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NCLEX-RN exam is not constructed like most of the test during the college. Instead of questions based on memorization, this exam is presented with various nursing scenarios. You can start practicing answering these type of questions by taking this 60-item that covers Obstetrical Nursing.
Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom.
– Harriette Hartigan
Included topics in this exam are:
- Labor and Delivery
- Fetal Heart Rate
- Questions about oxytocin
- Disseminated Intravascular Coagulation (DIC)
- Leopold's Maneuver
To make the most out of this quiz, follow the guidelines below:
- Read each question carefully and choose the best answer.
- You are given one minute per question. Spend your time wisely!
- Answers and rationales are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
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Obstetrical Nursing: Intrapartum Practice Quiz (60 Questions)
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Obstetrical Nursing: Intrapartum Practice Quiz (60 Questions)
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In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.
1. A nurse is caring for a client in labor. The nurse determines that the client is beginning in the second stage of labor when which of the following assessments is noted?
A. The client begins to expel clear vaginal fluid
B. The contractions are regular
C. The membranes have ruptured
D. The cervix is dilated completely
2. A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to:
A. Place the mother in the supine position
B. Document the findings and continue to monitor the fetal patterns
C. Administer oxygen via face mask
D. Increase the rate of Pitocin IV infusion
3. A nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate a need to contact the physician?
A. Fetal heart rate of 180 beats per minute
B. White blood cell count of 12,000
C. Maternal pulse rate of 85 beats per minute
D. Hemoglobin of 11.0 g/dL
4. A client in labor is transported to the delivery room and is prepared for a cesarean delivery. The client is transferred to the delivery room table, and the nurse places the client in the:
A. Trendelenburg's position with the legs in stirrups
B. Semi-Fowler position with a pillow under the knees
C. Prone position with the legs separated and elevated
D. Supine position with a wedge under the right hip
5. A nurse is caring for a client in labor and prepares to auscultate the fetal heart rate by using a Doppler ultrasound device. The nurse most accurately determines that the fetal heart sounds are heard by:
A. Noting if the heart rate is greater than 140 BPM
B. Placing the diaphragm of the Doppler on the mother's abdomen
C. Performing Leopold's maneuvers first to determine the location of the fetal heart
D. Palpating the maternal radial pulse while listening to the fetal heart rate
6. A nurse is caring for a client in labor who is receiving Pitocin by IV infusion to stimulate uterine contractions. Which assessment finding would indicate to the nurse that the infusion needs to be discontinued?
A. Three contractions occurring within a 10-minute period
B. A fetal heart rate of 90 beats per minute
C. Adequate resting tone of the uterus palpated between contractions
D. Increased urinary output
7. A nurse is beginning to care for a client in labor. The physician has prescribed an IV infusion of Pitocin. The nurse ensures that which of the following is implemented before initiating the infusion?
A. Placing the client on complete bed rest
B. Continuous electronic fetal monitoring
C. An IV infusion of antibiotics
D. Placing a code cart at the client's bedside
8. A nurse is monitoring a client in active labor and notes that the client is having contractions every 3 minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 BPM. Which of the following nursing actions is most appropriate?
A. Encourage the client's coach to continue to encourage breathing exercises
B. Encourage the client to continue pushing with each contraction
C. Continue monitoring the fetal heart rate
D. Notify the physician or nurse midwife
9. A nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions is most appropriate?
A. Document the findings and tell the mother that the monitor indicates fetal well-being
B. Take the mother's vital signs and tell the mother that bed rest is required to conserve oxygen.
C. Notify the physician or nurse-midwife of the findings.
D. Reposition the mother and check the monitor for changes in the fetal tracing
10. A nurse is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client's abdomen. After attachment of the monitor, the initial nursing assessment is which of the following?
A. Identifying the types of accelerations
B. Assessing the baseline fetal heart rate
C. Determining the frequency of the contractions
D. Determining the intensity of the contractions
11. A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has documented that the fetus is at (-1) station. The nurse determines that the fetal presenting part is:
A. 1 cm above the ischial spine
B. 1 fingerbreadth below the symphysis pubis
C. 1 inch below the coccyx
D. 1 inch below the iliac crest
12. A pregnant client is admitted to the labor room. An assessment is performed, and the nurse notes that the client's hemoglobin and hematocrit levels are low, indicating anemia. The nurse determines that the client is at risk for which of the following?
A. A loud mouth
B. Low self-esteem
C. Hemorrhage
D. Postpartum infections
13. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as signs of:
A. Hematoma
B. Placenta previa
C. Uterine atony
D. Placental separation
14. A client arrives at a birthing center in active labor. Her membranes are still intact, and the nurse-midwife prepares to perform an amniotomy. A nurse who is assisting the nurse-midwife explains to the client that after this procedure, she will most likely have:
A. Less pressure on her cervix
B. Increased efficiency of contractions
C. Decreased number of contractions
D. The need for increased maternal blood pressure monitoring
15. A nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction?
A. Early decelerations
B. Variable decelerations
C. Late decelerations
D. Short-term variability
16. A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage is:
A. A form of biofeedback to enhance bearing down efforts during delivery
B. Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus
C. The application of pressure to the sacrum to relieve a backache
D. Performed to stimulate uterine activity by contracting a specific muscle group while other parts of the body rest
17. A nurse is caring for a client in the second stage of labor. The client is experiencing uterine contractions every 2 minutes and cries out in pain with each contraction. The nurse recognizes this behavior as:
A. Exhaustion
B. Fear of losing control
C. Involuntary grunting
D. Valsalva's maneuver
18. A nurse is monitoring a client in labor who is receiving Pitocin and notes that the client is experiencing hypertonic uterine contractions. List in order of priority the actions that the nurse takes.
A. Stop of Pitocin infusion
B. Perform a vaginal examination
C. Reposition the client
D. Check the client's blood pressure and heart rate
E. Administer oxygen by face mask at 8 to 10 L/min
19. A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition?
A. Medication that will provide sedation
B. Increased hydration
C. Oxytocin (Pitocin) infusion
D. Administration of a tocolytic medication
20. A nurse in the labor room is preparing to care for a client with hypertonic uterine dysfunction. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention would be to:
A. Monitor the Pitocin infusion closely
B. Provide pain relief measures
C. Prepare the client for an amniotomy
D. Promote ambulation every 30 minutes
21. A nurse is developing a plan of care for a client experiencing dystocia and includes several nursing interventions in the plan of care. The nurse prioritizes the plan of care and selects which of the following nursing interventions as the highest priority?
A. Keeping the significant other informed of the progress of the labor
B. Providing comfort measures
C. Monitoring fetal heart rate
D. Changing the client's position frequently
22. A maternity nurse is preparing to care for a pregnant client in labor who will be delivering twins. The nurse monitors the fetal heart rates by placing the external fetal monitor:
A. Over the fetus that is most anterior to the mother's abdomen
B. Over the fetus that is most posterior to the mother's abdomen
C. So that each fetal heart rate is monitored separately
D. So that one fetus is monitored for a 15-minute period followed by a 15 minute fetal monitoring period for the second fetus
23. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa?
A. Disseminated intravascular coagulation
B. Chronic hypertension
C. Infection
D. Hemorrhage
24. A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the newborn, the nurse assists in delivering the placenta. Which observation would indicate that the placenta has separated from the uterine wall and is ready for delivery?
A. The umbilical cord shortens in length and changes in color
B. A soft and boggy uterus
C. Maternal complaints of severe uterine cramping
D. Changes in the shape of the uterus
25. A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action?
A. Place the client in Trendelenburg's position
B. Call the delivery room to notify the staff that the client will be transported immediately
C. Gently push the cord into the vagina
D. Find the closest telephone and stat page the physician
26. A maternity nurse is caring for a client with abruptio placenta and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation?
A. Swelling of the calf in one leg
B. Prolonged clotting times
C. Decreased platelet count
D. Petechiae, oozing from injection sites, and hematuria
27. A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present?
A. Absence of abdominal pain
B. A soft abdomen
C. Uterine tenderness/pain
D. Painless, bright red vaginal bleeding
28. A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician's orders and would question which order?
A. Prepare the client for an ultrasound
B. Obtain equipment for external electronic fetal heart monitoring
C. Obtain equipment for a manual pelvic examination
D. Prepare to draw a Hgb and Hct blood sample
29. An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these findings, the nurse would prepare the client for:
A. Complete bed rest for the remainder of the pregnancy
B. Delivery of the fetus
C. Strict monitoring of intake and output
D. The need for weekly monitoring of coagulation studies until the time of delivery
30. A nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse would monitor the client closely for the risk of uterine rupture if which of the following occurred?
A. Hypotonic contractions
B. Forceps delivery
C. Schultz delivery
D. Weak bearing down efforts
31. A client is admitted to the birthing suite in early active labor. The priority nursing intervention on the admission of this client would be:
A. Auscultating the fetal heart
B. Taking an obstetric history
C. Asking the client when she last ate
D. Ascertaining whether the membranes were ruptured
32. A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus' head is:
A. Not yet engaged
B. Entering the pelvic inlet
C. Below the ischial spines
D. Visible at the vaginal opening
33. After doing Leopold's maneuvers, the nurse determines that the fetus is in the ROP position. To best auscultate the fetal heart tones, the Doppler is placed:
