What type of dystocia should the nurse prepare for if prominent ischial spines are palpated?

Correct Answer: A

Rationale: If prominent ischial spines are palpated during a pelvic exam, the nurse should prepare for pelvic dystocia. Pelvic dystocia refers to a type of obstructed labor where the baby's head is unable to pass through the maternal pelvis due to various reasons, such as the shape or size of the pelvis. Prominent ischial spines indicate a narrow pelvic outlet, which can obstruct the passage of the baby during labor. Incorrect choices: B: Fetal dystocia is related to issues with the fetus itself, such as abnormal presentation or size. Palpating prominent ischial spines does not directly indicate fetal dystocia. C: Contraction dystocia refers to ineffective uterine contractions that can lead to labor complications. Palpating ischial spines is not a sign of contraction dystocia. D: Uterine dystocia involves abnormalities in the uterus that can hinder labor progress. Palpating ischial spines is more indicative of a pelvic issue rather than a uterine problem. In summary, the correct answer is A because prominent ischial spines suggest a potential obstruction in the pelvic outlet, which can lead to pelvic dystocia during labor.

Correct Answer: A

Rationale: A precipitous labor is defined as a labor that lasts less than 3 hours from the onset of contractions to delivery. This rapid labor process can lead to various complications for the newborn, including respiratory distress. Choice A: Respiratory distress is a common neonatal complication of precipitous labor because the rapid delivery does not allow for the normal process of fluid being squeezed out of the baby's lungs as it passes through the birth canal. This can result in the baby having difficulty breathing after birth. Choice B: Low birth weight is not typically associated with precipitous labor. The speed of labor does not necessarily impact the baby's weight at birth, as this is more influenced by factors such as maternal nutrition and health during pregnancy. Choice C: Prelabor rupture of membranes refers to the breaking of the amniotic sac before labor begins. While this can lead to complications such as infection, it is not specifically linked to precipitous labor. Choice D: Placenta previa is a condition where the placenta partially or completely covers the cervix, which can cause bleeding during pregnancy and delivery. This is not directly related to the speed of labor, so it is not a neonatal complication of precipitous labor. In conclusion, the correct answer is A because respiratory distress is a common neonatal complication of precipitous labor due to the lack of time for proper fluid clearance in the baby's lungs during delivery.

Correct Answer: B

Rationale: Preeclampsia is a serious condition that can occur during pregnancy, characterized by high blood pressure and signs of damage to other organ systems. Magnesium sulfate is the medication of choice for managing preeclampsia because it helps prevent seizures (eclampsia) and can lower blood pressure. Option A, ampicillin, is an antibiotic used to treat bacterial infections, not preeclampsia. It would not address the underlying issue of high blood pressure in preeclampsia. Option C, nalbuphine hydrochloride (Nubain), is an opioid pain medication used for pain relief during labor, it does not treat preeclampsia or its associated symptoms. Option D, sodium bicarbonate, is used to treat acidosis or certain types of poisoning, not preeclampsia. It would not address the high blood pressure or prevent seizures associated with preeclampsia. In conclusion, magnesium sulfate is the correct medication for preeclampsia as it helps prevent seizures and manage high blood pressure, which are critical in the management of this condition.

Correct Answer: C

Rationale: Multiple gestation refers to the presence of more than one fetus in the uterus, such as twins or triplets. One complication that can arise from multiple gestation is uterine dystocia. Uterine dystocia is a condition in which the uterus is unable to contract effectively during labor, leading to difficulties in the progression of labor and potentially increasing the risk of complications for both the mother and the babies. Choice A, tachysystole, refers to excessively frequent contractions of the uterus. While tachysystole can be a complication of labor, it is not specifically associated with multiple gestation. In fact, tachysystole is more commonly seen in cases of induced or augmented labor, rather than in cases of multiple gestation. Choice B, postterm birth, refers to a pregnancy that extends beyond 42 weeks gestation. While multiple gestation can increase the risk of preterm birth (delivery before 37 weeks), it is not typically associated with postterm birth. Postterm birth is more commonly seen in singleton pregnancies and is not a direct complication of multiple gestation. Choice D, early decelerations, refers to a pattern seen on fetal heart rate monitoring during labor. Early decelerations are typically associated with head compression during contractions and are not specifically linked to multiple gestation. While fetal heart rate patterns should be closely monitored during labor, early decelerations are not a direct complication of multiple gestation. In conclusion, the correct answer is C, uterine dystocia, as this is a potential complication that can arise specifically from multiple gestation. Choices A, B, and D are incorrect as they are not directly associated with multiple gestation or are more commonly seen in other pregnancy scenarios.

Correct Answer: C

Rationale: C: Skull fracture is the correct answer for a fetal complication of obstetric forceps. When forceps are used during delivery, there is a risk of excessive pressure being applied to the baby's head, which can result in a skull fracture. This can lead to serious complications for the baby, including brain injury and potential long-term developmental issues. A: Flexion of the head is not a fetal complication of obstetric forceps. While forceps may be used to help guide the baby's head through the birth canal, the goal is to assist with delivery rather than causing excessive flexion of the head. B: Abdominal complications are not typically associated with the use of obstetric forceps. Forceps are specifically designed to assist with the delivery of the baby's head and are not typically used in a way that would cause abdominal complications for the fetus. D: Femur fracture is not a fetal complication of obstetric forceps. Forceps are not applied to the baby's legs or lower body during delivery, so the risk of a femur fracture would not be associated with the use of forceps.