OB ch. 21

b

A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed? a. bronchodilators b. tocolytic therapy c. muscle relaxants d. anti-anxiety therapy

b

When caring for a client requiring a forceps-assisted birth, the nurse would be alert for: a. increased risk for uterine rupture. b. potential lacerations and bleeding. c. increased risk for cord entanglement. d. damage to the maternal tissues.

c

A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and birth. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm dilated. She continues to report severe pain in her back with each contraction. The client finds it comforting when her doula uses the ball of her hand to put counterpressure on her lower back. What is the likely cause of the woman's back pain? a. Breech presentation b. Fetal macrosomia c. Occiput posterior position d. Nongynecoid pelvis

d

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find? a. preterm pregnancy b. small body size of mother c. maternal rickets d. gestational diabetes

a, b, c, d, f

A nurse is preparing to teach a class to pregnant women about the signs of preterm labor and what to do if these occur. Which signs of preterm labor should the nurse include in the presentation? Select all that apply. a. uterine contractions, cramping, low back pain b. feeling of pelvic pressure or fullness c. increase in vaginal discharge d. nausea, vomiting, and diarrhea e. feelings of stress f. leaking of fluid from the vagina

a

A nurse working with a woman in preterm labor receives a telephone report for the fetal fibronectin test done 10 hours ago. The report indicates an absence of the protein, which the nurse knows indicates: a. birth is unlikely within the 2 next weeks. b. birth is likely within the next 2 weeks. c. no infection is present. d. infection is present.

a, b, d

A nursing instructor highlights which risk factors associated with preterm labor? Select all that apply. a. history of previous preterm birth b. current multiple gestation pregnancy c. weight of fetus d. uterine or cervical abnormalities e. weight of pregnant mother

a, c, d, e

A nursing student doing a rotation in labor and birth correctly identifies which medications as most commonly used for tocolysis? Select all that apply. a. magnesium sulfate b. nitroglycerin c. atosiban d. indomethacin e. nifedipine

b

A nursing student has learned that precipitous labor is when the uterus contracts so frequently and with such intensity that a very rapid birth will take place. This means the labor will be completed in which span of time? a. less than 5 hours b. less than 3 hours c. less than 4 hours d. less than 8 hours

b

A pregnant woman has just found out that she is having twin girls. She asks the nurse the difference between fraternal and identical twins. The nurse explains that with one set of twins there is fertilization of two ova, and with the other set one fertilized ovum splits. What type of twins result from the split ovum? a. fraternal b. identical c. neither type results from a split ovum d. both types can result from the split ovum

c

A woman is admitted to the labor suite with contractions every 5 minutes lasting 1 minute. She is post-term and has oligohydramnios. What does this increase the risk of during birth? a. fetal hydrocephalus b. macrosomia c. cord compression d. shoulder dystocia

a

A woman is to undergo labor induction. The nurse determines that the woman requires cervical ripening if her Bishop score is: a. 5. b. 6. c. 7. d. 9.

c

A woman receiving an oxytocin infusion for labor induction develops contractions that occur every minute and last 75 seconds. Uterine resting tone remains at 20 mm Hg. Which action would be most appropriate? a. Slow the oxytocin infusion to the initial rate. b. Continue to monitor contractions and fetal heart rate. c. Stop the infusion immediately. d. Notify the birth attendant.

c

After an hour of administering oxytocin intravenously, the nurse assesses a woman's contractions to be 80 seconds in length. The nurse's first action would be to: a. slow the infusion to under 10 gtt per minute. b. increase the flow rate of the main line infusion. c. discontinue the oxytocin infusion. d. continue to monitor contraction duration every 2 hours.

b

Before calling the primary care provider to report a slow progression or an arrest of labor, several assessments need to be made. What other maternal assessment does the nurse need to make prior to calling the care provider? a. Make sure the epidural medication is turned down. b. Check for a full bladder. c. Make sure the client is lying on her left side. d. Assess vital signs every 30 minutes.

c

The experienced labor and birth nurse knows to evaluate progress in active labor by using which simple rule? a. 2 cm/hour for cervical dilation b. 1/2 cm/hour for cervical dilation c. 1 cm/hour for cervical dilation d. 1/4 cm/hour for cervical dilation

a, c, d, e

The nurse is preparing to talk to a group of pregnant women about elective induction and why it is not highly recommended. Which statements should she include in her presentation? Select all that apply. a. It significantly increases the risk of cesarean birth. b. It significantly increases the weight of the newborn. c. It significantly increases instrumented birth. d. It significantly increases the use of epidural analgesia. e. It significantly increases the admissions to the neonatal ICU.

a, b, d, e

The nurse who works at the local health department is preparing to give a talk on post-term pregnancies. She wants to include the fetal risks. Which risks should she include? Select all that apply. a. macrosomia b. shoulder dystocia c. failure to thrive d. brachial plexus injuries e. cephalopelvic disproportion

b

The nurse would be alert for possible placental abruption during labor when assessment reveals which finding? a. macrosomia b. gestational hypertension c. gestational diabetes d. low parity

a

The nurse would prepare a client for amnioinfusion when which action occurs? a. Severe variable decelerations occur and are due to cord compression. b. Fetal presenting part fails to rotate fully and descend in the pelvis. c. The fetus shows abnormal fetal heart rate patterns. d. Maternal pushing is compromised due to anesthesia.

b

When a woman in labor has reached 8 cm dilation, the nurse notices the fetal heat rate suddenly slows. On perineal inspection, the nurse observes the fetal cord has prolapsed. The nurse's first action would be to: a. turn her to her left side. b. place her in a knee-chest position. c. replace the cord with gentle pressure. d. cover the exposed cord with a dry, sterile wrap.