If shoulder dystocia occurred during delivery, the newborn should be examined for

Correct Answer: A

Rationale: In cases of shoulder dystocia during delivery, the newborn should be examined for a fractured clavicle and Erb's palsy. This is because shoulder dystocia can lead to excessive traction on the baby's shoulder during delivery, potentially causing injuries such as a fractured clavicle (collarbone) due to the pressure exerted. Erb's palsy, also known as brachial plexus injury, can occur when there is stretching or tearing of the nerves in the baby's shoulder, leading to weakness or paralysis of the affected arm. Option B, skull fracture and cerebral palsy, is incorrect because shoulder dystocia primarily affects the shoulder area, not the head where skull fractures may occur. Cerebral palsy is a neurological disorder not directly related to shoulder dystocia. Option C, spinal cord injury and paralysis, is incorrect as shoulder dystocia does not typically result in spinal cord injuries. Paralysis is more commonly associated with nerve injuries like Erb's palsy in cases of shoulder dystocia. It is crucial for healthcare providers to be aware of potential complications following shoulder dystocia to provide appropriate care and early intervention for any injuries sustained during birth. Understanding the specific injuries that may result from shoulder dystocia is essential for ensuring the well-being of the newborn and guiding the appropriate course of treatment.

Correct Answer: A

Rationale: In the context of breastfeeding, the correct answer is A) tetracyclines. Tetracyclines can pass into breast milk and have the potential to harm the baby's developing teeth and bones. Therefore, they are not recommended for long-term use while breastfeeding. Erythromycin (Option B) and cephalosporins (Option C) are generally considered safe during breastfeeding as they have a lower risk of adverse effects on the infant. Providing this information is crucial for healthcare professionals working with breastfeeding women to ensure safe medication practices. Understanding the specific considerations for medication use during breastfeeding is essential for promoting the health and well-being of both the mother and the infant.

Correct Answer: B

Rationale: In the postpartum period, the correct answer to this question is B) bladder distension. When the nurse palpates the uterus and finds the fundus displaced superior to the umbilicus and to the right, it suggests that the bladder is full and pushing the uterus upwards and to the right. Bladder distension is common after childbirth due to the pressure exerted by the uterus on the bladder, especially if the mother has difficulty emptying her bladder completely. Option A) uterine atony is incorrect because uterine atony would typically present as a boggy uterus that is enlarged and displaced, not shifted to a specific direction like in this scenario. Option C) uterine hemorrhage would not cause the fundus to be displaced in a specific direction; instead, it would result in excessive bleeding. Educationally, understanding the postpartum assessment is crucial for nurses caring for postpartum women. Recognizing the signs of bladder distension is important to prevent complications such as uterine displacement, urinary retention, and potential infection. Proper education on postpartum assessment helps nurses provide optimal care to new mothers during a critical period of recovery.

Correct Answer: B

Rationale: In the context of a woman who has taken methadone during pregnancy and wishes to breastfeed, the correct answer is B) continue the same dose of methadone. This is because abrupt cessation of methadone can lead to withdrawal symptoms in both the mother and the infant, which can be harmful. By continuing the same dose, the woman can safely breastfeed while managing her opioid dependence. Option A) take the lowest dose of methadone is incorrect because sudden dose reduction can also trigger withdrawal symptoms. Option C) stop taking methadone is not recommended as it can lead to relapse and harm the mother's and infant's well-being. Educationally, it is crucial to understand the principles of medication management during pregnancy and lactation. Methadone maintenance therapy is a common approach for pregnant women with opioid use disorder to prevent withdrawal and reduce the risk of relapse. Continuation of a stable methadone dose under medical supervision is generally considered safe for breastfeeding, as the benefits often outweigh the risks. It is essential for healthcare providers to support and educate women on the best practices for managing opioid dependence while breastfeeding to ensure the health and well-being of both the mother and the infant.

Correct Answer: A

Rationale: In the context of normal anatomy and physiology of the female pelvis, it's important to understand the typical postpartum changes that occur. In this scenario, the correct answer is A) normal postpartal elevation. After delivery, it is common for a woman's white blood cell count to increase as a normal physiological response to the stress of childbirth. The count can reach up to 30,000-40,000 cells/mm3 without indicating infection. By the second day postpartum, a count of 40,000 is within the expected range for this normal postpartal elevation. Option B) acute infection is incorrect because in cases of infection, the white blood cell count would typically be much higher than 40,000, indicating a more severe immune response. Option C) chronic infection is also incorrect as chronic infections usually present with more subtle changes in white blood cell count over a longer period of time, rather than the rapid increase seen in this case. Understanding these normal physiological changes is crucial for healthcare providers working in obstetrics and gynecology to differentiate between expected postpartum elevations and signs of infection, ensuring appropriate care for postpartum women.