A client with an obstetrical history of G1 P0000 received dinoprostone for cervical ripening 8 hours ago.
The Bishop score at that time was 4. The Bishop score is now 10. Which of the following actions by the nurse is appropriate?
Report abnormal findings to the obstetrician.
Place client on her side.
Monitor for onset of labor.
Perform nitrazine analysis of amniotic fluid.
The Correct Answer is C
Choice A rationale
Reporting abnormal findings to the obstetrician is unnecessary because an increase in the Bishop score from 4 to 10 indicates successful cervical ripening and readiness for labor induction.
Choice B rationale
Placing the client on her side is not directly related to the assessment of cervical ripening or the Bishop score. It may be considered for comfort during labor.
Choice C rationale
Monitoring for the onset of labor is appropriate since the increase in the Bishop score to 10 suggests that the cervix is favorable for labor. Continuous monitoring is essential to detect the onset and progression of labor.
Choice D rationale
Performing nitrazine analysis of amniotic fluid is not relevant to the assessment of cervical ripening or the Bishop score. This test is typically used to confirm the presence of amniotic fluid in cases of suspected rupture of membranes.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A respiratory rate of 18 breaths/min is normal and does not indicate magnesium toxicity or the need for calcium gluconate.
Choice B rationale
Urinary output of 30 mL/hr is within the acceptable range and does not suggest magnesium toxicity. This indicates adequate renal function.
Choice C rationale
Patellar reflexes rated at one indicate mild hyporeflexia, which can be a side effect of magnesium sulfate but does not necessitate immediate intervention.
Choice D rationale
Serum magnesium level of 10 mg/dL is significantly elevated, indicating magnesium toxicity. Calcium gluconate is the antidote for magnesium toxicity and should be administered promptly to prevent severe complications.
Correct Answer is C
Explanation
Choice A rationale
A 15-year-old, G3 P0020, although young, doesn't have an increased risk of uterine rupture related to prior surgical deliveries or other known factors.
Choice B rationale
A 22-year-old, G1 P0000 with eclampsia requires close monitoring for complications related to eclampsia but not specifically for uterine rupture.
Choice C rationale
A 25-year-old, G4 P3003 with a previous cesarean section is at increased risk for uterine rupture due to the scar from the prior surgery which could weaken under the stress of labor.
Choice D rationale
A 32-year-old, G2 P0100's history of a prior fetal demise does not specifically increase the risk of uterine rupture unless accompanied by other risk factors. .
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