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NUR 306 Vsim Amelia Sung Pre Pro-Test Questions And Accurate Solutions
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NUR 306 Vsim Amelia Sung Pre Pro-Test QuestionsAnd Accurate Solutions
Shoulder dystocia is a complication of Labour related to which of these factors? -
ANSWER Prolonged second stage of labour
Explanations: Dystocia should occur when the anterior fetal shoulder get caught behind
the mother's pubic bone. One of the factors related to the presence of shoulder dystocia
is prolonged second stage of labor. The uterine contractions are usually of adequate
strength. The volume of amniotic fluid and the length of active phase of labor are not the
risk factors for shoulder dystocia.
Which of the following pregnancy-related conditions increases increase the risk for
shoulder dystocia? - ANSWER Uncontrolled maternal gestational diabetes
Uncontrolled gestational diabetes results in fetal macrosomia, fat pads at the fetal neck,
and increased maternal weight gain, all factors increasing the incidence of shoulder
dystocia. Preeclampsia and IUGR both result in smaller infants and thus do not increase
the risk of shoulder dystocia. Hyperemesis While it may continue throughout the
pregnancy it is generally a problem of the first trimester and not related to the delivery
A patient is admitted to the labor and delievery unit at 40 weeks gestation. Which of the
following pieces of information collected during the patient interview would be most
significant in alerting the nurse to the potential for shoulder dystocia (SATA) - ANSWER
Maternal height 5 ft, 3 in
Estimated fetal weight 8 lbs, 13 oz or more
Maternal weight gain greater than 50 lb
Discussion Shoulder dystocia is associated with excessive maternal weight gain, short
maternal stature, and a high estimated fetal weight. Ethnicity is a demographic factor
that is not associated with shoulder dystocia. Previous delivery is evidence that she has
delivered an infant of that size without complications previously, and an active phase of
, labor that lasted 4 hours is not an acute finding.
If a shoulder dystocia amergency is anticipated, what additional actions should be
implemented by the nurse (sata) - ANSWER Put a step stool at the bedside
Explain to the patient and family what may happen
Have extra staff available if needed
Explanation: The stool is so the provider can apply suprapubic pressure by standing
directly over the patient. Extra staff is needed to implement the maneuvers used to
deliver the fetal shoulder. Communication with the patient and the family about what
might happen in the delivery room will prepare them and decrease their anxiety. It is not
a therapeutic response to take the family from the delivery room and will further
increase their anxiety. Consent for a cesarean delivery is not appropriate at this time.
The nurse identifies that the client is in labor and is a risk for shoulder dystocia. After
delivery of the fetal head, the nurse announces in a clear, loud voice, "fetal heart rate 90
bpm with minimal variability" Why is this significant for the nurse to communicate?-
ANSWER To inform the provider about the fetal status
Explanation: A call-out is a clear and concise statement of data or an event that
everyone on the health care team needs to know in order to care for the patient
effectively. Changes in the FHR are not routinely announced in the delivery room;
however, in this scenario, it is important for the nurse to call out so that data are
provided to the provider. This permits the provider to evaluate the fetal status and
determine the best course of action. The patient is focused on pushing out the fetus, so
the information is not for her benefit. The nurse's interpretation of the routine fetal
activity is documented in the patient's chart, not verbally
What is a positive turtle sign - ANSWER The fetal head emerges and then retracts tightly
against the perineal floor
Explanation: A positive turtle sign is when the head delivers and that is retracted back
and rests firmly against the perineum
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