A client in active labor at 39 weeks of gestation is receiving continuous IV oxytocin and has early decelerations in the FHR on the monitor tracing. What action should the nurse take?

Correct Answer: B

Rationale: The correct action for the nurse to take when a client in active labor at 39 weeks of gestation has early decelerations in the FHR on the monitor tracing is to continue monitoring the client. Early decelerations are typically benign and are associated with head compression during contractions, which is a normal response to labor. There is no need to discontinue the oxytocin infusion as early decelerations do not indicate fetal distress. Requesting the provider to assess the client may not be necessary at this point unless other concerning signs are present. Increasing the infusion rate of the maintenance IV fluid is not indicated as it would not address the early decelerations. Therefore, the best course of action is to continue monitoring the client for any changes in the FHR pattern.

Correct Answer: D

Rationale: The correct answer is D: Pregestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine during pregnancy. Pregestational diabetes is a known risk factor for developing preeclampsia due to the underlying vascular and inflammatory changes associated with diabetes. In contrast, choices A, B, and C are not typically considered risk factors for preeclampsia. A singleton pregnancy (choice A) is a normal occurrence and not a risk factor for preeclampsia. A BMI of 20 (choice B) falls within the healthy weight range and is not a known risk factor for preeclampsia. Maternal age of 32 years (choice C) is also not considered a significant risk factor for preeclampsia in the absence of other factors.

Correct Answer: C

Rationale: The correct answer is C: "I plan to drink more orange juice while taking this pill." Orange juice is rich in vitamin C, which enhances the absorption of iron from ferrous sulfate, helping to combat iron deficiency anemia during pregnancy. Taking the pill with a vitamin C source is important for optimal absorption. A: Taking the pill with breakfast may not provide enough vitamin C for optimal absorption. B: Milk may inhibit iron absorption due to its calcium content, so it is not ideal to take with ferrous sulfate. D: While increasing calcium-rich foods is important during pregnancy, it is not directly related to enhancing iron absorption from ferrous sulfate.

Correct Answer: D

Rationale: The correct answer is D: Place the newborn skin-to-skin on the mother's chest. This technique promotes bonding, warmth, and comfort, which can help minimize the newborn's pain perception during the procedure. Skin-to-skin contact releases oxytocin, which has analgesic effects. It also provides emotional support and reduces stress for both the newborn and the mother. A, applying a cool pack, may cause vasoconstriction and increase pain perception. B, requesting an IM analgesic, is not typically necessary for a routine heel stick and may have potential adverse effects. C, using a manual lancet, does not address the emotional and psychological aspects of pain perception in newborns.

Correct Answer: D

Rationale: The correct sequence for performing Leopold maneuvers is to first palpate the fundus to identify the fetal part (A), then determine the location of the fetal back (B), and finally palpate for the fetal part presenting at the inlet (C). Choosing option D (All of the Above) is correct because it encompasses all the necessary steps in the correct order to perform Leopold maneuvers effectively. Palpating the fundus helps identify the presenting part, determining the location of the fetal back provides information on the fetal lie, and palpating for the presenting part at the inlet helps confirm the position of the fetus. The other choices are incorrect because they do not provide the complete sequence required for performing Leopold maneuvers accurately.

Correct Answer: C

Rationale: The correct answer is C because it accurately describes an episiotomy as an incision made by the provider to facilitate delivery of the fetus. This information is crucial for the client to understand the purpose and potential benefits of the procedure. A: While choice A is similar to the correct answer, it includes unnecessary detail about who makes the incision, which may confuse the client. B: Choice B is incorrect as it provides inaccurate information about a fourth-degree episiotomy extending into the rectal area, which is not recommended as it would involve cutting through the anal sphincter. D: Choice D is incorrect because it introduces unnecessary information about the types of episiotomies without providing the basic understanding of what an episiotomy is.

Correct Answer: D

Rationale: The correct answer is D: All of the Above. All three infections - Gonorrhea, Chlamydia, and HIV - can be treated during labor or immediately following birth to prevent transmission to the newborn. Antibiotics can be administered for Gonorrhea and Chlamydia, while antiretroviral medications can be given for HIV. Prompt treatment is crucial to reduce the risk of vertical transmission. The other choices are incorrect because each infection listed can be effectively managed during labor or post-birth, making choice D the most comprehensive and accurate option.

Correct Answer: D

Rationale: The correct answer is D: Calcium gluconate. When magnesium sulfate toxicity is suspected, calcium gluconate is administered because it antagonizes the effects of magnesium on the heart and central nervous system. This helps to counteract the muscle weakness, respiratory depression, and cardiac arrhythmias associated with magnesium toxicity. Nifedipine (A) is a calcium channel blocker and is not indicated for magnesium toxicity. Pyridoxine (B) is a form of vitamin B6 and is not used to treat magnesium toxicity. Ferrous sulfate (C) is an iron supplement and is not relevant in the management of magnesium toxicity.

Correct Answer: A

Rationale: The correct answer is A: Contractions become stronger with walking. This is because true labor is characterized by contractions that consistently increase in intensity and frequency, which is often enhanced by physical activity like walking. Contractions in false labor do not typically intensify with movement. Discomfort in true labor is usually not easily relieved by a back massage (B) and contractions in true labor remain regular even with changes in activity (C). Discomfort in true labor is typically felt in the lower abdomen and back, not above the umbilicus (D).