A. Above the umbilicus at the midline
B. Above the umbilicus on the left side
C. Below the umbilicus on the right side
D. Below the umbilicus near the left groin
34. The physician asks the nurse the frequency of a laboring client's contractions. The nurse assesses the client's contractions by timing from the beginning of one contraction:
A. Until the time it is completely over
B. To the end of a second contraction
C. To the beginning of the next contraction
D. Until the time that the uterus becomes very firm
35. The nurse observes the client's amniotic fluid and decides that it appears normal, because it is:
A. Clear and dark amber in color
B. Milky, greenish yellow, containing shreds of mucus
C. Clear, almost colorless, and containing little white specks
D. Cloudy, greenish-yellow, and containing little white specks
36. At 38 weeks gestation, a client is having late decelerations. The fetal pulse oximeter shows 75% to 85%. The nurse should:
A. Discontinue the catheter, if the reading is not above 80%
B. Discontinue the catheter, if the reading does not go below 30%
C. Advance the catheter until the reading is above 90% and continue monitoring
D. Reposition the catheter, recheck the reading, and if it is 55%, keep monitoring
37. When examining the fetal monitor strip after the rupture of the membranes in a laboring client, the nurse notes variable decelerations in the fetal heart rate. The nurse should:
A. Stop the oxytocin infusion
B. Change the client's position
C. Prepare for immediate delivery
D. Take the client's blood pressure
38. When monitoring the fetal heart rate of a client in labor, the nurse identifies an elevation of 15 beats above the baseline rate of 135 beats per minute lasting for 15 seconds. This should be documented as:
A. An acceleration
B. An early elevation
C. A sonographic motion
D. A tachycardic heart rate
39. A laboring client complains of low back pain. The nurse replies that this pain occurs most when the position of the fetus is:
A. Breech
B. Transverse
C. Occiput anterior
D. Occiput posterior
40. The breathing technique that the mother should be instructed to use as the fetus' head is crowning is:
A. Blowing
B. Slow chest
C. Shallow
D. Accelerated-decelerated
41. During the period of induction of labor, a client should be observed carefully for signs of:
A. Severe pain
B. Uterine tetany
C. Hypoglycemia
D. Umbilical cord prolapse
42. A client arrives at the hospital in the second stage of labor. The fetus' head is crowning, the client is bearing down, and the birth appears imminent. The nurse should:
A. Transfer her immediately by stretcher to the birthing unit
B. Tell her to breathe through her mouth and not to bear down
C. Instruct the client to pant during contractions and to breathe through her mouth
D. Support the perineum with the hand to prevent tearing and tell the client to pant
43. A laboring client is to have a pudendal block. The nurse plans to tell the client that once the block is working she:
A. Will not feel the episiotomy
B. May lose bladder sensation
C. May lose the ability to push
D. Will no longer feel contractions
44. Which of the following observations indicates fetal distress?
A. Fetal scalp pH of 7.14
B. Fetal heart rate of 144 beats/minute
C. Acceleration of fetal heart rate with contractions
D. Presence of long-term variability
45. Which of the following fetal positions is most favorable for birth?
A. Vertex presentation
B. Transverse lie
C. Frank breech presentation
D. Posterior position of the fetal head
46. A laboring client has external electronic fetal monitoring in place. Which of the following assessment data can be determined by examining the fetal heart rate strip produced by the external electronic fetal monitor?
A. Gender of the fetus
B. Fetal position
C. Labor progress
D. Oxygenation
47. A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in cervical dilation. In which of the following phases of the first stage does cervical dilation occur most rapidly?
A. Preparatory phase
B. Latent phase
C. Active phase
D. Transition phase
48. A multiparous client who has been in labor for 2 hours states that she feels the urge to move her bowels. How should the nurse respond?
A. Let the client get up to use the potty
B. Allow the client to use a bedpan
C. Perform a pelvic examination
D. Check the fetal heart rate
49. Labor is a series of events affected by the coordination of the five essential factors. One of these is the passenger (fetus). Which are the other four factors?
A. Contractions, passageway, placental position and function, pattern of care
B. Contractions, maternal response, placental position, psychological response
C. Passageway, contractions, placental position, and function, psychological response
D. Passageway, placental position and function, paternal response, psychological response
50. Fetal presentation refers to which of the following descriptions?
A. Fetal body part that enters the maternal pelvis first
B. Relationship of the presenting part to the maternal pelvis
C. Relationship of the long axis of the fetus to the long axis of the mother
D. A classification according to the fetal part
51. A client is admitted to the L & D suite at 36 weeks' gestation. She has a history of C-section and complains of severe abdominal pain that started less than 1 hour earlier. When the nurse palpates tetanic contractions, the client again complains of severe pain. After the client vomits, she states that the pain is better and then passes out. Which is the probable cause of her signs and symptoms?
A. Hysteria compounded by the flu
B. Placental abruption
C. Uterine rupture
D. Dysfunctional labor
52. Upon completion of a vaginal examination on a laboring woman, the nurse records 50%, 6 cm, -1. Which of the following is a correct interpretation of the data?
A. Fetal presenting part is 1 cm above the ischial spines
B. Effacement is 4 cm from completion
C. Dilation is 50% completed
D. Fetus has achieved passage through the ischial spines
53. Which of the following findings meets the criteria of a reassuring FHR pattern?
A. FHR does not change as a result of fetal activity
B. Average baseline rate ranges between 100 – 140 BPM
C. Mild late deceleration patterns occur with some contractions
D. Variability averages between 6 – 10 BPM
54. Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position, and her vital signs are stable and fall within a normal range. Contractions are intense, last 90 seconds, and occur every 1 1/2 to 2 minutes. The nurse's immediate action would be to:
A. Change the woman's position
B. Stop the Pitocin
C. Elevate the woman's legs
D. Administer oxygen via a tight mask at 8 to 10 liters/minute
55. The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia would be:
A. Severe postpartum headache
B. Limited perception of bladder fullness
C. Increase in respiratory rate
D. Hypotension
56. Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:
A. Uses soap and warm water to wash the vulva and perineum
B. Washes from symphysis pubis back to episiotomy
C. Changes her perineal pad every 2 – 3 hours
D. Uses the peri bottle to rinse upward into her vagina
57. Which measure would be least effective in preventing postpartum hemorrhage?
A. Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered
B. Encourage the woman to void every 2 hours
C. Massage the fundus every hour for the first 24 hours following birth
D. Teach the woman the importance of rest and nutrition to enhance healing
58. When making a visit to the home of a postpartum woman one week after birth, the nurse should recognize that the woman would characteristically:
A. Express a strong need to review events and her behavior during the process of labor and birth
B. Exhibit a reduced attention span, limiting readiness to learn
C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn
D. Have reestablished her role as a spouse/partner
59. Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. The nurse should:
A. Tell the woman she can rest after she feeds her baby
B. Recognize this as a behavior of the taking-hold stage
C. Record the behavior as ineffective maternal-newborn attachment
D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time
60. Parents can facilitate the adjustment of their other children to a new baby by:
A. Having the children choose or make a gift to give to the new baby upon its arrival home
B. Emphasizing activities that keep the new baby and other children together
C. Having the mother carry the new baby into the home so she can show the other children the new baby
D. Reducing stress on other the by limiting their involvement in the care of the new baby
Answers and Rationale
1. Answer: D. The cervix is dilated completely.
The second stage of labor begins when the cervix is dilated completely and ends with the birth of the neonate.
2. Answer: C. Administer oxygen via face mask.
Late decelerations are due to uteroplacental insufficiency as the result of decreased blood flow and oxygen to the fetus during the uterine contractions. This causes hypoxemia; therefore oxygen is necessary.
- Option A: The supine position is avoided because it decreases uterine blood flow to the fetus. The client should be turned to her side to displace pressure of the gravid uterus on the inferior vena cava.
- Option D: An intravenous Pitocin infusion is discontinued when a late deceleration is noted.
3. Answer: A. Fetal heart rate of 180 beats per minute.
A normal fetal heart rate is 120-160 beats per minute. A count of 180 beats per minute could indicate fetal distress and would warrant physician notification. By full term, a normal maternal hemoglobin range is 11-13 g/dL as a result of the hemodilution caused by an increase in plasma volume during pregnancy.
4. Answer: D. Supine position with a wedge under the right hip. Vena cava and descending aorta compression by the pregnant uterus impedes blood return from the lower trunk and extremities. This leads to decreasing cardiac return, cardiac output, and blood flow to the uterus and the fetus. The best position to prevent this would be side-lying with the uterus displaced off of abdominal vessels. Positioning for abdominal surgery necessitates a supine position; however, a wedge placed under the right hip provides displacement of the uterus.
5. Answer: D. Palpating the maternal radial pulse while listening to the fetal heart rate.
The nurse simultaneously should palpate the maternal radial or carotid pulse and auscultate the fetal heart rate to differentiate the two. If the fetal and maternal heart rates are similar, the nurse may mistake the maternal heart rate for the fetal heart rate. Leopold's maneuvers may help the examiner locate the position of the fetus but will not ensure a distinction between the two rates.
6. Answer: B. A fetal heart rate of 90 beats per minute.
A normal fetal heart rate is 120-160 BPM. Bradycardia or late or variable decelerations indicate fetal distress and the need to discontinue to Pitocin. The goal of labor augmentation is to achieve three good-quality contractions in a 10-minute period.
7. Answer: B. Continuous electronic fetal monitoring.
Continuous electronic fetal monitoring should be implemented during an IV infusion of Pitocin.
8. Answer: D. Notify the physician or nurse midwife.
A normal fetal heart rate is 120-160 beats per minute. Fetal bradycardia between contractions may indicate the need for immediate medical management, and the physician or nurse-midwife needs to be notified.
9. Answer: A. Document the findings and tell the mother that the monitor indicates fetal well-being.
