C Reason: Result in neonatal respiratory depression. This is because narcotic analgesia can cross the placenta and aﬀect the fetal central nervous system, which can cause decreased respiratory drive, apnea, bradycardia, or hypotonia in the newborn. The risk of neonatal respiratory depression is higher when narcotic analgesia is administered close to delivery, as there is less time for placental clearance or maternal metabolism.

Choice D Reason: Prevent the need for anesthesia with an episiotomy. This is an inaccurate answer that overestimates the eﬀect of narcotic analgesia on perineal pain. Narcotic analgesia can provide some relief of labor pain, but it does not block pain sensation completely or locally. An episiotomy is a surgical incision made in the perineum to enlarge the vaginal opening during delivery, which requires local anesthesia or regional anesthesia (such as epidural or spinal). Narcotic analgesia does not prevent or replace anesthesia with an episiotomy.

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Before applying a cord clamp, the nurse assesses the umbilical cord for vessels. The nurse expects to find: Select one:

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Naxlex Comprehensive Predictor Exams

An infant of a Diabetic Mother (IDM) has a blood glucose of 60 upon admission to the well-baby nursery. Which of the following is an appropriate nursing action? Select one:

Correct Answer is B

Explanation

Narcotic analgesia is administered to a laboring client at 10:00 a.m. The infant is delivered at 10:35 A.M. The nurse would anticipate that the narcotic analgesia could: Select one:

Correct Answer is C

Explanation

If a woman has a pre-existing condition of diabetes, the nurse knows that she would be at risk for what symptom(s) during her pregnancy? Select one:

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The nurse assesses a 1-day-old newborn. Which finding indicates that the newborn's oxygenation needs are not being met? Select one:

During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse interprets this finding as: Select one:

The patient is 34 weeks pregnant and during a regular prenatal visit she asks how to do kick counts. The best response by the nurse would be: Select one:

Assessment of a pregnant woman reveals a pigmented vertical line between the umbilicus and the pubis. The nurse documents this finding as: Select one:

Which of the following would the nurse include in the plan of care for a newborn receiving phototherapy? Select one: