Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible:
Select one:

Manifestations of uteroplacental insufficiency.

Manifestations of prolapsed cord.

Manifestations of anaphylactoid syndrome of pregnancy.

Manifestations of an acute asthmatic episode.

Answer and Explanation

The Correct Answer is C

Choice A Reason: Manifestations of uteroplacental insufficiency. This is an incorrect answer that describes a diﬀerent condition that aﬀects the fetus, not the mother. Uteroplacental insufficiency is a condition where the placenta fails to deliver adequate oxygen and nutrients to the fetus, which can result in fetal growth restriction, distress, or demise. Uteroplacental insufficiency does not cause shortness of breath, hypoxia, or cyanosis in the mother.

Choice B Reason: Manifestations of prolapsed cord. This is an incorrect answer that refers to another condition that aﬀects the fetus, not the mother. Prolapsed cord is a condition where the umbilical cord slips through the cervix before the baby and becomes compressed by the fetal head, which can reduce oxygen ﬂow to the fetus. Prolapsed cord does not cause shortness of breath, hypoxia, or cyanosis in the mother.

Choice C Reason: Manifestations of anaphylactoid syndrome of pregnancy. This is because anaphylactoid syndrome of pregnancy, also known as amniotic ﬂuid embolism, is a rare and fatal condition where amniotic ﬂuid enters into the maternal bloodstream and causes an allergic reaction, which can lead to respiratory failure, cardiac arrest, coagulopathy, and coma. Anaphylactoid syndrome of pregnancy can occur during or after labor and delivery, especially in cases of NSVD, multiparity, advanced maternal age, or placental abruption.

Choice D Reason: Manifestations of an acute asthmatic episode. This is an incorrect answer that assumes that the mother has a history of asthma or an allergic trigger. Asthma is a chronic inﬂammatory disorder of the airways that causes wheezing, coughing, chest tightness, and dyspnea. Asthma can be exacerbated by pregnancy or labor, but it is not a common cause of sudden onset respiratory distress in the postpartum period.

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Correct Answer is C

Explanation

Choice A Reason: Continuing to monitor and document fetal heart rate. This is an inadequate response that does not address the urgency of the situation or intervene to prevent fetal distress or demise.

Choice B Reason: Changing the mother's position to left lateral and giving oxygen by nasal cannula. This is a partial response that may improve maternal-fetal blood ﬂow and oxygenation, but it does not resolve the cord compression or facilitate delivery.

Choice C Reason: With a sterile glove, maintaining pressure to lift the presenting part and emergently notifying the provider for a STAT C-section. This is an appropriate response that aims to reduce the cord compression by elevating the fetal head away from the cord and prepare for an immediate cesarean delivery.

Choice D Reason: Bolusing the patient with 1000cc lactated ringers. This is an irrelevant response that does not address the cause of the problem or improve fetal outcome.

A. Retained placental fragments. B. Cervical or vaginal lacerations. C. Uterine inversion. D. Uterine atony.

Correct Answer is D

Explanation

Choice A Reason: Retained placental fragments. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is less common than uterine atony. Retained placental fragments are pieces of placenta that remain atached to the uterine wall after delivery, which prevent uterine contraction and involution, and provide a source of bleeding and infection. Retained placental fragments can be caused by abnormal placentation (such as placenta accreta), manual removal of placenta, or incomplete separation of placenta.

Choice B Reason: Cervical or vaginal lacerations. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is more likely to cause early postpartum hemorrhage than late postpartum hemorrhage. Cervical or vaginal lacerations are tears or cuts in the cervix or vagina that occur during delivery, which can cause bleeding from the damaged blood vessels. Cervical or vaginal lacerations can be caused by rapid or instrumental delivery, large or malpositioned fetus, or episiotomy.

Choice C Reason: Uterine inversion. This is an incorrect answer that refers to a diﬀerent cause of late postpartum hemorrhage, which is rare and life-threatening. Uterine inversion is a condition where the uterus turns inside out and protrudes through the cervix and vagina after delivery, which can cause massive bleeding and shock. Uterine inversion can be caused by excessive traction on the umbilical cord, fundal pressure, or uterine relaxation.

Choice D Reason: Uterine atony. This is because uterine atony is a condition where the uterus fails to contract and retract after delivery, which leads to bleeding from the placental site. Uterine atony is the most common cause of late postpartum hemorrhage, accounting for about 75% of cases. Late postpartum hemorrhage is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders.

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Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible: Select one:

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Naxlex Comprehensive Predictor Exams

The nurse, working in labor and delivery, performs a sterile vaginal exam on a laboring woman. During the exam, she feels a loop of pulsating cord in the vagina. The nurse would anticipate: Select one:

Correct Answer is C

Explanation

When reviewing the causes of late postpartum hemorrhage, which of the following would the nurse identify as the most common cause? Select one:

Correct Answer is D

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:

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A woman has just entered the third stage of labor. The nurse would focus care on which of the following? 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:

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 60 beats per minute. Which of these actions should the nurse take? Select one:

The Mother-Baby nurse is caring for a two hour old newborn who is 36 4/7 weeks gestation. The nurse assesses that the newborn is experiencing tremors (jiteriness). What nursing action has the highest priority? Select one:

Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible:
Select one: