A client with an obstetrical history of G1 P0000 received dinoprostone for cervical ripening 8 hours ago.
The Bishop score at that time was 4. The Bishop score is now 10. Which of the following actions by the nurse is appropriate?
Report abnormal findings to the obstetrician.
Place client on her side.
Monitor for onset of labor.
Perform nitrazine analysis of amniotic fluid.
The Correct Answer is C
Choice A rationale
Reporting abnormal findings to the obstetrician is unnecessary because an increase in the Bishop score from 4 to 10 indicates successful cervical ripening and readiness for labor
induction.
Choice B rationale
Placing the client on her side is not directly related to the assessment of cervical ripening or the Bishop score. It may be considered for comfort during labor.
Choice C rationale
Monitoring for the onset of labor is appropriate since the increase in the Bishop score to 10 suggests that the cervix is favorable for labor. Continuous monitoring is essential to detect
the onset and progression of labor.
Choice D rationale
Performing nitrazine analysis of amniotic fluid is not relevant to the assessment of cervical ripening or the Bishop score. This test is typically used to confirm the presence of amniotic
fluid in cases of suspected rupture of membranes.
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Correct Answer is B
Explanation
Choice A rationale
Decreased muscle tone is not typically associated with NAS. NAS often presents with increased muscle tone due to withdrawal symptoms.
Choice B rationale
A continuous high-pitched cry is a hallmark sign of NAS, indicating withdrawal and discomfort. This is due to overstimulation of the central nervous system.
Choice C rationale
Newborns with NAS often have difficulty sleeping due to irritability and discomfort, sleeping for shorter periods.
Choice D rationale
Tremors in NAS are typically pronounced and continuous, not just when disturbed. These tremors result from withdrawal effects on the nervous system.
Correct Answer is D
Explanation
Choice A rationale
Precipitous labor and birth are not directly associated with postpartum endometritis. The primary risk factors are related to infections during labor.
Choice B rationale
Postpartum endometritis is typically treated with a combination of antibiotics for 7-10 days, not a single dose of ampicillin or cephalosporin. A single dose would be insufficient for
treating the infection.
Choice C rationale
Postpartum endometritis is more common following cesarean birth due to increased risk of infection despite the use of sterile techniques during surgery.
Choice D rationale
Postpartum endometritis is associated with internal monitoring, amnioinfusion, prolonged labor, and prolonged rupture of membranes. These factors increase the risk of infection,
which can lead to endometritis.