During a delivery complicated by shoulder dystocia, the baby’s head retracts back against the perineum after it emerges, a phenomenon known as ‘turtling’. Which of the following is the most appropriate immediate action for the healthcare provider to take?
Wait for the next contraction to try and deliver the shoulders naturally.
Perform the McRoberts maneuver to reposition the mother’s legs and widen the pelvis.
Apply fundal pressure to help push the baby out.
Use vacuum extraction to assist the delivery of the shoulders.
The Correct Answer is B
Choice A rationale
Waiting for the next contraction is inappropriate in shoulder dystocia, where immediate action is required to prevent fetal hypoxia. Delaying intervention can lead to serious complications for the newborn.
Choice B rationale
The McRoberts maneuver, involving hyperflexion of the mother's legs, widens the pelvis, facilitating shoulder delivery in cases of shoulder dystocia. This technique reduces shoulder impaction effectively.
Choice C rationale
Applying fundal pressure is contraindicated in shoulder dystocia as it may worsen the impaction by compressing the fetal shoulders against the maternal pelvis, increasing the risk of injury.
Choice D rationale
Vacuum extraction is not recommended for shoulder dystocia management. This obstetric emergency requires specific maneuvers, like the McRoberts maneuver, to relieve the impacted shoulder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Rh (D) immunoglobulin does not destroy Rh antibodies in newborns; it prevents maternal immune response.
Choice B rationale
Rh (D) immunoglobulin does not damage Rh antibodies in Rh-negative mothers; it prevents antibody formation.
Choice C rationale
Rh (D) immunoglobulin does not stop Rh antibody formation in Rh-positive newborns but prevents it in Rh-negative mothers.
Choice D rationale
Rh (D) immunoglobulin prevents the formation of Rh antibodies in Rh-negative mothers, reducing the risk of hemolytic disease in future pregnancies.
Correct Answer is C
Explanation
Choice A rationale
Checking basal temperature during specific days of the menstrual cycle does not provide as accurate an indication of ovulation as consistent daily measurements.
Choice B rationale
Checking temperature before bed may not accurately reflect basal body temperature due to daily activities affecting body temperature.
Choice C rationale
Basal body temperature should be measured every morning before arising, as this reflects the body’s lowest resting temperature and helps identify ovulation.
Choice D rationale
Checking temperature after intercourse may be affected by physical activity and does not provide an accurate basal temperature reading for ovulation tracking.
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