A nurse is assisting an anesthesiologist who is inserting an epidural catheter. Which of the following positions should the nurse assist the woman into?

Correct Answer: A

Rationale: The correct position for a woman to be in when inserting an epidural catheter is the fetal position. This position allows for easier access to the epidural space in the lower back. The fetal position involves the patient curling up on their side with their knees drawn up towards their chest. This position helps to widen the spaces between the vertebrae, making it easier for the anesthesiologist to insert the catheter into the epidural space. Option B, the lithotomy position, is not appropriate for inserting an epidural catheter. The lithotomy position involves the patient lying on their back with their legs elevated and spread apart. This position is typically used for gynecological exams and procedures, not for epidural placement. Option C, the Trendelenburg position, is also not suitable for inserting an epidural catheter. The Trendelenburg position involves the patient lying flat on their back with the legs elevated higher than the head. This position is used to improve venous return to the heart and is not necessary or beneficial for epidural placement. Option D, the lateral recumbent position, is not the ideal position for inserting an epidural catheter either. The lateral recumbent position involves the patient lying on their side with their top leg straight and bottom leg bent. While this position may be used for certain medical procedures, it does not provide the optimal access to the epidural space for catheter insertion.

Correct Answer: C

Rationale: Choice A is incorrect because encouraging the father to hold his partner's hand during labor is not specifically related to the patient's religious or cultural beliefs as an Orthodox Jewish woman. While emotional support is important during labor, this choice does not address any specific cultural needs of the patient. Choice B is incorrect because asking the woman if she would like to speak with her priest assumes that the patient is Catholic or another faith that has priests. In this case, the patient is identified as being Orthodox Jewish, so it would not be appropriate to offer the services of a priest, as this does not align with her religious beliefs. Choice D is incorrect because placing an order for the woman's postpartum vegetarian diet assumes that all Orthodox Jewish individuals follow a vegetarian diet, which is not necessarily the case. While some may choose to follow a vegetarian diet for religious or personal reasons, it is not a universal practice among Orthodox Jewish individuals. Choice C is the correct answer because providing the woman with a long-sleeved hospital gown aligns with the modesty and privacy guidelines of Orthodox Jewish women. Modesty is an important aspect of Orthodox Jewish culture, and providing appropriate attire that respects this aspect of her beliefs is an important part of culturally competent care.

Correct Answer: A

Rationale: To calculate the drip rate for the IV infusion, you first need to determine the total volume of fluid to be infused per hour. The order is to infuse 1000 cc of D5 1/2 NS at a rate of 150 cc/hr. Next, you need to convert the volume to drops per minute using the drop factor of 10 gtt/cc. First, calculate the total volume to be infused per hour: 1000 cc ÷ 150 cc/hr = 6.67 hours Next, convert the volume to drops per minute: 1000 cc × 10 gtt/cc = 10,000 gtt 10,000 gtt ÷ 60 min = 166.67 gtt/min Therefore, the correct drip rate is 167 gtt/min (rounded to the nearest whole number), which corresponds to answer choice A. Choices B, C, and D are marked as N/A because they do not provide a numerical value for the drip rate. These choices are incorrect as they do not offer a solution to the question posed. The correct answer, choice A, is based on accurate calculations and proper conversion of units to determine the appropriate drip rate for the IV infusion.

Correct Answer: A

Rationale: Before proceeding with a physical assessment, the nurse should check the client's weight gain in the prenatal record. This is important because weight gain during pregnancy is a significant indicator of the health of both the mother and the developing fetus. Monitoring weight gain helps healthcare providers assess if the mother is gaining an appropriate amount of weight for a healthy pregnancy and if there are any potential complications such as gestational diabetes or preeclampsia. Choice B, the client's ethnicity and religion, is incorrect because while cultural considerations are important in providing individualized care, they do not directly impact the physical assessment process. Choice C, the client's age, is also incorrect as age alone does not provide enough information to determine the client's health status during pregnancy. Choice D, the type of insurance the woman has, is incorrect because insurance status is not a determining factor in conducting a physical assessment. While insurance coverage may impact the client's access to healthcare services, it does not directly influence the physical assessment process. Monitoring weight gain is essential for assessing the health and well-being of both the mother and the developing fetus during pregnancy.

Correct Answer: C

Rationale: If a hard round mass is felt in the fundal area and a soft round mass is felt above the symphysis, the nurse can conclude that the fetal position is in a vertical lie. This is because the hard round mass in the fundal area indicates the head of the fetus, which is the presenting part in a vertical lie. The soft round mass above the symphysis is likely the buttocks or back of the fetus, further supporting the vertical lie position. Choice A, transverse position, is incorrect because in a transverse position, the fetus would be lying sideways across the abdomen, not with a hard round mass in the fundal area and a soft round mass above the symphysis. Choice B, vertex presentation, is also incorrect because a vertex presentation refers to the head of the fetus being the presenting part, which would not explain the soft round mass felt above the symphysis. Choice D, attitude is difficult to determine, is not the correct answer because based on the description provided, the nurse can actually make a conclusion about the fetal position being in a vertical lie based on the different characteristics of the masses felt in the fundal area and above the symphysis.