Accelerations are transient increases in the fetal heart rate that often accompany contractions or are caused by fetal movement. Episodic accelerations are thought to be a sign of fetal-well being and adequate oxygen reserve.
10. Answer: B. Assessing the baseline fetal heart rate.
Assessing the baseline fetal heart rate is important so that abnormal variations of the baseline rate will be identified if they occur. Options 1 and 3 are important to assess, but not as the first priority.
11. Answer: A. 1 cm above the ischial spine.
Station is the relationship of the presenting part to an imaginary line drawn between the ischial spines, is measured in centimeters, and is noted as a negative number above the line and a positive number below the line. At -1 station, the fetal presenting part is 1 cm above the ischial spines.
12. Answer: D. Postpartum infections.
Anemic women have a greater likelihood of cardiac decompensation during labor, postpartum infection, and poor wound healing. Anemia does not specifically present a risk for hemorrhage.
13. Answer: D. Placental separation.
As the placenta separates, it settles downward into the lower uterine segment. The umbilical cord lengthens, and a sudden trickle or spurt of blood appears.
14. Answer: B. Increased efficiency of contractions.
Amniotomy can be used to induce labor when the condition of the cervix is favorable (ripe) or to augment labor if the process begins to slow. Rupturing of membranes allows the fetal head to contact the cervix more directly and may increase the efficiency of contractions.
15. Answer: B. Variable decelerations.
Variable decelerations occur if the umbilical cord becomes compressed, thus reducing blood flow between the placenta and the fetus.
- Option A: Early decelerations result from pressure on the fetal head during a contraction.
- Option C: Late decelerations are an ominous pattern in labor because it suggests uteroplacental insufficiency during a contraction.
- Option D: Short-term variability refers to the beat-to-beat range in the fetal heart rate.
16. Answer: B. Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus.
Effleurage is a specific type of cutaneous stimulation involving light stroking of the abdomen and is used before a transition to promote relaxation and relieve mild to moderate pain. Effleurage provides tactile stimulation to the fetus.
17. Answer: B. Fear of losing control.
Pains, helplessness, panicking, and fear of losing control are possible behaviors in the 2nd stage of labor.
18. Answer: A, D, B, E, C.
If uterine hypertonicity occurs, the nurse immediately will intervene to reduce uterine activity and increase fetal oxygenation. The nurse would stop the Pitocin infusion and increase the rate of the nonadditive solution, check maternal BP for hyper or hypotension, position the woman in a side-lying position, and administer oxygen by snug face mask at 8-10 L/min. The nurse then would attempt to determine the cause of the uterine hypertonicity and perform a vaginal exam to check for prolapsed cord.
19. Answer: C. Oxytocin (Pitocin) infusion.
Therapeutic management for hypotonic uterine dysfunction includes oxytocin augmentation and amniotomy to stimulate a labor that slows.
20. Answer: B. Provide pain relief measures.
Management of hypertonic labor depends on the cause. Relief of pain is the primary intervention to promote a normal labor pattern.
21. Answer: C. Monitoring fetal heart rate.
The priority is to monitor the fetal heart rate.
22. Answer: C. So that each fetal heart rate is monitored separately.
In a client with a multi-fetal pregnancy, each fetal heart rate is monitored separately.
23. Answer: D. Hemorrhage.
Because the placenta is implanted in the lower uterine segment, which does not contain the same intertwining musculature as the fundus of the uterus, this site is more prone to bleeding.
24. Answer: D. Changes in the shape of the uterus.
Signs of placental separation include lengthening of the umbilical cord, a sudden gush of dark blood from the introitus (vaginal), a firmly contracted uterus, and the uterus changing from a discoid (like a disk) to a globular (like a globe) shape. The client may experience vaginal fullness, but not severe uterine cramping.
25. Answer: A. Place the client in Trendelenburg's position.
When cord prolapse occurs, prompt actions are taken to relieve cord compression and increase fetal oxygenation. The mother should be positioned with the hips higher than the head to shift the fetal presenting part toward the diaphragm. Oxygen at 8 to 10 L/min by face mask is delivered to the mother to increase fetal oxygenation.
- Options B and D: The nurse should push the call light to summon help, and other staff members should call the physician and notify the delivery room.
- Option C: No attempt should be made to replace the cord. The examiner, however, may place a gloved hand into the vagina and hold the presenting part off of the umbilical cord.
26. Answer: A. Swelling of the calf in one leg.
DIC is a state of diffuse clotting in which clotting factors are consumed, leading to widespread bleeding. Swelling and pain in the calf of one leg are more likely to be associated with thrombophlebitis.
- Options B, C, and D: Platelets are decreased because they are consumed by the process; coagulation studies show no clot formation (and are thus normal to prolong); and fibrin plugs may clog the microvasculature diffusely, rather than in an isolated area. The presence of petechiae, oozing from injection sites, and hematuria are signs associated with DIC.
27. Answer: C. Uterine tenderness/pain.
In abruptio placentae, acute abdominal pain is present. Uterine tenderness and pain accompany placental abruption, especially with a central abruption and trapped blood behind the placenta. The abdomen will feel hard and board like on palpation as the blood penetrates the myometrium and causes uterine irritability. Observation of the fetal monitoring often reveals increased uterine resting tone, caused by failure of the uterus to relax in an attempt to constrict blood vessels and control bleeding.
28. Answer: C. Obtain equipment for a manual pelvic examination.
Manual pelvic examinations are contraindicated when vaginal bleeding is apparent in the 3rd trimester until a diagnosis is made and Placental previa is ruled out. Digital examination of the cervix can lead to maternal and fetal hemorrhage.
- Option A: A diagnosis of placenta previa is made by ultrasound.
- Option B: External fetal monitoring is crucial in evaluating the fetus that is at risk for severe hypoxia.
- Option D: The H/H levels are monitored, and external electronic fetal heart rate monitoring is initiated.
29. Answer: B. Delivery of the fetus.
The goal of management in abruptio placentae is to control the hemorrhage and deliver the fetus as soon as possible. Delivery is the treatment of choice if the fetus is at term gestation or if the bleeding is moderate to severe and the mother or fetus is in jeopardy.
30. Answer: B. Forceps delivery.
Excessive fundal pressure, forceps delivery, violent bearing down efforts, tumultuous labor, and shoulder dystocia can place a woman at risk for traumatic uterine rupture. Hypotonic contractions and weak bearing down efforts do not alone add to the risk of rupture because they do not add to the stress on the uterine wall.
31. Answer: A. Auscultating the fetal heart.
Determining the fetal well-being supersedes all other measures. If the FHR is absent or persistently decelerating, immediate intervention is required.
32. Answer: C. Below the ischial spines.
A station of +1 indicates that the fetal head is 1 cm below the ischial spines.
33. Answer: C. Below the umbilicus on the right side.
Fetal heart tones are best auscultated through the fetal back; because the position is ROP (right occiput presenting), the back would be below the umbilicus and on the right side.
34. Answer: C. To the beginning of the next contraction.
This is the way to determine the frequency of the contractions
35. Answer: C. Clear, almost colorless, and containing little white specks.
By 36 weeks gestation, normal amniotic fluid is colorless with small particles of vernix caseosa present.
36. Answer: D. Reposition the catheter, recheck the reading, and if it is 55%, keep monitoring.
Adjusting the catheter would be indicated. Normal fetal pulse oximetry should be between 30% and 70%. 75% to 85% would indicate maternal readings.
37. Answer: 2. Change the client's position.
Variable decelerations usually are seen as a result of cord compression; a change of position will relieve pressure on the cord.
38. Answer: A. An acceleration.
An acceleration is an abrupt elevation above the baseline of 15 beats per minute for 15 seconds; if the acceleration persists for more than 10 minutes it is considered a change in baseline rate. A tachycardic FHR is above 160 beats per minute.
39. Answer: D. Occiput posterior.
A persistent occiput posterior position causes intense back pain because of fetal compression of the sacral nerves. Occiput anterior is the most common fetal position and does not cause back pain.
40. Answer: A. Blowing.
Blowing forcefully through the mouth controls the strong urge to push and allows for a more controlled birth of the head.
41. Answer: B. Uterine tetany.
Uterine tetany could result from the use of oxytocin to induce labor. Because oxytocin promotes powerful uterine contractions, uterine tetany may occur. The oxytocin infusion must be stopped to prevent uterine rupture and fetal compromise.
42. Answer: D. Support the perineum with the hand to prevent tearing and tell the client to pant.
Gentle pressure is applied to the baby's head as it emerges so it is not born too rapidly. The head is never held back, and it should be supported as it emerges so there will be no vaginal lacerations. It is impossible to push and pant at the same time.
43. Answer: A. May lose the ability to push.
A pudendal block provides anesthesia to the perineum.
44. Answer: A. Fetal scalp pH of 7.14.
A fetal scalp pH below 7.25 indicates acidosis and fetal hypoxia.
45. Answer: A. Vertex presentation.
Vertex presentation (flexion of the fetal head) is the optimal presentation for passage through the birth canal.
- Option B: Transverse lie is an unacceptable fetal position for vaginal birth and requires a C-section.
- Option C: Frank breech presentation, in which the buttocks present first, can be a difficult vaginal delivery.
- Option D: Posterior positioning of the fetal head can make it difficult for the fetal head to pass under the maternal symphysis pubis.
46. Answer: D. Oxygenation.
Oxygenation of the fetus may be indirectly assessed through fetal monitoring by closely examining the fetal heart rate strip. Accelerations in the fetal heart rate strip indicate good oxygenation, while decelerations in the fetal heart rate sometimes indicate poor fetal oxygenation.
47. Answer: C. Active phase.
Cervical dilation occurs more rapidly during the active phase than any of the previous phases. The active phase is characterized by cervical dilation that progresses from 4 to 7 cm.
- Options A and B: The preparatory, or latent, phase begins with the onset of regular uterine contractions and ends when rapid cervical dilation begins.
- Option D: Transition is defined as cervical dilation beginning at 8 cm and lasting until 10 cm or complete dilation.
48. Answer: C. Perform a pelvic examination.
A complaint of rectal pressure usually indicates a low presenting fetal part, signaling imminent delivery. The nurse should perform a pelvic examination to assess the dilation of the cervix and station of the presenting fetal part.
49. Answer: C. Passageway, contractions, placental position and function, psychological response.
