Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible:
Select one:

Manifestations of uteroplacental insufficiency.

Manifestations of prolapsed cord.

Manifestations of anaphylactoid syndrome of pregnancy.

Manifestations of an acute asthmatic episode.

Answer and Explanation

The Correct Answer is C

Choice A Reason: Manifestations of uteroplacental insufficiency. This is an incorrect answer that describes a diﬀerent condition that aﬀects the fetus, not the mother. Uteroplacental insufficiency is a condition where the placenta fails to deliver adequate oxygen and nutrients to the fetus, which can result in fetal growth restriction, distress, or demise. Uteroplacental insufficiency does not cause shortness of breath, hypoxia, or cyanosis in the mother.

Choice B Reason: Manifestations of prolapsed cord. This is an incorrect answer that refers to another condition that aﬀects the fetus, not the mother. Prolapsed cord is a condition where the umbilical cord slips through the cervix before the baby and becomes compressed by the fetal head, which can reduce oxygen ﬂow to the fetus. Prolapsed cord does not cause shortness of breath, hypoxia, or cyanosis in the mother.

Choice C Reason: Manifestations of anaphylactoid syndrome of pregnancy. This is because anaphylactoid syndrome of pregnancy, also known as amniotic ﬂuid embolism, is a rare and fatal condition where amniotic ﬂuid enters into the maternal bloodstream and causes an allergic reaction, which can lead to respiratory failure, cardiac arrest, coagulopathy, and coma. Anaphylactoid syndrome of pregnancy can occur during or after labor and delivery, especially in cases of NSVD, multiparity, advanced maternal age, or placental abruption.

Choice D Reason: Manifestations of an acute asthmatic episode. This is an incorrect answer that assumes that the mother has a history of asthma or an allergic trigger. Asthma is a chronic inﬂammatory disorder of the airways that causes wheezing, coughing, chest tightness, and dyspnea. Asthma can be exacerbated by pregnancy or labor, but it is not a common cause of sudden onset respiratory distress in the postpartum period.

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Correct Answer is D

Explanation

Choice A Reason: Possible Meconium Aspiration Syndrome (MAS). This is an unlikely condition for this newborn, as MAS occurs when fetal stool (meconium) enters into the lungs before or during birth, causing airway obstruction, inﬂammation, and infection. MAS usually aﬀects term or post-term infants who experience fetal distress or hypoxia in utero.

Choice B Reason: Possible polycythemia. This is an unrelated condition for this newborn, as polycythemia refers to an abnormally high number of red blood cells in the blood, which can increase blood viscosity and impair circulation.

Polycythemia may occur in infants who have delayed cord clamping, intrauterine growth restriction, maternal diabetes, or high altitude exposure.

Choice C Reason: Possible Transient Tachypnea of the Newborn (TTN). This is a less serious condition than RDS, as TTN is a mild respiratory problem that results from delayed clearance of fetal lung ﬂuid after birth. TTN causes rapid breathing, nasal ﬂaring, grunting, and mild cyanosis. It usually resolves within 24 to 48 hours after birth.

Choice D Reason: Possible Respiratory Distress Syndrome (RDS). This is a serious condition that requires immediate intervention and treatment, as RDS can lead to life-threatening complications such as pulmonary hemorrhage, pneumothorax, or bronchopulmonary dysplasia. RDS causes respiratory distress, nasal ﬂaring, retractions, grunting, and central cyanosis. It usually occurs within minutes to hours after birth.

A. Prepare for IV dextrose administration. B. Provide routine care, per hospital IDM protocol. C. Place the infant in a warmed incubator. D. Alert the clinician immediately for orders.

Correct Answer is B

Explanation

Choice A Reason: Prepare for IV dextrose administration. This is an incorrect answer that indicates an unnecessary and invasive intervention for an IDM with normal blood glucose. IV dextrose administration is indicated for an IDM with severe or persistent hypoglycemia, which is defined as a blood glucose below 40 mg/dL or below 60 mg/dL after two feedings.

Choice B Reason: Provide routine care, per hospital IDM protocol. This is because a blood glucose of 60 is within the normal range for an IDM, which is 40 to 80 mg/dL. An IDM is a newborn whose mother has pre-existing or gestational diabetes, which can aﬀect the fetal and neonatal glucose metabolism and regulation. An IDM may have hypoglycemia (low blood glucose), hyperglycemia (high blood glucose), or other complications such as macrosomia, polycythemia, or congenital anomalies. An IDM requires routine care and monitoring according to the hospital IDM protocol, which may include blood glucose testing, feeding, temperature regulation, and observation for signs of distress.

Choice C Reason: Place the infant in a warmed incubator. This is an incorrect answer that suggests an irrelevant and potentially harmful action for an IDM with normal blood glucose. Placing the infant in a warmed incubator is indicated for an IDM with hypothermia, which is a low body temperature that can impair glucose utilization and increase oxygen consumption. However, placing the infant in a warmed incubator without proper indication can cause hyperthermia, which is a high body temperature that can lead to dehydration, electrolyte imbalance, or brain damage.

Choice D Reason: Alert the clinician immediately for orders. This is an incorrect answer that implies an urgent and unwarranted situation for an IDM with normal blood glucose. Alerting the clinician immediately for orders is indicated for an IDM with signs of distress or complications, such as apnea, cyanosis, seizures, or jaundice.

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Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible: Select one:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses a newborn at 36 weeks' gestation, and the following behaviors are noted: nasal ﬂaring, labored breathing, and excessive mucus. The nurse is most concerned about: Select one:

Correct Answer is D

Explanation

An infant of a Diabetic Mother (IDM) has a blood glucose of 60 upon admission to the well-baby nursery. Which of the following is an appropriate nursing action? Select one:

Correct Answer is B

Explanation

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A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 60 beats per minute. Which of these actions should the nurse take? Select one:

Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible:
Select one: