What is a sign of fetal distress?

Correct Answer: C

Rationale: Repetitive late decelerations (Choice C) are a sign of fetal distress because they indicate that there is a decreased blood flow and oxygen supply to the fetus during contractions. Late decelerations occur when the fetal heart rate decreases after the peak of a contraction, which is a concerning sign as it suggests that the fetus is not receiving enough oxygen. When late decelerations occur repeatedly, it signifies that the fetus is not tolerating labor well and is in distress. Prolonged moderate variability (Choice A) is actually a normal finding in fetal heart rate monitoring. Moderate variability refers to the fluctuations in the fetal heart rate that indicate a healthy autonomic nervous system. It is a reassuring sign that the fetus is well-oxygenated and not in distress. Accelerations (Choice B) are also a positive sign in fetal heart rate monitoring. Accelerations are temporary increases in the fetal heart rate that occur in response to fetal movement or stimulation. They indicate a healthy, responsive fetal central nervous system and are a reassuring sign that the fetus is not in distress. Variable decelerations (Choice D) are another type of deceleration that occur in response to umbilical cord compression. While variable decelerations can be concerning, they are not as specific as late decelerations in indicating fetal distress. Variable decelerations can also be caused by other factors such as maternal position changes or cord compression that may not necessarily indicate fetal distress.

Correct Answer: B

Rationale: The placenta is considered retained when it has not been delivered within 30 minutes after the birth of the baby. This is because the placenta should ideally be delivered within this time frame to prevent any complications such as excessive bleeding or infection for the mother. Choice A: 10 minutes is too short of a time frame to diagnose the placenta as retained. It is normal for the placenta to take some time to be delivered after the baby is born, so 10 minutes would be premature to consider it retained. Choice C: 1 hour is too long of a time frame to diagnose the placenta as retained. Waiting for an hour could lead to potential complications for the mother if the placenta is indeed retained, as it should ideally be delivered within 30 minutes. Choice D: 2 hours is also too long of a time frame to diagnose the placenta as retained. Waiting for 2 hours could put the mother at risk for complications associated with a retained placenta, so it is not the correct answer. In conclusion, the correct answer is B (30 minutes) because it is the appropriate time frame within which the placenta should be delivered to prevent any potential complications for the mother.

Correct Answer: D

Rationale: Methylergonovine is the correct answer for treating uterine atony. Uterine atony is a condition where the uterus fails to contract after childbirth, leading to postpartum hemorrhage. Methylergonovine is a medication that works by causing the uterine muscles to contract, helping to control bleeding and prevent further complications. This drug is specifically used to treat postpartum hemorrhage caused by uterine atony. Ampicillin (Choice A) is an antibiotic used to treat bacterial infections, not uterine atony. Nitroglycerine (Choice B) is a vasodilator used to treat conditions like angina and heart failure, not uterine atony. Magnesium sulfate (Choice C) is a medication used to prevent seizures in conditions like preeclampsia and eclampsia during pregnancy, not specifically for treating uterine atony. In conclusion, methylergonovine is the correct choice for treating uterine atony because it helps stimulate uterine contractions and control postpartum bleeding. The other options are not appropriate for this condition and do not address the underlying issue of uterine atony.

Correct Answer: B

Rationale: Restlessness, cyanosis, and nasal flaring are all signs that indicate an alteration in oxygenation, making option B the correct answer. Restlessness is a common symptom seen in individuals who are experiencing difficulty breathing or low oxygen levels in their blood. Cyanosis, on the other hand, is a bluish discoloration of the skin and mucous membranes that occurs when there is inadequate oxygenation of the blood. It is a clear indication that the body is not receiving enough oxygen. Nasal flaring, where the nostrils widen during breathing, is a compensatory mechanism used by the body to try to increase airflow and oxygen intake. Option A, liver failure, is incorrect because restlessness, cyanosis, and nasal flaring are not typical signs or symptoms associated with liver failure. Liver failure is more commonly linked to symptoms such as jaundice, abdominal pain, and swelling in the legs and abdomen. Option C, preeclampsia, is also incorrect because while preeclampsia can cause high blood pressure and protein in the urine during pregnancy, it does not typically present with restlessness, cyanosis, or nasal flaring as primary symptoms. Preeclampsia is more commonly associated with symptoms such as headaches, blurred vision, and upper abdominal pain. Option D, gestational diabetes, is also an incorrect choice as restlessness, cyanosis, and nasal flaring are not indicative of gestational diabetes. Gestational diabetes is a condition characterized by high blood sugar levels during pregnancy and is often associated with symptoms such as excessive thirst, frequent urination, and fatigue. In conclusion, the presence of restlessness, cyanosis, and nasal flaring is a clear indication of an alteration in oxygenation, making option B the correct choice in this scenario.

Correct Answer: D

Rationale: Vaginal examination provides the most valuable information regarding the client's labor status because it allows healthcare providers to assess cervical dilation, effacement, and station of the fetus in the birth canal. These factors are crucial in determining the progress of labor and whether the client is in active labor or not. Leopold's maneuvers (Choice A) are a series of four movements used to assess the position of the fetus in the uterus. While this assessment can provide valuable information about fetal position, it does not provide direct information about the client's labor status. Fundal contractility (Choice B) refers to the strength and frequency of contractions of the uterus. While monitoring fundal contractility is important during labor, it does not provide information about cervical dilation or the position of the fetus, which are key indicators of labor progress. Fetal heart assessment (Choice C) is important for monitoring the well-being of the fetus during labor. However, it does not provide direct information about the client's labor status in terms of cervical dilation and fetal position. It is more focused on the fetal response to labor rather than the progress of labor itself. In conclusion, vaginal examination is the most valuable assessment for determining the client's labor status as it provides direct information about cervical dilation, effacement, and fetal station, which are critical indicators of labor progress.