The five essential factors (5 P's) are passenger (fetus), passageway (pelvis), powers (contractions), placental position and function, and psyche (psychological response of the mother).
50. Answer: A. Fetal body part that enters the maternal pelvis first.
Presentation is the fetal body part that enters the pelvis first; it's classified by the presenting part; the three main presentations are cephalic/occipital, breech, and shoulder.
- Option B: The relationship of the presenting fetal part to the maternal pelvis refers to fetal position.
- Option C: The relationship of the long axis to the fetus to the long axis of the mother refers to fetal lie; the three possible lies are longitudinal, transverse, and oblique.
51. Answer: C. Uterine rupture.
Uterine rupture is a medical emergency that may occur before or during labor. Signs and symptoms typically include abdominal pain that may ease after uterine rupture, vomiting, vaginal bleeding, hypovolemic shock, and fetal distress. With placental abruption, the client typically complains of vaginal bleeding and constant abdominal pain.
52. Answer: A. Fetal presenting part is 1 cm above the ischial spines.
Station of – 1 indicates that the fetal presenting part is above the ischial spines and has not yet passed through the pelvic inlet. A station of zero would indicate that the presenting part has passed through the inlet and is at the level of the ischial spines or is engaged.
- Options B and C: Progress of effacement is referred to by percentages with 100% indicating full effacement and dilation by centimeters (cm) with 10 cm indicating full dilation.
- Option D: Passage through the ischial spines with internal rotation would be indicated by a plus station, such as + 1.
53. Answer: D. Variability averages between 6 – 10 BPM.
Variability indicates a well-oxygenated fetus with a functioning autonomic nervous system.
- Option A: FHR should accelerate with fetal movement.
- Option B: Baseline range for the FHR is 120 to 160 beats per minute.
- Option C: Late deceleration patterns are never reassuring, though early and mild variable decelerations are expected, reassuring findings.
54. Answer: B. Stop the Pitocin.
Late deceleration patterns noted are most likely related to alteration in uteroplacental perfusion associated with the strong contractions described. The immediate action would be to stop the Pitocin infusion since Pitocin is an oxytocin which stimulates the uterus to contract.
- Option A: The woman is already in an appropriate position for uteroplacental perfusion.
- Option C: Elevation of her legs would be appropriate if hypotension were present.
- Option D: Oxygen is appropriate but not the immediate action.
55. Answer: D. Hypotension.
Epidural anesthesia can lead to vasodilation and a drop in blood pressure that could interfere with adequate placental perfusion. The woman must be well hydrated before and during epidural anesthesia to prevent this problem and maintain an adequate blood pressure.
- Option A: Headache is not a side effect since the spinal fluid is not disturbed by this anesthetic as it would be with a low spinal (saddle block) anesthesia;
- Option B is an effect of epidural anesthesia but is not the most harmful.
- Option C: Respiratory depression is a potentially serious complication.
56. Answer: D. Uses the peri bottle to rinse upward into her vagina.
The peri bottle should be used in a backward direction over the perineum. The flow should never be directed upward into the vagina since debris would be forced upward into the uterus through the still-open cervix.
57. Answer: C. Massage the fundus every hour for the first 24 hours following birth.
The fundus should be massaged only when boggy or soft. Massaging a firm fundus could cause it to relax.
- Options A, B, and D are all effective measures to enhance and maintain contraction of the uterus and to facilitate healing.
58. Answer: C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn.
One week after birth the woman should exhibit behaviors characteristic of the taking-hold stage as described in option C. This stage lasts for as long as 4 to 5 weeks after birth.
- Options A and B are characteristic of the taking-in stage, which lasts for the first few days after birth.
- Option D reflects the letting-go stage, which indicates that psychosocial recovery is complete.
59. Answer: D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time.
Response 1 does not take into consideration the need for the new mother to be nurtured and have her needs met during the taking-in stage. The behavior described is typical of this stage and not a reflection of ineffective attachment unless the behavior persists. Mothers need to reestablish their own well-being in order to effectively care for their baby.
60. Answer: A. Having the children choose or make a gift to give to the new baby upon its arrival home.
Special time should be set aside just for the other children without interruption from the newborn. Someone other than the mother should carry the baby into the home so she can give full attention to greeting her other children. Children should be actively involved in the care of the baby according to their ability without overwhelming them.
See Also
You may also like these other quizzes and exam tip articles:
- 3,500+ NCLEX-RN Practice Questions for Free – Thousands of practice questions for different nursing concepts and topics to help you review for the NCLEX-RN.
- Nursing Exam Cram Sheet for NCLEX-RN – This downloadable guide contains condensed facts about the licensure exam and key nursing information.
- 20 NCLEX Tips and Strategies Every Nursing Students Should Know – Simple but effective tips you must know before you take the NCLEX or our exams.
- My NCLEX Experience: Study Tips and Resources for Nursing Students – Get personal and learn more review and exam tips in this article.
- 6 Easy Ways on How Nurses Can Master the Art of Delegation – Make delegation easier with these six strategies.
- 8-Step Guide to ABG Analysis: Tic-Tac-Toe Method – Know this trick in answering ABG Analysis questions!
- 5 Principles in Answering Therapeutic Communication Questions – How would you respond correctly when facing a theracom question? We break it down for you in this article.
- 12 Tips to Answer NCLEX Select All That Apply (SATA) Questions – There are tricks on how to tackle SATA questions, check them out in this article.
- 10 Effective NCLEX Test Taking Strategies and Tips and 11 Test Taking Tips & Strategies For Nurses – More tips on how to pass your licensure exam!
- 10 Brilliant Tips to Overcome Test Anxiety – Do you have test anxiety? Yes, it's a thing. Know more about overcoming it with this guide.
Related Study Notes
Maternal and Child Health Nursing
Questions in this set are about the care of the pregnant mother and her child.
- Maternal and Child Health Nursing #1 | 30 Questions
- Maternal and Child Health Nursing #2 | 30 Questions
- Maternal and Child Health Nursing #3 | 20 Questions
- Maternal and Child Health Nursing #4 | 50 Questions
- Maternal and Child Health Nursing #5 | 50 Questions
- Maternal and Child Health Nursing #6 | 50 Questions
- Maternal and Child Health Nursing #7 | 50 Questions
- Maternal and Child Health Nursing #8 | 50 Questions
- Maternal and Child Health Nursing #9 | 50 Questions
- Obstetrical Nursing: Antepartum | 50 Questions
- Obstetrical Nursing: Intrapartum | 60 Questions
- Obstetrical Nursing: Postpartum | 55 Questions
Pediatric Nursing NCLEX Practice Quizzes
A new set of questions related to the nursing care of youngsters.
- Newborn Nursing Care | 50 Questions
- Pediatric Nursing | 50 Questions
- Pediatric Nursing: Cardiovascular Disorders | 15 Questions
- Pediatric Nursing: Respiratory Disorders | 15 Questions
- Pediatric Nursing: Gastrointestinal Disorders | 15 Questions
- Pediatric Nursing: Genitourinary Disorders | 15 Questions
- Pediatric Nursing: Neurologic and Cognitive Disorders | 15 Questions
- Pediatric Nursing: Endocrine Disorders | 15 Questions
- Pediatric Nursing: Musculoskeletal and Neuromuscular Disorders | 15 Questions
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The Leanding Law Firms | 2016 | 341
CLIENTS Clients of KŠD LEGAL include leading entrepreneurs, national and international business companies active, for example, in areas of information technology and telecommunications, power industry, construction, mining industry, agriculture, tourism, etc., Czech and foreign banks, ministries, administrative authorities, local and regional authorities, and of course sports organizations, clubs, or individual athletes. As in regards to the scope of our expertise in individual areas of law, we also provide legal services in all main business sectors. Within our practice, we also provide legal services in newly developed areas of business.
tion to score further victories together with our clients. Some of the latest awards received by KŠD LEGAL are the following:
Corporate Intl. Legal Awards Winner Sports Law - Law Firm of the Year in the Czech Republic.
Czech Leading Law Firm In 2015, KŠD LEGAL became winner of the Czech Leading Law Firm ranking in the Sports Law category for the sixth time.
Individual members of the KŠD LEGAL team have professional knowledge of the relevant legal regulation of a particular sector and practical experience with specifics of business activities in the relevant area. Therefore, results of our work are ideal legal solutions for our clients with high added value to practical use.
We have also won the "Highly Recommended Law Firm" title in categories of Litigation and Arbitrations and Criminal Law and also the "Recommended Law Firm" title in other three areas of law.
Our clients – individual athletes – are, for example, Tomáš Berdych, Roman Kreuziger, or Eva Samková, as well as the following companies or associations:
Apart from Pro bono activities, KŠD LEGAL actively participates in a number of supporting projects, such as financial and legal support to athletes and young promising athletes, artists, or socially responsible projects. The collocation "legal support" is not only an empty phrase to us, but a real commitment to support individuals or organizations that may not afford legal representation in the relevant matter.
Autoclub of the Czech Republic, Cestovní kancelář FISCHER, a.s., Czech Olympic Committee, Czech Paralympic Committee, ČEZ, a.s., skupina CRESCON a.s., DATART INTERNATIONAL a.s., I&C Energo a.s., Investment group KKCG, the South Moravian Region, the Ústí Region, and the Vysočina Region, Mercedes-Benz Financial Services Česká republika s.r.o., ONDEO Services CZ, s.r.o., PSJ, a.s., SKANSKA a.s., Metrostav a.s., OHL ŽS, a.s., Raiffeisenbank a.s., UniCredit Bank Czech Republic and Slovakia, a.s, TECHO a.s., Tereos TTD, a.s., TOTAL ČESKÁ REPUBLIKA, s.r.o., UBM Bohemia Development s.r.o., or Vodafone Czech Republic a.s.
We would appreciate if you decide to become our satisfied client; together, we will achieve further success and score joint victories! KŠD LEGAL – WE KNOW HOW TO SCORE
AWARDS More than 10 years of tradition and experience in every-day work guarantee optimal legal services which you expect from a renowned and well-established Czech law firm. KŠD LEGAL is the winner of a number of awards granted by Czech and foreign entities, and it is one of the most successful Czech law firms in this area. We are honoured by each and every award received. Each award motivates us and strengthens our aspira-
KŠD LEGAL advokátní kancelář s.r.o. CITY TOWER Hvězdova 1716/2b 140 00 Prague 4 Tel.: +420 221 412 611 Fax: +420 222 254 030 e-mail: email@example.com www.ksd.cz

