The nurse is assessing a client at 29-weeks gestation. Which assessment method would provide the most accurate determination of fetal position?
Ultrasound.
Doppler.
Leopold's maneuvers.
Vaginal examination.
The Correct Answer is A
Rationale:
A. Ultrasound: Ultrasound provides the most accurate assessment of fetal position at 29 weeks, as it allows visualization of the fetus, placenta, and amniotic fluid. It is especially useful when Leopold’s maneuvers are inconclusive due to maternal obesity, uterine shape, or fetal movement.
B. Doppler: Doppler is primarily used to assess fetal heart rate and blood flow, not the position of the fetus. While it can confirm fetal presence, it does not provide reliable information about orientation or lie.
C. Leopold’s maneuvers: Leopold’s maneuvers can help estimate fetal position through abdominal palpation. However, at 29 weeks, the fetus is still relatively small and mobile, making this method less precise than ultrasound.
D. Vaginal examination: Vaginal examination can detect fetal presentation only when the fetus is low in the pelvis, usually near labor. At 29 weeks, the fetus is typically high in the uterus, so a vaginal exam would not accurately determine fetal position.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Let the infant breastfeed: Breastfeeding stimulates oxytocin release, which can promote uterine contraction and help prevent postpartum hemorrhage. While beneficial, it is not the first action when active bleeding is observed.
B. Assess her blood pressure: Monitoring blood pressure is a priority when continuous bright red vaginal bleeding occurs after delivery. Assessing vital signs allows the nurse to determine the hemodynamic stability of the client and identify early signs of hypovolemic shock, guiding urgent interventions.
C. Massage the fundus vigorously: The fundus is already firm at the umbilicus, indicating effective uterine contraction. Vigorous massage is unnecessary and may cause discomfort or trauma without addressing the source of bleeding.
D. Apply ice pack to perineum: Ice packs are useful for perineal pain or swelling but do not control vaginal bleeding from uterine sources. This intervention does not address the priority concern of postpartum hemorrhage.
Correct Answer is D
Explanation
Rationale:
A. Interest in enrolling in breastfeeding classes: While breastfeeding education is helpful, it does not directly address the immediate concern of poor weight gain in the infant.
B. Herbal supplements the mother is taking: Herbal supplements may affect milk production or infant tolerance in some cases, but they are less likely to be the primary factor when the infant is feeding frequently and producing an adequate number of wet diapers.
C. Types of foods the mother is eating: Maternal diet generally does not significantly impact breast milk quantity or quality in healthy, well-nourished women. While important for overall health, it is not the most critical factor to assess here.
D. Length of time the infant nurses at each breast: Assessing how long the infant feeds at each breast provides crucial information about milk transfer and effectiveness of breastfeeding. Despite frequent nursing and normal diaper output, inadequate time at the breast may explain why the infant has not regained birth weight.
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