A laboring patient's obstetrician suggested an amniotomy as a method for inducing the labor. Which assessment must be made before the amniotomy is performed?

Correct Answer: A

Rationale: Before performing an amniotomy (artificial rupture of membranes), it is essential to assess the fetal presentation, position, and station. This assessment helps ensure that the procedure is performed safely without causing harm to the baby. Knowing the fetal presentation (such as breech, transverse, or vertex), position (occiput anterior, occiput posterior, etc.), and station (how far down the baby's head is in the pelvis) allows the obstetrician to determine the best approach and technique for the amniotomy. It also helps in reducing the risk of complications during labor induction and delivery. Therefore, this assessment is crucial in ensuring the well-being of both the mother and the baby during the labor process.

Correct Answer: C

Rationale: Headache and vision changes can signal worsening preeclampsia, requiring prompt medical attention.

Correct Answer: A

Rationale: Uterine rupture is a rare but serious obstetric emergency that can occur during labor and delivery. One of the key assessment findings indicating uterine rupture is when contractions (ctx) abruptly stop during labor. This abrupt cessation of contractions can be a sign that the uterine muscle has torn due to excessive pressure or force, leading to a disruption in the normal progress of labor. Other signs and symptoms of uterine rupture may include severe abdominal pain, abnormal fetal heart rate patterns, loss of fetal station, and signs of hypovolemic shock in the mother. Immediate intervention and surgical management are required in cases of uterine rupture to ensure the safety of both the mother and the baby.

Correct Answer: B

Rationale: The diaphragm should be used with spermicide for maximum effectiveness. Choice A is incorrect because while the diaphragm is effective, spermicide enhances its performance and ensures greater protection. Choice C is unnecessary, as the diaphragm alone with spermicide is sufficient. Choice D is incorrect because while regular replacement is recommended, it does not require a backup method.

Correct Answer: A

Rationale: In the context of the question, the nurse is monitoring a 34-week gestation client. At 34 weeks, the trophoblast or inner cell mass has already developed into the placenta, which is formed earlier in pregnancy. Therefore, choice A is the most relevant option in this scenario. Trophoblast is critical for implantation and the formation of the placenta, which plays a vital role in supporting the developing fetus by providing oxygen and nutrients. Understanding the different stages of fetal development can help the nurse provide optimal care and monitor for any potential issues that may arise during pregnancy.