subset: commoncrawl


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End the year with a bang when the sky lights up at midnight! Make your evening in Chicago one to remember with this 3-hour cruise featuring dinner, sightseeing, and dancing along the shores of Lake Michigan. Feast your eyes on incredible views of iconic Windy City sights like Navy Pier, the Willis (Sears) Tower, Buckingham Fountain, and Soldier Field, then fill your belly with a bountiful all-you-can-eat buffet. Continue the celebration with a live DJ, who will mix up a selection of dance favorites.
Make your way to Navy Pier, where boarding begins at 8:30pm for a 9:30pm departure. You'll dance, dine, and celebrate during this beautiful 3-hour cruise along the shores of Lake Michigan, enjoying amazing Windy City skyline views along the way. Enjoy a few drinks (own expense) as you cruise, then sit down to an all-you-can-eat buffet that includes salads, pastas, gourmet entrees from a carving station, and an amazing spread of desserts. Following the meal, head to the dance floor to join a top DJ for the evening's party, grooving with the backdrop of the Chicago skyline. This 3-hour cruise concludes at the original departure point.


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Kerry Bishop leaves Frieze for ICA
Kerry Bishop, chief operating officer at Frieze since 2013, is leaving to become managing director of the Institute of Contemporary Arts.
The task she takes up on September 4 will be to implement the strategic vision for the ICA devised by director Stefan Kalmár since his arrival two years ago.
At Frieze Bishop, pictured, was in operational charge of its activities, including the recent launch of Frieze Los Angeles. Before that she worked in architecture and interior design.
Since 2017 the ICA has undergone changes in management and governance with new heads of most departments, and new board appointments including Wolfgang Tillmans and Francesca Thyssen-Bornemisza.
The ICA has extended its exhibitions programme under Kalmár and reinstated its programme of music and theatre commissions, as well as debate which last year featured the trans activist Chelsea Manning.


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Now, Dapple Baby Bottle and Dish Liquid is available in a fragrance-free version! It is perfect for safely cleaning baby bottles, sippy cups, pacifiers, and breast pump components. It features award-winning green technology to target milk residue and baking soda to combat odor. Our dish liquid rinses quickly and is made with all-natural ingredients. It is free of phthalates, parabens, SLS, SLES, and dyes. Features:
Perfect for cleaning baby bottles, sippy cups, pacifiers, and breast pump components
Baby safe
Removes residue and odor left behind by breast milk and formula
All Natural Refill pack fills 2 bottles of full-size 16.9 oz Dapple Fragrance-Free Baby Bottle and Dish Liquid.
IngredientsPurified water, alkyl polyglucoside (cleaner made from tree oils and glucose), sodium lauroamphoacetate (cleaner derived from tree oils and amino acid), sodium citrate (water softener derived from citric acid), baking soda, tetrasodium iminodisuccinate (natural complexing agent), and benzisothiazolinone (preservative). At Dapple, we occasionally make substitutions, additions and improvements to our formulas. We do our very best to keep our website up-to-date with a list of our most current ingredients. Please note that our products have a range of manufacturing dates. Consumers should consult product labels to see the exact ingredients in a product, at the time of manufacturing.


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Kolkata (West Bengal) [India], Jan 25 (ANI): Border Security Force (BSF) has recovered 16,90,000 Bangladeshi Taka and Fake Indian Currency Note (FICN) with the face value of Rs 3,48,000 at Indo-Bangladesh border, in two separate incidents on Friday.
According to BSF's press note, while performing operational duty on Indo-Bangladesh Border Fence (IBBF) a person was seen throwing some consignment from India to Bangladesh over the IBBF.
"Troops challenged and pursued the person however the suspect managed to escape towards Bangladesh taking advantage of bamboo bushes and thick vegetation ahead of the fence," it read.
"Upon search, 12 bundles were found wrapped in a cloth. The bundles were containing Bangladeshi currency in the denomination of 1000 Taka, 500 Taka, and 100 Taka," read the press note.
In another incident, acting on a tip-off about smuggling, BSF troops recovered four packets containing Fake Indian Currency Note (FICN) in the denomination of Rs 500 with the face value of Rs 3,48,000.
Fake Indian and Bangladeshi currency have been handed over to respective Police Stations for further legal action. (ANI)


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"We need excellence in our standards, not mediocrity, not dabbling. Life Planning is the essence of great financial planning."
George Kinder
Learn how to live the best life possible with the money you have.
Take our free 5-minute Return On Life online assessment and see what your ROL is.
Read our free guide to getting every aspect of your financial life under control.
Want to realise your wider life goals and ambitions, without the fear of ever running out of money?
Visit our Information Hub
Information is the key to wise decisions. The Otus Information Hub is packed with articles, videos and case studies to guide you in making smart choices about your financial future.
Get in touch with Otus
If you like what you've seen so far, please get in touch to ask any further questions you may have.


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Many of you have asked me about the benefits of Soft Foam Rolling as per my Florida Today article, 3 Reasons to Try Foam Rolling. During March, I added the same self-massage principles into our Gentle Yoga & Stretching Class. However, instead using a foam roller, we used "balls" for massaging the fascia of our hands and feet.
Working with the feet, in particular, offers many benefits as they are the foundation to our bodies. If we have problematic feet, (ie. plantar fasciitis, bunions, chronic pain), the negative affect may impact our knees, hips, spine, and so on. Also, our feet hold many accupressure points, that when massaged, can induce a healing response in other parts of our body. For example, a positive change to digestion, sleep, or anxiety may be the last thing we think about when it comes to working our feet, but massaging the feet can have a real impact on these areas.
So I hope we have fun on those days when I bring the balls to yoga class, but my wish is that you experience even more positive changes to your overall wellbeing that you derive from your regular yoga practice.
See you on the mat!


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Ether Podcast
A podcast to make and grow disciples
We found 1 episode of Ether Podcast with the tag "faith".
The Beginning
September 4th, 2018 | 54 mins 46 secs
bible study, christianity, discipleship, faith, gospel, resurrection
Mark 14-16 cover the last supper through the resurrection of the Christ. Then the book suddenly ends. We discuss why and we give our final thoughts on the book of Mark.


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Our company is a certified auditor of records management under Act No. 499/2004 Coll. on Archiving and Records Management, and our accredited staff are professionally qualified to inspect (audit) document management and records management in public administration and local government organizations in accordance with defined auditing standards
Our goal is to ensure optimal processes for document management and records management for our clients, therefore we offer the following services:
Analysis of the state of document management, and the subsequent implementation of corrective measures, offers significant benefits in the following areas:
The aim is to ensure that our clients would reach their established project goals as easily as possible in the shortest possible time.


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3100 Corbin Ln. - MLS# 9996948 - $470,000
Beautiful 3 bedroom, 2.5 bathroom home with new upstairs flooring, fresh interior paint and upgraded fixtures. Open kitchen and living area with large downstairs master bedroom and bathroom. Covered patio with only mature tree cover in development. Across from greenbelt area, near mailboxes and dog park.


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It's tax cuts for breakfast, lunch and supper in the topsy-turvy land of make-believe. The stakes are high as political parties try to claim the tax cut high ground. How will it be paid for, is it just talk and will they put our money where their mouth is?
The tax cut war has turned old politics on its head. Borrowing Brown wants to bowl 'em over with a spending spree. Caution Cameron is the new Prudence. Clegg, a latter day Robin Hood.
Today's supposed to be the Tories big day for small business. Not to be out-smarted or out-gunned, the government is firing on all cylinders ahead of the Pre-budget Report, due out in months/weeks/days, with the LibDems bringing up the rear.
Brown is on a borrowing spree as he sets out to save the word with his New World Order. His answer - just borrow more cash. It's borrow now, pay later - or rather leave it for the new suckers to pick up the tab.
The government is adamant the only way forward is to increase the already crippling national debt. Golden borrowing rules have bit the dust. Prudence is alive and well but living in the Tory Party.
Cameron's Conservatives are looking more and more like the Angry Party of late. They've managed to turn a traditional Tory agenda on its head. Instead of reaching out for the plastic, tax cuts would have to come from real savings.
Sit down with the household budget, tighten the purse strings, decide what to cut back on. And, at the same time, hammer home the message that it was Brown and the gang who got us in this mess in the first place. But that sort of reality check may be hard to swallow after a decade of the false good times.
And the LibDems? Clegg bless him has turned into Robin Hood with funding coming from a "tax on the wealthy". Great for sound-bites but an estimated £15 billion is needed for tax cuts and breaks to make any real difference to people's pockets. You have to start to climb down the wealth ladder to rake in all that cash.
The Orange Party is all for a redistribution of wealth - hit the obscenely rich by all means - but how far down the that wealth ladder do you have to go, before 'wealthy' becomes just the 'better off'?
Slashing interest rates to an all time low kicked off the tax cut bidding war, when everyone suddenly realised that would take ages to work through and, for now, there's nowt in it for them. Politicians were quick to realise there's equally nowt in it for them too.
The point was made here earlier that the current interest rate cut isn't deep enough for a deep recession.
In the real economy it's supposed to make people spend more. But faced with crippling debt and huge bills, any interest rate cut will just be gobbled up to help pay the bills. Tax cuts, in whatever form, put real cash in people's pockets but debt is now so endemic, tax cuts too will probably end up on the bills, loans and mortgages.
For a decade New Labour has spun its way out of trouble with public spending craftily kept off the balance sheet. The Tories have never shied away from wanting cuts in public spending. No-ones quite sure what the LibDems really, really want.
For the first time in an age there is clear water between all three main political parties on the billion dollar economic question. And they are all convinced they have the magic formula.
Few would disagree that tax breaks are needed. It's how they are going to be paid for that polarises the political parties. In this topsy-turvy land you can do whatever you want. As long as it's the vote winner.


