OB Exam 2

A nurse is caring for a client following the administration of an epidural block and is preparing to administer an IV fluid bolus. The client's partner asks about the purpose of the IV fluids. Which of the following is an appropriate response for the nurse to make?

"It is needed to counteract hypotension"

A nurse is caring for a client who is in the first stage of labor and is encouraging the client to void every 2 hours. Which of the following statements should the nurse make?

"A distended bladder reduces pelvic space needed for birth"

A nurse is caring for a client in the third stage of labor. Which of the following findings indicate that placental seperation?

-Lengthing of the umbilical cord -Appearance of dark blood from the vagina -Fundus firm upon palpation

A nurse is caring for a client and her partner during the second stage of labor. The client's partner asks the nurse to explain how he will know when crowning occurs. Which of the following responses should the nurse make?

"The vaginal area will bulge as the baby's head appear"

A nurse educator in the labor delivery unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly hired nurses. Which of the following statesments by a nurse indicates understanding of the teaching?

"They are administered in an oral form"

A nurse is teaching a client about the benefits of internal fetal heart monitoring. Which of the following should statements the nurse include in the teaching?

-"It can detect abnormal fetal heart tones early" -"It allows for accurate readings with maternal movement" -"It can measure uterine contraction intensity"

A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions every 3-5min and becoming stronger. A vaginal exam reveals that the client's cervix is 3cm dilated, 80% effaced, and -1 station. The client asks for pain medication. Which of the following actions should the nurse take?

-Encourage use of patterned breathing techniques -Administer opioid analgesic medication -Suggest application of cold

A nurse is caring for a client who has a prescription for magnesium sulfate. The nurse should recognize that which of the following are contraindications for use of this medication?

-Fetal distress -Vaginal bleeding -Cervical dilation greater than 6cm

A nurse is providing care for a client who is in active labor. Her cervix is dilated to 5cm, and her membranes are intact. Based on the use of external electronic fetal monitoring, the nurse notes a FHR of 115 to 125/min with occasional increases up to 150-155/min that last for 25 seconds, and have beat-to-beat variablitiy of 20/min. There is no slowing of FHR from the baseline. The nurse should recognize that this client is exhibiting signs of which of the following?

-Moderate variability -FHR accelerations -Normal baseline FHR

A nurse is caring for a client who is at 42 weeks of gestation and is admitted to the labor and delivery unit. During an ultrasound, it is noted that the fetus is large for gestational age. The nurse reviews the prescription from the provider to begin an amnioinfusion. Which of the following conditions should the nurse plan to prepare an amnioinfusion?

-Oligohydramnios -Fetal cord compression

A nurse is caring for a client who reports inidcations of preterm labor. Which of the following findings are risk factors of this condition?

-UTI -Multifetal pregnancy -Diabetes mellitus -Uterine abnormalities

A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should take?

Assist the client into the left-lateral position

A nurse in labor and delivery is providing care for a client who is in preterm labor at 32 weeks of gestation. Which of the following medications should the nurse prescribe to hasten fetal lung maturity?

Betamethasone

A nurse is caring for a client in active labor. When last examined 2 hr ago, the client's cervix was 3 cm dilated, 100% effaced, membranes intact, and the fetus was at a -2 station. The client suddenly states "My water broke." The monitor reveals a FHR of 80-85/min, and the nurse performs a vaginal examination, noticing clear fluid and a pulsing loop of umbilical cord in the client's vagina. Which of the following actions should the nurse perform first?

Call for assistance

A nurse in labor and delivery is planning care for a newly admitted client who reports she is in labor and has been having vaginal bleeding for 2 weeks. Which of the following should the nurse include in the plan of care?

Defer vaginal examinations

A nurse is caring for a client who is receiving nifedipine for prevention of preterm labor. The nurse should monitor the client for which of the following manifestations?

Dizziness

A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue infusion of oxytocin?

Duration of 90-120 seconds

A nurse is caring for a client who has been in labor for 12 hours, and her membranes are intact. The provider has decided to perform an amniotomy in an effort to facilitate the progress of labor. The nurse performs a vaginal examination to ensure which of the following prior to the performance of the amniotomy?

Fetal engagement

A nurse in the labor and delivery unit is caring for a client in labor and applies an external fetal monitor and tocotrsducer. The FHR is around 140/min. Contractions are occurring every 8 min and 30 to 40 seconds in duration. The nurse performs a vaginal exam and finds the cervix is 2cm dilated, 50% effaced, and the fetus is at a -2 station. Which of the following stages and phases of labor is this client experiencing?

First stage, latent phase

A nurse is caring for a client who is in active labor and reports severe back pain. During assessment, the fetus is noted to be in the acciput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress?

Hands and knees

A nurse in labor and delivery unit is completing an admission assessment for a client who is at 39 weeks of gestation. The client reports that she has been leaking fluid from her vagina for 2 days. Which of the following conditions is the client at risk for developing?

Infection

A nurse is reveiwing discharge teaching with a client who has premature rupture of membranes at 26 weeks of gestation. Which of the following instructions should the nurse include in the teaching?

Keep a daily record of fetal kick counts

A nurse is caring for a client who is at 42 weeks of gestation and in active labor. Which of the following findings is the fetus is at risk for developing?

Meconium aspiration

A client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. Which of the following actions should the nurse take first?

Monitor FHR for distress

A nurse is performing Leopold maneuvers on a client who is in labor. Which of the following techniques should the nurse use to identify the fetal lie?

Palpate the fundus of the uterus

A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take?

Place an oxygen mask over the client's nose and mouth

A nurse is caring for a client who is in the transition phase of labor and reports that she needs to have a bowel movement with the peak of contractions. Which of the following actions should the nurse make?

Prepare for an impending delivery

A nurse is caring for a client who is admitted to the labor and delivery unit. With the use of Leopold maneuvers, it is noted that the fetus is in a breech presentation. For which of the following possible complications should the nurse observe?

Prolapsed umbilical cord

A nurse is caring for a client who is in the second stage of labor. The client's labor has been progressing, and she is expected to deliver vaginally in 20min. The provider is preparing to administer lidocaine for pain relief and perform an episiotomy. The nurse should know that which of the following types of regional anesthetic block is to be administered?

Pudendal

A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse should identify that this contraction pattern increases the risk for which of the following complications?

Reduced fetal oxygen supply

A nurse is reviewing the electronic monitor tracing of a client who is in active labor. The nurse should know that a fetus receives more oxygen when which of the following appears in the tracing?

Relaxation between uterine contractions

A nurse is caring for a client who had no prenatal care, is Rh-negative, and will undergo an external version at 37 weeks of gestation. Which of the following medication should the nurse plan to administer prior to the version?

Rho(D) immune globulin

A nurse is caring for a client who is in active labor. The client reports lower-back-pain. The nurse suspects that this pain is related to a persistent occiput posterior fetal postion. Which of the following nonpharmacological nursing interventions should the nurse recommend to the client?

Sacral counterpressure

A nurse in the labor and delivery unit receives a phone call from a client who reports that her contractions started about 2 hr ago, did not go away when she had two glasses of water and rested, and became stronger since she started walking. Her contractions occur every 10 min and last about 30 seconds. she hasn't had any fluid leak from her vagina. However, she saw some blood when she wiped after voiding. Based on this report, which of the following clinical findings should the nurse recognize that the client is experiencing?

T rue contractions T rue contractions

A nurse is caring for a client who is in active labor and becomes nauseous and vomits. The client is very irritable and feels the urge to have a bowel movement. She states, "Ive had enough. I can't do this anymore. I want to go home right now." Which of the following stages of labor is the client experiencing?

Transition phase