A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction.

What would the nurse do next?

Notify the primary care provider immediately.

Perform a vaginal exam.

Change the linen saver pad.

Check the fetal heart rate.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Notifying the primary care provider is important but not the immediate next step. The nurse has other immediate responsibilities to ensure the safety of the mother and baby.

Choice B rationale:

A vaginal exam could introduce bacteria into the uterus and is not the immediate next step after rupture of membranes.

Choice C rationale:

Changing the linen saver pad is not the immediate next step. While it might be necessary for the comfort of the mother, it does not address the potential risks associated with rupture of membranes.

Choice D rationale:

Checking the fetal heart rate is the correct next step. This ensures that the baby is not in distress following the rupture of membranes.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale:

Cephalic refers to the presentation of the fetus, not the lie. The lie refers to the orientation of the fetus in relation to the mother’s spine.

Choice B rationale:

Flexion refers to the attitude or posture of the fetus, not the lie.

Choice C rationale:

Longitudinal is the term used to describe the fetal lie when the fetus is aligned with the mother’s spine, either head down (cephalic) or buttocks down (breech).

Choice D rationale:

Extension refers to the attitude or posture of the fetus, not the lie.

A. Cephalhematoma. B. Vertex presentation. C. Caput Succedaneum. D. Molding.

Correct Answer is D

Explanation

Choice A rationale:

A cephalhematoma is a collection of blood that can occur under the scalp of a newborn. It does not aid in the passage of the fetal skull through the birth canal.

Choice B rationale:

Vertex presentation refers to the position of the fetus in the womb, not a feature of the skull that aids in birth.

Choice C rationale:

Caput succedaneum is a swelling of the scalp in a newborn. It is caused by pressure from the uterus or vaginal wall during a head-first (vertex) delivery, not a feature that aids in birth.

Choice D rationale:

Molding refers to the shaping of the fetal skull to fit through the birth canal. This is possible due to the presence of sutures and fontanelles in the skull, which allow the bony plates of the skull to move and overlap.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care to a woman in labor. After the assessment of the fetus, the nurse documents the fetal lie. Which term would the nurse use?

Correct Answer is C

Explanation

The skull is the most important factor in relation to the labor and birth processes. The fetal skull must be small enough to travel through the bony pelvis. What feature of the fetal skull helps to make this passage possible?

Correct Answer is D

Explanation

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out when I lie down flat on my back.”. The nurse explains that this is due to:.

Your patient is ordered to receive 20 units Pitocin in D5%W 500 mLs at 12 milliunits/minute. What flow rate will you set the IV pump to deliver? Numeric values only.

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:.

A nurse palpates a woman's fundus to determine contraction intensity. What would be most appropriate for the nurse to use for palpation?.

The pharmacy sends a bag of 150 mLs of D5W/0.456 normal saline with 25 units of Regular Insulin. The patient is ordered to receive an insulin drip at a rate of 9 units/hour. What rate will you set the IV pump to deliver? Numeric values only.

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect?

A pregnant woman is diagnosed with iron deficiency anemia and is prescribed an iron supplement. After teaching her about her prescribed iron supplement, which statement indicates successful teaching?.

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction.

What would the nurse do next?