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This article was originally published by our friends at Authority Nutrition
Urinary tract infections affect millions of people every year.
Though they're traditionally treated with antibiotics, there are also many home remedies available that help treat them and prevent them from reoccurring.
What Is a Urinary Tract Infection?
A urinary tract infection (UTI) is an infection that affects any part of the urinary tract, including the kidneys, ureters, bladder or urethra (1).
Bacteria from the bowel are the most common cause of UTIs, but fungi and viruses can also cause infection (1).
The two strains of bacteria Escherichia coli and Staphylococcus saprophyticus account for about 80% of cases (2).
Common symptoms of UTI include (1):
- A burning sensation when peeing
- Frequent urination
- Cloudy or dark urine
- Urine with a strong odor
- A feeling of incomplete bladder emptying
- Pelvic pain
Though UTIs can affect anyone, women are more prone to infection. This is because the urethra, the tube that carries urine out of the bladder, is shorter in women than men. This makes it easier for bacteria to enter and reach the bladder (2).
In fact, nearly half of all women will experience a UTI at some point in their lives (3).
Antibiotics are used to treat UTIs and are sometimes used in low doses long-term to prevent recurrence (4).
There are also several natural ways to protect against infections and reduce the risk of recurrence.
Without further ado, here are the top 6 home remedies to fight UTI.
1. Drink Plenty of Fluids
Hydration status has been linked to the risk of urinary tract infection.
This is because regular urination can help flush bacteria from the urinary tract to prevent infection (5).
One study examined participants with long-term urinary catheters and found that low urine output was associated with an increased risk of developing a UTI (6).
A 2003 study looked at 141 girls and showed that low fluid intake and infrequent urination were both linked to recurrent UTIs (7).
In another study, 28 women self-monitored their hydration status using a probe to measure their urine concentration. They found that an increase in fluid intake led to a decrease in UTI frequency (8).
To stay hydrated and meet your fluid needs, it's best to drink water throughout the day and always when you're thirsty.
Summary: Drinking plenty of liquids can decrease the risk of UTIs by making you pee more, which helps remove bacteria from the urinary tract.
2. Increase Vitamin C Intake
Some evidence shows that increasing your intake of vitamin C could protect against urinary tract infections.
Vitamin C is thought to work by increasing the acidity of the urine, thereby killing off the bacteria that cause infection (9).
A 2007 study of UTIs in pregnant women looked at the effects of taking 100 mg of vitamin C every day.
The study found that vitamin C had a protective effect, cutting the risk of UTIs by more than half in those taking vitamin C compared to the control group (10).
Another study looked at behavioral factors that affected the risk of UTIs and found that a high vitamin C intake decreased the risk (11).
Fruits and vegetables are especially high in vitamin C and are a good way to increase your intake.
Red peppers, oranges, grapefruit and kiwifruit all contain the full recommended amount of vitamin C in just one serving (12).
Summary: Increasing vitamin C intake may decrease the risk of UTIs by making the urine more acidic, thus killing off infection-causing bacteria.
3. Drink Unsweetened Cranberry Juice
Drinking unsweetened cranberry juice is one of the most well-known natural remedies for urinary tract infections.
Cranberries work by preventing bacteria from adhering to the urinary tract, thus preventing infection (13, 14).
In one recent study, women with recent histories of UTIs drank an 8-ounce (240-ml) serving of cranberry juice every day for 24 weeks. Those who drank cranberry juice had fewer UTI episodes than the control group (15).
Another study showed that consuming cranberry products may lower the number of UTIs in a year, especially for women who have recurrent UTIs (16).
A 2015 study showed that treatment with cranberry juice capsules equivalent to two 8-ounce servings of cranberry juice could cut the risk of urinary tract infections in half (17).
However, some other studies suggest that cranberry juice may not be as effective in the prevention of UTIs.
One review looked at 24 studies with a total of 4,473 participants. Though some smaller studies did find that cranberry products could reduce UTI frequency, other larger studies found no benefit (18).
Although the evidence is mixed, cranberry juice may be helpful in reducing the risk of urinary tract infections.
Keep in mind that these benefits only apply to unsweetened cranberry juice, rather than sweetened commercial brands.
Summary: Some studies show that unsweetened cranberry juice could help reduce the risk of urinary tract infections by preventing bacteria from adhering to the urinary tract.
4. Take a Probiotic
Probiotics are beneficial microorganisms that are consumed through food or supplements. They can promote a healthy balance of bacteria in your gut.
Probiotics are available in supplement form or can be found in fermented foods, such as kefir, kimchi, kombucha and probiotic yogurt.
The use of probiotics has been linked to everything from improved digestive health to enhanced immune function (19, 20).
Some studies also show that certain strains of probiotics may decrease the risk of UTIs.
One study found that Lactobacillus, a common probiotic strain, helped prevent UTIs in adult women (21).
Another study found that taking both probiotics and antibiotics was more effective at preventing recurrent UTIs than using antibiotics alone (22).
Antibiotics, the main line of defense against UTIs, can cause disturbances in levels of gut bacteria. Probiotics may be beneficial in restoring gut bacteria after antibiotic treatment (23).
Studies have shown that probiotics can increase levels of good gut bacteria and reduce side effects associated with antibiotic use (24, 25).
Summary: Probiotics could help prevent UTIs when used alone or in combination with antibiotics.
5. Practice These Healthy Habits
Preventing urinary tract infections starts with practicing a few good bathroom and hygiene habits.
First, it's important not to hold urine for too long. This can lead to a buildup of bacteria, resulting in infection (26).
Peeing after sexual intercourse can also reduce the risk of UTIs by preventing the spread of bacteria (11).
Additionally, those who are prone to UTIs should avoid using spermicide, since it has been linked to an increase in UTIs (27).
Finally, when you use the toilet, make sure you wipe front to back. Wiping from back to front can cause bacteria to spread to the urinary tract and is associated with an increased risk of UTIs (28).
Summary: Urinating frequently and after sexual intercourse can reduce the risk of UTI. Spermicide use and wiping from back to front may increase the risk of UTI.
6. Try These Natural Supplements
Several natural supplements may decrease the risk of developing a UTI.
Here are a few supplements that have been studied:
- D-Mannose: This is a type of sugar that is found in cranberries and has been shown to be effective in treating UTIs and preventing recurrence (29).
- Bearberry leaf: Also known as uva-ursi. One study showed that a combination of bearberry leaf, dandelion root and dandelion leaf decreased UTI recurrence (30).
- Cranberry extract: Like cranberry juice, cranberry extract works by preventing bacteria from adhering to the urinary tract.
- Garlic extract: Garlic has been shown to have antimicrobial properties and may be able to block the growth of bacteria to prevent UTIs (32, 33).
Summary: D-Mannose, bearberry leaf, cranberry extract and garlic extract are natural supplements that have been shown to prevent UTIs and decrease recurrence.
The Bottom Line
Urinary tract infections are a common problem and can be frustrating to deal with.
However, staying hydrated, practicing some healthy habits and supplementing your diet with some UTI-fighting ingredients are good ways to lower your risk of getting them.
Breakfast, blood sugar, & inflammation
Recent research has shown that Inflammation is responsible for 7 out of 10 Deaths in the United States. But it doesn't have to be the same way for you.
In fact, in a fairly short amount of time, you could start to experience better sleep…less stomach issues…more energy and stamina…less muscle and joint pain…a drop in weight…lower stress levels…and much, much more!
Learn how to Prevent—Even Reverse—Most Major Diseases by "Turning Off" Inflammation!
==> Naturally Fight & Reverse Damaging Inflammatory Effects in Your Body!
Best stretch before bed (1 minute)
Did you know that one of the best times to stretch is right before bed? However…
What stretches should you do? Here's a 1-minute stretch routine you can do before bed...
=> Best stretch before bed (takes 1-min)
Lisa, Yoga Coach
eatlocalgrown / wisemindhealthybody
Stop Snoring in 3 Minutes - Starting Tonight
...easy, 3-minute exercise that completely cured his horrendous snoring! We can both finally sleep!
Today is a good day. Tonight will be even better. Why?
Because you're about to learn easy throat exercises that cure (not just treated) your stubborn snoring – in 3 minutes – starting TONIGHT!
...even if straps, sprays and even torturing CPAP masks have failed you in the past.
Most people heal their snoring in just a few minutes per day using these powerful throat exercises. And they're so easy, you can do them, regardless of your age or physical shape.
Use them anytime, anywhere... even while stuck in traffic or watching TV.
Plus the results are permanent!
To learn more and test-drive the easy snoring and sleep apnea exercises for yourself, click here...
The #1 "bodyfat-eating" hormone...
Did you know that your bodyfat can become "calorie-resistant"?
True. And it's completely unaffected by even the strictest diets... and most intense exercises.
However, there's good news- Calorie-resistant bodyfat can be now removed...
It's a little-known, calorie-burning hormone we all have... just waiting for the right spark to come alive. It's not thyroid, leptin, ghrelin, insulin, adiponectin, HGH or any other "fat loss" hormone you may know. Read more to find out precisely how to unleash its calorie-burning power:
==> How to Activate Your #1 "Bodyfat-Eating" Hormone...
To your health!
PS - Studies show that it can also reduce your risk of diabetes by 53.7%, a heart attack by 83.3% and stroke by 51.4%. Here's more of the scientific proof...
#1 muscle that eliminates joint and back pain, anxiety and looking fat
I bet you can't guess which muscle in your body is the #1 muscle that eliminates joint and back pain, anxiety and looking fat. This "hidden survival muscle" in your body will boost your energy levels, immune system, sexual function, strength and athletic performance when unlocked.
If this "hidden" most powerful primal muscle is healthy, we are healthy.
Is it…
a) Abs
b) Chest
c) Glutes
d) Hip Flexors
Take the quiz above and see if you got the correct answer!
In April, 2009, researchers stunned the medical community when they reported chronic inflammation as the root cause of several major diseases.
See, every year 610,000 people in the U.S. die of heart disease. Cancer claims another 584,000...stroke 130,000...Alzheimer's disease nearly 85,000 — and the list goes on.
Truth is, we now know... chronic inflammation is responsible for 7 out of the top 10 leading causes of death in the United States! Hundreds of studies and scientific reviews prove it.
Fortunately, newer research shows you can prevent-even reverse-most major diseases by "turning off" inflammation. And in our new book, we show you how to do just that.
If you or a loved one is suffering from a debilitating condition-and you"re not sure what the culprit is-now's the time to find out...while you can still do something about it!
Get the Free Inflammation Book
--> Grab your FREE copy of this groundbreaking soft cover book today (while supplies still last.)
Free Paleo / Keto Cookbook
Over the past year, my friend Dave over at PaleoHacks has been working on a super secret cookbook project with our good friend Peter Servold a Le Cordon Bleu trained Chef and owner of Pete's Paleo...
And today, this new incredible Paleo Cookbook is finally available to be shipped right to your door for FREE!
The cookbook is called Paleo Eats, and it's filled with over 80 chef created, insanely tasty Paleo recipes which means they are free from gluten, soy, dairy, and refined sugar.
Get your FREE copy of Paleo Eats Here. (Grab this today, because they only ordered a small batch of these cookbooks for this freebie promotion, and they will sell out FAST!)
Sponsored Health Resources
In the years that I've been working on this website project I've come across some amazing resources by some very special people. I'd like to share them with you here.
NOTE: I update these links often so please check back to see what's new!
1) Everyone knows green smoothies are healthy right? Have you heard of a "red" smoothie? If not, check out this story…
--> "Red" Smoothie Helps Alabama Girl Shed 80lbs!
2) Forget what you've read about 10-day lemonade cleanses, 7-day detoxes with green juices and Gwyneth's gruel. All you need to do, and this is perfect for Saturday or or anytime really, is a simple 1-day cleanse.
--> Get the 1 Day Cleanse (better than 7-day detoxes!)
3) This "hidden survival muscle" in your body will boost your energy levels, immune system, sexual function, strength and athletic performance when unlocked.
--> #1 muscle that eliminates joint and back pain, anxiety and looking fat
4) I thought it was virtually impossible for a website to be able to tell me anything even a little bit insightful after only submitting my name and date of birth... I was wrong!
--> Your Birth Date + Name - Free Report
5) Turmeric is amazing. The problem is - It's hard to absorb!
--> The best way to get maximum effects of Turmeric
6) Wonder why your stomach still sticks out even though you're hammering the core exercises every day? It's a common myth that bulging belly is due to weak abdominal muscles.
--> Why Some People LOOK Fat that Aren't
7) Even if you're the most active of athletes, you may still suffer from tight hip flexors due to the amount of time you spend each day planted to a chair.
Enjoy! Let me know how these work out for you. And if you run across anything I've missed please let me know.
Rick D.


