What do nurses understand about the induction of labor?
It is rated for probability of success by a Bishop score.
It is always done for medical reasons.
It is also known as a trial of labor (TOL).
It can electively be done at 37 weeks’ gestation.
The Correct Answer is A
Choice A rationale:
Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.
Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.
Score of 6 or less: Induction is less likely to be successful.
Score of 9 or higher: Induction is more likely to be successful.
Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.
Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.
Choice B rationale:
Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.
Examples of medical reasons:
Gestational hypertension or preeclampsia
Fetal growth restriction
Prolonged pregnancy
Chorioamnionitis
Oligohydramnios
Choice C rationale:
Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.
Not synonymous with induction of labor: TOL can occur spontaneously or be induced.
Choice D rationale:
Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.
Factors considered:
Maternal and fetal health
Bishop score
Patient preferences
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Drug/alcohol use: While substance abuse during pregnancy can lead to adverse outcomes such as preterm labor, fetal growth restriction, and birth defects, it is not considered a primary factor in determining high-risk status for this patient. The specific substances involved (cocaine and alcohol) are indeed associated with risks, but they are not as significant as other factors in this case.
Age: The patient's age of 24 is not considered a high-risk factor for pregnancy. Advanced maternal age (typically defined as 35 years or older) is associated with increased risks for chromosomal abnormalities and other complications, but this patient falls below that age threshold.
Family history: Family history of diabetes mellitus, cancer, and neural tube defects can be relevant to pregnancy risk, but in this case, other factors outweigh their significance.
Choice B rationale:
Blood pressure: The patient's blood pressure of 108/70 mm Hg is within the normal range and does not contribute to highrisk categorization. High blood pressure (hypertension) during pregnancy can lead to preeclampsia and other complications, but this patient does not present with hypertension.
Age: As explained in Choice A, the patient's age is not a high-risk factor.
BMI: A BMI of 17 is considered underweight, which can increase the risk of certain pregnancy complications such as preterm birth and low birth weight. However, in this case, other factors are more significant in determining high-risk status.
Choice C rationale:
Family history: The patient's family history of a neural tube defect (NTD) in a close relative is a significant risk factor for NTDs in her own pregnancy. NTDs are serious birth defects that affect the brain and spinal cord, and they can have lifelong implications for the child. This factor alone warrants a high-risk categorization.
BMI: The patient's underweight BMI of 17 further contributes to her high-risk status, as it can increase the likelihood of certain complications as mentioned earlier.
Drug/alcohol abuse: The patient's admission of cocaine and alcohol use, even if occasional, is a concerning factor for pregnancy. Cocaine, in particular, is a potent vasoconstrictor that can negatively impact fetal growth and development. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders (FASDs), which can cause a range of physical, cognitive, and behavioral problems.
Choice D rationale:
Age: As explained previously, the patient's age is not a high-risk factor.
BMI: The patient's BMI is a contributing factor, but not the most significant one in this case.
Family history: The patient's family history is relevant, but the presence of a neural tube defect in a close relative is the most significant aspect of her family history in terms of pregnancy risk.
Correct Answer is C
Explanation
Choice A rationale:
Attaching the IV line to the distal port is not a safe practice for oxytocin administration. This is because oxytocin is a high-alert medication that can have serious adverse effects if administered incorrectly. Attaching the IV line to the distal port increases the risk of the medication being infused too quickly, which can lead to uterine hyperstimulation, fetal distress, or even uterine rupture. The safest practice is to attach the IV line to the proximal port, which is closer to the patient's body and allows for slower infusion rates.
Choice B rationale:
Customizing the concentration of oxytocin is not a recommended practice. Oxytocin is available in a premixed solution of 10 units/mL, and this concentration should not be altered. Altering the concentration can lead to dosing errors and increase the risk of adverse effects.
Choice D rationale:
Titrating oxytocin to gravity is not a safe practice. Oxytocin should be administered using an infusion pump that can accurately control the infusion rate. Infusion pumps are necessary to ensure that the medication is administered at the correct dose and rate. Gravity-based infusions are less accurate and can lead to over- or under-infusion of the medication.
Choice C rationale:
Two RN verification is a safe practice for oxytocin administration. This practice involves having two registered nurses independently verify the medication, dose, and infusion rate before administration. This helps to prevent errors and ensure that the medication is administered safely.
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