The nurse is assessing the client for the presence of ballottement. Which should the nurse perform to test for the presence of ballottement?

Correct Answer: C

Rationale: The correct answer is C. To test for the presence of ballottement, the nurse should initiate a gentle upward tap on the cervix. Ballottement is a technique used in obstetrics to assess for the presence of a floating object in the uterus, such as a fetus. By tapping the cervix gently, the nurse can feel for a rebound effect, indicating the presence of a floating object. This technique helps to confirm the presence of a fetus in the uterus. Explanation of why other choices are incorrect: A: Palpating the uterus for contractions is not relevant to testing for ballottement. B: Assessing the skin for increased pigmentation is not related to assessing for the presence of a floating object in the uterus. D: Palpating the abdomen for fetal outline does not specifically test for ballottement, which involves tapping the cervix.

Correct Answer: B

Rationale: The correct answer is B: 41-year-old. Advanced maternal age increases the risk of labor dystocia due to reduced uterine muscle tone and coordination. Older individuals are more likely to experience prolonged labor or difficulty with fetal descent. Choice A (38-week gestation) is not a risk factor for labor dystocia. Prenatal anemia (Choice C) may lead to complications during pregnancy but is not directly linked to labor dystocia. Lack of prenatal care (Choice D) can increase the risk of complications but is not a specific risk factor for labor dystocia.

Correct Answer: C

Rationale: The correct answer is C: misoprostol. Misoprostol is used for cervical ripening in obstetrics due to its ability to soften and dilate the cervix, making it favorable for induction of labor. It is a prostaglandin E1 analogue that helps prepare the cervix for childbirth. Amniotomy (A) is the artificial rupture of membranes and does not directly aid in cervical ripening. Hemabate (B) is a medication used to treat postpartum hemorrhage, not for cervical ripening. Progesterone (D) is a hormone that helps maintain pregnancy and is not used for cervical ripening.

Correct Answer: D

Rationale: The correct answer is D: fetal growth restriction. Oligohydramnios refers to low levels of amniotic fluid, which can restrict fetal growth due to decreased cushioning and space for movement. This can lead to complications such as poor fetal nutrition, musculoskeletal abnormalities, and pulmonary hypoplasia. Fetal macrosomia (A) is the opposite of fetal growth restriction, preterm labor (B) is not directly associated with oligohydramnios, and placenta previa (C) is a separate condition involving the placenta's position in the uterus.

Correct Answer: C

Rationale: The correct answer is C: postterm birth. Multiple gestation, such as twins or triplets, often leads to a higher risk of postterm birth due to the increased likelihood of preterm labor and delivery. This is because the uterus may become overdistended and unable to maintain the pregnancy to full term, resulting in postterm birth. Incorrect choices: A: Tachysystole is excessive uterine contractions, which is not directly related to multiple gestation. B: Postterm birth is already covered as the correct answer. D: Early decelerations are a common finding in labor but not specifically associated with multiple gestation complications.