Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth

Select one:

Bulging of the vulva

The membranes rupture during a contraction

The fetal head is felt at 0 station during vaginal examination

Bloody mucus discharge increases

Answer and Explanation

The Correct Answer is A

a.   Bulging of the vulva: This indicates that the fetal head is descending but does not necessarily mean the woman is almost ready to give birth. This indicates that the fetal head is crowning and putting pressure on the perineum, which means that delivery is imminent.
b.   This indicates that the amniotic sac has ruptured but does not necessarily mean the woman is almost ready to give birth.
c.   The fetal head at 0 station means that it is at the level of the maternal ischial spines, but it still needs to descend further to reach the perineum.
d.   This indicates that the woman is in the early stages of labor but does not necessarily mean she is almost ready to give birth.

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Correct Answer is A

Explanation

a. This would help determine the location of the placenta and whether placenta previa is present, which can cause painless vaginal bleeding.
b. This is not typically done for diagnosis of painless vaginal bleeding.
c. While an abdominal ultrasound can also determine the location of the placenta, a vaginal ultrasound is more accurate for this purpose.
d. This is not typically done for diagnosis of painless vaginal bleeding.

A. Continuous fetal monitoring B. Obtain a daily weight. C. c Assess deep tendon reflexes every hour. D. Ambulate as tolerated

Correct Answer is D

Explanation

a. This is an appropriate order for a client with severe preeclampsia to monitor fetal well-being.
b. This is an appropriate order for a client with severe preeclampsia to monitor fluid status.
c. This is an appropriate order for a client with severe preeclampsia to monitor for signs of worsening preeclampsia.
d. This order may not be appropriate for a client with severe preeclampsia who may be at risk for falls or other complications. The nurse should clarify this order with the provider.

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Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth Select one:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider's orders. Which of the following orders requires clarification?

Correct Answer is D

Explanation

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Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth

Select one: