A nurse is performing a digital examination on a client who is at 34 weeks of gestation and has pre-term labor.
Which of the following findings indicates cervical effacement?
Cervix is soft and pliable
Cervix is shortened and thinned
Cervix is dilated and open
Cervix is posterior and high
The Correct Answer is B
Cervix is shortened and thinned. This indicates cervical effacement, which is the thinning and softening of the cervix in preparation for childbirth. Cervical effacement is measured in percentages, from 0% (no effacement) to 100% (fully effaced).
Choice A is wrong because cervix is soft and pliable does not necessarily mean it is effaced. The cervix can soften before it thins and shortens.
Choice C is wrong because cervix is dilated and open indicates cervical dilation, which is the opening of the cervix. Cervical dilation is measured in centimeters, from 0 cm (closed) to 10 cm (fully dilated).
Cervical dilation and effacement are related, but not the same.
Choice D is wrong because cervix is posterior and high indicates the position of the cervix in relation to the vagina. The cervix can move from posterior (back) to anterior (front) and from high to low as labor progresses.
The position of the cervix does not indicate effacement.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Magnesium sulfate is a drug that is used to prevent seizures associated with pre-eclampsia and to stop preterm labor.However, it can also cause adverse effects such as respiratory depression, which is a condition where the breathing rate becomes too slow and shallow.
Respiratory depression can be life-threatening for both the mother and the baby, so the nurse should monitor the client’s respiratory rate and oxygen saturation closely.
Choice A is wrong because magnesium sulfate can cause hypotension, not hypertension.Hypotension is low blood pressure, which can lead to dizziness, fainting, and shock.
Choice B is wrong because magnesium sulfate can cause hyporeflexia, not hyperreflexia.Hyporeflexia is a reduced or absent reflex response, which can indicate magnesium toxicity.
The nurse should check the client’s deep tendon reflexes regularly and stop the infusion if they are absent.
Choice D is wrong because magnesium sulfate can cause bradycardia, not tachycardia.
Bradycardia is a slow heart rate, which can reduce the blood flow to vital organs.
Correct Answer is A
Explanation
Infection on speculum examination.
Infection is a major cause of preterm labor and can lead to serious complications for the mother and the fetus.
Infection can be detected by a speculum examination that shows signs of inflammation, such as erythema, edema, discharge, or odor.
Infection can also be confirmed by laboratory tests, such as culture, gram stain, or polymerase chain reaction.Infection should be treated promptly with antibiotics and other supportive measures.
Choice B. Bleeding on speculum examination is wrong because bleeding is not a direct cause of preterm labor, but rather a sign of other conditions that may increase the risk of preterm labor, such as placenta previa, placental abruption, or cervical trauma.Bleeding should be evaluated further to determine the source and severity of the hemorrhage and to manage any complications.
Choice C. Positive fetal fibronectin test (FFN) is wrong because a positive FFN test indicates the presence of fetal fibronectin in the cervical or vaginal secretions, which is a marker of increased risk of preterm labor, but not a definitive marker.
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