After a birth complicated by a shoulder dystocia, the infant’s Apgar scores were 7 at 1 minute and 9 at 5 minutes. The infant is now crying vigorously.
What should the nurse in the birthing room do?

Palpate the infant’s clavicles

Encourage the parents to hold the infant

Perform a complete newborn assessment

Give supplemental oxygen with a small face mask

Answer and Explanation

The Correct Answer is A

Choice A rationale
After a birth complicated by shoulder dystocia, it is important to palpate the infant’s clavicles. This is because shoulder dystocia can lead to a clavicle fracture.
Choice B rationale
While encouraging the parents to hold the infant is generally a good practice, it is not the immediate action to take after a birth complicated by shoulder dystocia.
Choice C rationale
A complete newborn assessment is important, but the immediate action after a birth complicated by shoulder dystocia is to check for any injuries related to the difficult birth.
Choice D rationale
Giving supplemental oxygen is not the immediate action to take after a birth complicated by shoulder dystocia unless the baby shows signs of respiratory distress.

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Correct Answer is C

Explanation

Choice A (Prepare for a vaginal delivery) is incorrect. Vaginal delivery is generally not recommended for women with active genital herpes lesions present during labor due to the high risk of transmitting the virus to the newborn. This risk is especially high when the mother experiences a primary infection (first outbreak) during the third trimester or has visible lesions at the time of delivery.
Choice B (Administer antiviral medication) is partially correct. While antiviral medications can be helpful in managing and potentially shortening outbreaks, they alone are not enough to prevent transmission during delivery. Antiviral medication can be used in combination with cesarean delivery to further reduce the risk of transmission.
Choice C (Prepare for a cesarean delivery) is correct. A cesarean delivery is the preferred method of delivery for women with active genital herpes lesions present during labor because it significantly reduces the risk of the virus being transmitted to the newborn. This risk can be as high as 50% during vaginal delivery with active lesions, while the risk with cesarean delivery is significantly lower, typically around 1% or less.
Choice D (Discharge the patient) is incorrect. Discharging a patient in active labor with active genital herpes lesions is not a safe or appropriate course of action. The patient needs to be carefully monitored and managed in a healthcare setting to minimize the risk of transmission to the newborn and ensure the safety of both mother and baby.

A. 30 years B. 35 years C. 40 years D. 45 years

Correct Answer is D

Explanation

Choice A rationale
The American Cancer Society does not recommend starting mammograms at age 30 for women at average risk. This age is too young for the initiation of routine screening mammograms.
Choice B rationale
The American Cancer Society does not recommend starting mammograms at age 35 for women at average risk. This age is still considered too young for the initiation of routine screening mammograms.
Choice C rationale
The American Cancer Society does not recommend starting mammograms at age 40 for women at average risk, although women between 40 and 44 have the option to start screening with a mammogram every year.
Choice D rationale
According to the American Cancer Society, women at average risk should start having mammograms at age 45. From age 45 to 54, they should get mammograms every year.

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After a birth complicated by a shoulder dystocia, the infant’s Apgar scores were 7 at 1 minute and 9 at 5 minutes. The infant is now crying vigorously. What should the nurse in the birthing room do?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The labor nurse is admitting a patient in active labor who has a history of genital herpes. The patient reports a recent outbreak, and the nurse verifies lesions on the perineum. What action should the nurse take in anticipating the plan of care for this patient?

Correct Answer is C

Explanation

A woman at low risk and with no family history of breast cancer comes to the clinic and asks the nurse about when she should have her first mammogram. According to the recommendations of the American Cancer Society, at what age should the woman have her first mammogram?

Correct Answer is D

Explanation

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After a birth complicated by a shoulder dystocia, the infant’s Apgar scores were 7 at 1 minute and 9 at 5 minutes. The infant is now crying vigorously.
What should the nurse in the birthing room do?