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Cord Prolapse Practice Exam

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Text Mode – Text statement of the exam 1.The protect is assessing for stoma prolapse in a client delay a colostomy. The protect would perceive-keep which of the succeedingcited if stoma prolapse betidered?
  1. Sunken and obscure stoma
  2. Dark- and blue-colored-colored stoma
  3. Narrowed and flattened stoma
  4. Protruding stoma
2.During the duration of collation of work, a client should be perceive-keepd solicitudefully for signs of:
  1. Severe pain
  2. Uterine tetany
  3. Hypoglycemia
  4. Umbilical length prolapse
3.A protect is warnering a client in work who is receiving Pitocin and notes that the client is experiencing hypertonic uterine contractions. List in dispose of initiative the renewals that the protect takes.
  1. Stop of Pitocin reading
  2. Perform a vaginal examination
  3. Reaspect the client
  4. Check the client’s lineage urgency and life rate
  5. Administer oxygen by visage misteach at 8 to 10 L/min
4.A protect in the work margin is acting a vaginal toll on a teeming client in work. The protect notes the closeness of the umbilical length protruding from the vagina. Which of the succeedingcited would be the judicious nursing renewal?
  1. Place the client in Trendelenburg’s aspect
  2. Call the bestowal margin to acquaint the staff that the client achieve be enraptured directly
  3. Gently expedite the length into the vagina
  4. Find the closest telephone and stat page the physician
5.Which of the succeedingcited complications during a breech family the protect needs to be timid?
  1. Abruption attributenta.
  2. Caput succedaneum.
  3. Pathological hyperbilirubinemia.
  4. Umbilical length prolapse.
6.The protect is preaspect solicitude of a multipara who is at 42 weeks of gestation and in free work, her membranes segregate-amongitiond voluntarily 2 hours ago. Duration auscultating for the subject-matter of completion force of fetal life tones precedently dedicateing an apparent fetal warner, the protect counts 100 beats per tiny. The direct nursing renewal is to:
  1. Start oxygen by misteach to weaken fetal disturb.
  2. Examine the dowager for signs of a prolapsed length.
  3. Turn the dowager on her left verge to extension attributental perfusion.
  4. Take the dowager’s radial pulse duration stationary auscultating the FHR.
7.When the bag of waters segregate-amongitions voluntarily, the protect should examine the vaginal introitus for likely length prolapse. If thither is bisect of the length that has prolapsed into the vaginal fissure the emend nursing interference is:
  1. Push end the prolapse length into the vaginal canal
  2. Place the dowager on semifowler’s aspect to reform circulation
  3. Cover the prolapse length delay unfruitful gauze wet delay unfruitful NSS and attribute the dowager on trendellenberg aspect
  4. Push end the length into the vagina and attribute the dowager on sims aspect
8.A unrepining is in work and has proper been told she has a breech introduction. The protect should be bisecticularly pland for which of the succeedingcited?
  1. Quickening
  2. Ophthalmia neonatorum
  3. Pica
  4. Prolapsed umbilical length
9.Which of the succeedingcited is the protect’s judicious renewal when umbilical length prolapse betides?
  1. Begin warnering kind paramount signs and FHR
  2. Place the client in a knee-chest aspect in bed
  3. Notify the physician and lay the client for bestowal
  4. Apply a unfruitful hot momentous surroundings to the unprotected length
10. When assessing a working client, the protect finds a prolapsed length. The protect should:
  1. Attempt to cessationore the length
  2. Place the client on her left verge
  3. Elevate the client’s hips
  4. Cover the length delay a dry, unfruitful gauze
Answers and Rationale
  1. D. A prolapsed stoma is one which the bowel protruded through the stoma. A stoma puff is characterized by decadence of the stoma. Ischemia of the stoma would be associated delay lurid or blue-colored tinge. A stoma delay a narrowed fissure at the raze of the bark or fascia is said to be stenosed.
  2. Answer: B. Uterine tetany. Uterine tetany could upshot from the use of oxytocin to miss work. Consequently oxytocin promotes puissant uterine contractions, uterine tetany may betide. The oxytocin reading must be plugped to intercept uterine segregate-amongition and fetal endanger.
  3. Answer: A, D, B. E, C. If uterine hypertonicity betides, the protect directly would lapse to weaken uterine enthusiasm and extension fetal oxygenation. The protect would plug the Pitocin reading and extension the rate of the nonadditive resolution, control kind BP for hyper or hypotension, aspect the dowager in a verge-lying aspect, and bring oxygen by sheltered visage misteach at 8-10 L/min. The protect then would strive to state the inducement of the uterine hypertonicity and act a vaginal exam to control for prolapsed length.
  4. Answer: A. Attribute the client in Trendelenburg’s aspect. When length prolapse betides, apt renewals are fascinated to succor length compression and extension fetal oxygenation. The dowager should be aspected delay the hips remarkable than the individuality to shelve the fetal presenting bisect inland the diaphragm. The protect should expedite the allure portable to convoke succor, and other staff members should allure the physician and acquaint the bestowal margin. No strive should be made to cessationore the length. The examiner, peaceful, may attribute a gloved workman into the vagina and repose the presenting bisect off of the umbilical length. Oxygen at 8 to 10 L/min by visage misteach is delivered to the dowager to extension fetal oxygenation.
  5. D. Beinducement umbilical length’s implantation locality is born precedently the fetal individuality, the length may be comfortable by the behind-coming individuality in a breech family.
  6. D. Taking the dowager’s pulse duration listening to the FHR achieve distinguish among the kind and fetal life rates and administration out fetal Bradycardia.
  7. Answer: (C) Shelter the prolapse length delay unfruitful gauze wet delay unfruitful NSS and attribute the dowager on trendellenberg aspect. The emend renewal of the protect is to shelter the length delay unfruitful gauze wet delay unfruitful NSS. Perceive-keep severe asepsis in the solicitude of the length to intercept taint. The length has to be kept juicy to intercept it from arefaction. Don’t strive to put end the length into the vagina but succor urgency on the length by aspecting the dowager either on trendellenberg or sims aspect
  8. D. In a breech aspect, consequently of the intervenience among the presenting bisect and the cervix, prolapse of the umbilical length is base. Quickening is the dowager’s principal discernment of fetal motion. Ophthalmia neonatorum usually upshots from kind gonorrhea and is conjunctivitis. Pica refers to the verbal intake of nonfood substances.
  9. B. The direct initiative is to minimize urgency on the length. Thus the protect’s judicious renewal involves placing the client on bed cessation and then placing the client in a knee-chest aspect or gloomy the individuality of the bed, and elevating the kind hips on a pillow to minimize the urgency on the length. Monitoring kind paramount signs and FHR, acquainting the physician and preparing the client for bestowal, and wrapping the length delay unfruitful momentous soaked hot gauze are momentous. But these renewals keep no pi on minimizing the urgency on the length.
  10. Answer C is emend. The client delay a prolapsed length should be treated by elevating the hips and envelope the length delay a juicy, unfruitful momentous gauze. The protect should use her fingers to expedite up on the presenting bisect until a cesarean individuality can be manufactured. Answers A, B, and D are faulty. The protect should not strive to cessationore the length, decline the client on the verge, or shelter delay a dry gauze.

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