text:
While running the out of the box provided database view "matching_user_group_skills", getting below error:
Error Message Syntax Error or Access Rule Violation detected by database (Unknown column 'sys_user_group0.type' in 'where clause')
Any supported release.
Reviewing the "matching_user_group_skills" database view revealed that system couldn't find the "user_task_stats" table and hence it had orange color dot on the view tables section of the database view.
Table "user_task_stats" is coming from a plugin called "Resource Matching Engine" (Id="com.snc.matching_rule"). And this plugin was not active on the affected instance and hence "user_task_stats" table was not available.
Eventually this failed the "matching_user_group_skills" database view.
Get the "Resource Matching Engine" (Id="com.snc.matching_rule") plugin activated, it should create the missing "user_task_stats" table and hence should resolve the issue with "matching_user_group_skills" database view.


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Intermediary Network Sales Support and Expertise
August 6, 2019
This year, Desjardins Insurance will use 6% or the rate obtained by applying the calculation formula used to determine the GLWB Bonus Rate, whichever is higher. This 6% rate only applies to new Contracts opened in 2019*.
* A client with a Helios2 Contract opened prior to 2019 can open a new Contract with a Deposit of $50,000 or more.
Your clients must set up a Contract with Helios2 – 75/100 GLWB as the selected Guarantee and they cannot make any withdrawals in 2019. The GLWB Bonus will be applied on the GLWB Bonus Base, which is 100% of the value of each Deposit made since the Contract was opened. New Contracts must be opened by no later than December 31, 2019.
If these clients meet all the conditions, the rate that will apply to their Contract will be the rate obtained by applying the calculation formula used to determine the GLWB Bonus Rate, as described in the Contract and Information Folder.
See the
Helios2 section for more details.
Intermediary Network Sales Support and Expertise


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Stunning Mediterranean style home located in the prestigious Intercoastal Waterway Community of Arrowhead Grand. This 4-bedroom, 3-bathroom home is immaculate and was built with quality you can see the moment you walk in. A few details you will notice are the bull nose corners, arch ways, windows with frames and ledges, 9' smooth ceilings and tile in all wet areas. Entering the home, you'll see an airy foyer open to a large area that is currently used as the formal dining room. Through the archway you'll come into the open floor plan which boast granite countertops that overlook the kitchenette and living room. Stainless steel appliances, custom cabinets and a large breakfast bar are included. Large windows throughout the main floor bring natural light into the home. The master bedroom has tray ceilings and large bay window along with the bathroom which has a double sink, walk-in in closet and five-foot walk-in tiled shower! Upstairs you are greeted by an oversized loft area and one bedroom. The yard has an irrigation system set in place for ease with upkeep. Porch ceilings are cypress wood! Large finished attached garage, this home is sure to have all the elements you are looking for! Arrowhead Grand Community is nestled between the Waterway and Arrowhead Golf Course. This beautiful home won't last long with its convenient location just minutes from the golf courses, Market Commons and Coastal Grand Mall! Square footage is approximate and not guaranteed. Buyer is responsible for verification.
Listing courtesy of BeachConnection Realty , Byron Macdonald. Selling Office: Fallon & Associates Realty Co , Ryan Lundgren.
Provided courtesy of The Coastal Carolinas Association of REALTORS®. Information Deemed Reliable but Not Guaranteed. Copyright 2020 of the Coastal Carolinas Association of REALTORS® MLS. All rights reserved. Information is provided exclusively for consumers' personal, non-commercial use, that it may not be used for any purpose other than to identify prospective properties consumers may be interested in purchasing.


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Hello there! My name is Bea and this will be my second year teaching in Kids&Us. Since I was a child, I wanted to be an English teacher and the marvelous world of Kids&Us made my dream come true! My passion are the languages, that is why I decided to study English Philology and two more languages that are: Italian and French. I come from Albacete, in Castilla-La Mancha and it has been a one year since I am living in Barcelona, a city that I really love. I am looking forward to hearing from you all! See you around!
This year I'm teaching Mousy, Linda, Sam, Oliver, Marcia, Pam&Paul, Ben&Brenda and Animal Planet 2.
Hello! My name is Ana María. I am from Barcelona and I studied a degree on English Studies at the University of Barcelona and a Master in Translation for International Communication at the University of Vigo. One of my main passions is teaching, that is why I am so excited to teach at Kids & Us. It's my second year and I am enjoying this experience very much. I encourage you to contact me anytime you wish. See you around!
This year I'm teaching Linda, Emma, Oliver, Marcia, Pam&Paul, Ben&Brenda and Fairy Tales 1.
Hello! My name is Núria and I am from Barcelona. I have a degree on English Studies from the University of Barcelona and a postgraduate degree on Audiovisual Translation from Universitat Pompeu Fabra. This is my first year here at Kids&Us and I couldn't be more excited! I have been teaching English for over 5 years now and I hope I can continue to do so! Please feel free to contact me!
This year I'm teaching groups of Oliver, Marcia, Pam&Paul, Ben&Brenda and Animal Planet 1.
Hello everyone, my name is Eveline and I'm very enthusiastic to be teaching at Kids&Us Cornellà.
Here is a little bit more of information about me. I'm 27 years old and I'm originally from Belgium, but I have been living here for some years now. In Belgium we speak different languages and have different languages at school. English is integrated in so many ways. I have a degree in Occupational Therapy, but I wanted to specialise more in children and I have started studying again to get the Kindergarten Teacher's degree. I just love teaching children.
This year I'm teaching Linda, Sam, Emma, Oliver, Marcia, Pam&Paul and Animal Planet 1.


