A fetal associated risk of prolonged pregnancy includes

Correct Answer: A

Rationale: The correct answer is A: Fetal macrosomia. Prolonged pregnancy increases the risk of fetal macrosomia due to continued fetal growth beyond the normal term. This can lead to complications during delivery, such as shoulder dystocia and birth injuries. Placental dysfunction and cesarean section are possible outcomes of prolonged pregnancy but are not directly associated with fetal risks in this context. Shoulder dystocia is a potential complication of fetal macrosomia but is not a direct fetal risk of prolonged pregnancy.

Correct Answer: B

Rationale: The correct answer is B: Assess fetal lung maturity. Amniotic fluid analysis measures the levels of substances like surfactant, which indicates lung maturity. This helps in determining if the fetus is ready for delivery. Other choices are incorrect because amniotic fluid analysis is not primarily used to detect fetal infections (A), determine fetal position (C), or assess placental health (D). These functions are typically achieved through other diagnostic tests or imaging techniques.

Correct Answer: D

Rationale: The correct answer is D because both statements A and C are true. Older mothers have a higher risk of developing preeclampsia due to age-related complications. Additionally, advanced maternal age is associated with an increased likelihood of requiring a cesarean section due to factors like decreased uterine elasticity. Statement B is incorrect as younger mothers are not at higher risk of miscarriage compared to older mothers. This is because maternal age is not a significant factor in miscarriage risk.

Correct Answer: C

Rationale: The correct answer is C because precipitate labor is defined as labor that is concluded in less than three hours. This rapid progression can lead to complications such as increased risk of tearing and fetal distress. Choice A is incorrect because it describes a different condition where the cervix fails to dilate despite good contractions. Choice B is incorrect as it contradicts the definition of precipitate labor. Choice D is incorrect as it describes a scenario where the cervix fails to dilate due to poor uterine contractions, which is not characteristic of precipitate labor. Therefore, choice C is the correct answer based on the definition and characteristics of precipitate labor.

Correct Answer: B

Rationale: The correct answer is B. It is important to manage medications appropriately preoperatively to minimize complications. Metoprolol, a beta blocker, should be continued up until the day of surgery to prevent rebound hypertension or tachycardia. Metformin should be held on the day of surgery to avoid potential lactic acidosis due to its effects on kidney function. Warfarin should be discontinued 5-7 days before surgery to reduce the risk of bleeding. Vitamin E can increase bleeding risk and should be discontinued. Choice A is incorrect as not all medications should be taken until the morning of surgery. Choice C is incorrect as warfarin should be held earlier than 5 days before surgery. Choice D is incorrect as metformin should be held on the day of surgery, regardless of blood sugar levels, to prevent lactic acidosis.

Correct Answer: B

Rationale: The correct answer is B - Culture and level of education. Culture influences beliefs about pain and coping mechanisms. Education can affect understanding of pain and pain management techniques. Labor preparedness and fatigue (A) may impact pain perception but are not as influential. Age (C) alone does not determine pain perception. Number of deliveries and anxiety (D) can play a role but are not as significant as culture and education.

Correct Answer: A

Rationale: The correct answer is A: Frank breech, complete breech, footling breech. In a frank breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and extended at the knees. In a complete breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and knees. In a footling breech presentation, one or both of the baby's feet are positioned to come out first. These are the three main types of breech presentations. Choices B, C, and D do not accurately describe the different types of breech presentations, making them incorrect.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

Correct Answer: A

Rationale: The correct answer is A: Observation. As an AGACNP, observation is crucial for monitoring the progression of the condition before considering any invasive treatments. Hyperextension casting (B) and Jewett brace (C) are more specific interventions for spinal conditions and not typically indicated for this scenario. Surgical intervention (D) is typically considered only if conservative treatments fail, making it a last resort option. Therefore, observation allows for a conservative approach to assess the patient's response to initial management before considering more aggressive interventions.