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Dreamed 1981/5/25 by Chris Wayan
I'm in an empty theater in southern Europe. By me sits the Duke of Venice. He says "Europe used to be so cooperative, when it was run by sensible folk. I knew everyone then..."
"Everyone, eh?" Yeah, the rest of us non-aristocrats were no one...
"These decadent days," he complains, "only a few regions still know how to treat a Duke." He lists them--all dominated by right-wing cliques, I notice--Northern Ireland, part of rural Holland? "Not even a whole country" he complains. Well, he controls a few kingdoms. Luxembourg? Lichtenstein? But they're microscopic. "All the rest pursue their own interests, run by commoners--businessmen!"
I don't tell him what I'm thinking: "I HATE corporate capitalists... but better them than YOU."
I was raised by leftists. So I've had to struggle to accept money in my life--for the poor are honest and noble, the rich are all crooks!
Well, they largely are... but I tend to forget the even more arrogant assholes who came before.
And the murderers who came before THEM...
Me plus money doesn't equal corporate slimeball. Me plus dinner doesn't equal the Duke of Venice.
World Dream Bank homepage - Art gallery - New stuff - Introductory sampler, best dreams, best art - On dreamwork - Books
Indexes: Subject - Author - Date - Names - Places - Art media/styles
Titles: A - B - C - D - E - F - G - H - IJ - KL - M - NO - PQ - R - Sa-Sh - Si-Sz - T - UV - WXYZ
Email: email@example.com - Catalog of art, books, CDs - Behind the Curtain: FAQs, bio, site map - Kindred sites


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Montash have been engaged by a leading FTSE 100 Company to source A process improvement analyst to work in Luton for a 6 month role with travel to Stockholm (once per month for 3 -4 days). *please note that Lean Six Sigma qualifications are required for this role*
You will be working on a large business transformation programme coordinating two end markets, and IT platforms and ensuring common processes.
The client are looking for a Business Analyst / Process Improvement Analyst with a background in Lean Six Sigma to scope out the operating model definition. The Role involves mapping out processes in operation in both markets, facilitating workshops and mapping "to be" processes.
The Business has embarked on an initiative which will see the consolidation of it's operating model across both the UK and Nordics business, which will result in a move from multiple teams and systems performing the same/ similar roles to a single platform, a single way of working and a single team.
A programme has been formed in the technology space, which focuses on the IT element of the change.
This workstream will review the operating model acrosss the UK & I and Nordic Technology Teams and landscapes, with a view to creating a single northern Europe Technology platform and operating model.
Duties/Typical Week
- Running and facilitating workshops to drive out differences in capabilities and process
- Planning approach
- Drive a common way of working, prioritizing requirements - ensuring non functional requirement documents aligned to processes agreed
- Outputs - coordinating these to key decision makers
- Planning for further process reviews
- Represent their workstream at meetings / project boards
- Clear communications - Stakeholder management - ability to highlight key points in a way that's appropriate to the level of the audience - especially where there may be conflicting interests/agendas
Essential Skills:
- Lean 6 Sigma (Black belt ideally)
- Business Process Mapping
- Visio
- Strong relationship management and excellent Stakeholder engagement skills
- Experience on large, multi market large transformation programmes within complex organisations
- Gravitas
- Strong communications skills
- Ability to be objective - question and probe Ability to show value of project
- Clear communications - Stakeholder management - ability to highlight key points in a way that's appropriate to the level of the audience - especially where there may be conflicting interests/agendas
- Create collaboration
- International projects experience- exp with different cultures
- Travel not essential but experience on similar projects with disparate teams a big plus


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Sheriff Mike Lewis of Wicomico County Maryland is no stranger to winning attention with bold talk.
Local critics accused him of overkill when he sent a military assault vehicle 145 miles north to Baltimore during riots there in 2015.
His Facebook repost of Hilary Clinton in handcuffs sparked outrage.
Lewis is an outspoken supporter of President Donald Trump who recently joined the President in the oval office to support the veto of a resolution opposing a border wall.
Lewis has also spoken of "civil war" being sparked by additional gun control regulations.
But recent declarations that he will openly defy state law by refusing to enforce new gun regulations proposed in the Maryland General Assembly has critics saying he has gone too far.
"This is potentially dangerous," Jamaad Gould, local progressive activist, said.
Gould recently ran unsuccessfully for the Wicomico County Council.
"He has the responsibility to understand that his words can openly lead to violence," Gould said. "White Nationalists very easily can be inspired by noncompliance."
Sheriff Lewis said he continues to stand by his "We Will Not Comply" declaration depending on the details of any Maryland gun legislation that may pass the 2019 General Assembly Session.
"I would have to see what passes first," Lewis said. "But had it passed in its original format, would not have complied. Absolutely not."
RELATED: Maryland authorities could face open defiance if new gun laws pass, including from one of their own
One bill currently before the legislature would criminalize the possession of "heavy barrel" assault rifles that have already been legally purchased under an exemption to a previous Maryland law restricting certain assault-style rifles.
Another bill proposed in the wake of the mass shooting at the Annapolis Capital Gazette Newspaper would require training, state-level background checks and state-licensing for all gun purchases including shotguns and rifles more commonly used for hunting and target shooting. Currently those restrictions only apply to handguns and the state list of semi-auto assault rifles.
A shotgun was used in the attack on the newspaper that killed five people.
That bill has been pared down in committees to only require federal background checks for the private person-to-person sales of shotguns and rifles.
Sheriff Lewis first took his defiant stand during a rally of Second Amendment supporters gathered in Annapolis to lobby legislators in February. The crowd shouted and applauded loudly after his declaration "We will not comply".
Lewis, as an elected law enforcement officer, has become the most powerful and visible supporter of the "We Will Not Comply" movement started by the Maryland gun rights group Patriot Picket who are frequently seen at the state house wearing tee shirts emblazoned with the statement.
Lewis said when he talks about "civil war" it's not to inspire defiance or violence. He says it's his duty to "warn" leaders of the stakes.
"What's going on here is once again they [gun control advocates] are pushing and they're pushing," Lewis said. "I know many people who will not surrender their guns, period. And it would be an all out Civil War. Do I think it's going to come to that, Scott? No I do not."
Salisbury resident R.S. Mitchell, who runs a firearms training school, says he supports Lewis "completely 100 percent."
Mitchell scoffed at the idea that open defiance of state gun laws might inspire confrontation or violence.
"I think you need to look at Ghandi who had non-violent, non-compliance," Mitchell said. "That's where we're at."
Lewis, a Republican, was elected to be Sheriff in Wicomico County in 2006 after a 22-year career with the Maryland State Police where he left with the rank of sergeant.
He was re-elected in 2018 and has never been opposed since taking office.
Wicomico County has slightly more than 100,000 residents with a median household income of about $53,000. It's the home of the chicken producer Perdue Farms, and much of the county is rural.
The city of Salisbury is the county seat. The city is home to Salisbury University and the region's major medical complex making the health care and education sectors major employers in the county.
Fifty-two percent of the county voted for President Donald Trump in 2016.
"We're a conservative county," Lewis said. "The majority of people down here rely heavily on their weapons to protect their farms and to protect their homes. We only have 96 sworn deputies but were covering 374 square miles."


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With the last full week of school upon us, the summer months are within your reach! Though Plattsburgh is known for some crazy weather throughout the year, the summer months are beautiful with everything blooming, lush and green, making it the best time to schedule your senior portraits! If you love the lake, sun, tall grass and gorgeous green trees, the best time to schedule your Jared and Debbie senior portrait session is from June through August. We are now scheduling for these busy summer months and while we currently have plenty of availability, dates fill up FAST! Contact us soon or have your parents give us a call to chat session details!
Get started with learning more about our Jared and Debbie Seniors Portrait Session options!
Email us using the contact tab above or to email@example.com, give us a ring at 518.310.0698 or Facebook message us to start planning your senior portraits! It's going to be an awesome summer!


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Tractors and, somewhat surprisingly, home fire sprinklers got the attention of the public during Ontario's recent International Plowing Match and Rural Expo.
"Looks like a small hockey puck!" said an intrigued visitor eyeing a concealed sprinkler head during a model home exhibit during the event, where free information from the Home Fire Sprinkler Coalition was on hand. He and others were interviewed by a local news station, which obtained a variety of perspectives from different stakeholder groups--including some groups typically at odds with each other on the issue of sprinklers--on the necessity of these life-saving devices.
"A nice glass shower could be $5,000, and here we have a home sprinkler system that's going to run less than that," Howard Sher, CEO of Quality Homes, a Canadian modular home and cottage builder, told the news station.
Offering some sprinkler 101 at the exhibit was Chief Cynthia Ross-Tustin with the Essa Fire Department. "More people die in residential home fires than any other fire in this province," she said. "Every sprinkler head is [like] having your own personal firefighter."
Insurers also vocalized their sprinkler support. Frank Santana with The Co-Operators Insurance, which offers a 10 percent sprinkler discount, discussed measures his company is taking to get sprinklers mandated in the areas they serve. "We're lobbying with the government, working with the government as best we can to make [sprinklers] mandatory with new builds," he said.
Watch the video for more highlights from the event. (Click on the Wednesday, September 17 news broadcast. The sprinkler segment begins near the 5:40 mark.)


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Entry Update
Addition of ATS setup started Nov 9, 2014. First day input of micro size algae on screen. Floss and PhosGuard removed. Rearranged some live rocks and corals.
Parameters: (API test kit)
Specific gravity: 1.025
Temp: 21 - 25
Nitrate: 0ppm
pH: 8.2
Calcium : 440
Alkalinity: 7
Phosphate, Silica, Iodine, Strontium, Boron, Iron : to be updated
LS Additions:
1 polyp suncoral
several Nassarius snails
1 green/blue acropora
1 purple/blue acropora (guest)
5 polyp golden clove (today: 7 new polyps)
Frag Gorgonian (no PE)
small red zoa colony