Exam 1: Chapter 16 Labor & Delivery

A nurse is describing the different types of regional analgesia and anesthesia for labor to a group of pregnant women. Which statement by the group indicates that the teaching was successful? A) "We can get up and walk around after receiving combined spinal—epidural analgesia. "B) "Higher anesthetic doses are needed for patient-controlled epidural analgesia. "C) "A pudendal nerve block is highly effective for pain relief in the first stage of labor. "D) "Local infiltration using lidocaine is an appropriate method for controlling contraction pain."

A) "We can get up and walk around after receiving combined spinal—epidural analgesia.

The nurse notes persistent early decelerations on the fetal monitoring strip. Which action should the nurse prioritize in this situation? A) Continue to monitor the FHR because this pattern is benign. B) Perform a vaginal exam to assess cervical dilation and effacement. C) Stay with the client while reporting the finding to the primary care provider. D) Administer oxygen after turning the client on her left side.

A) Continue to monitor the FHR because this pattern is benign.

The nurse is performing Leopold's maneuvers as part of the initial assessment. Which action would the nurse do first? A) Feel for the fetal buttocks or head while palpating the abdomen. B) Feel for the fetal back and limbs as the hands move laterally on the abdomen. C) Palpate for the presenting part in the area just above the symphysis pubis. D) Determine flexion by pressing downward toward the symphysis pubis.

A) Feel for the fetal buttocks or head while palpating the abdomen.

The nurse is assessing the external fetal monitor and notes the following: FHR of 175 bpm, decrease in variability, and late decelerations. Which action should the nurse prioritize at this time? A) Have the woman change her position. B) Administer oxygen. C) Notify the health care provider. D) Continue to monitor the pattern every 15 minutes.

A) Have the woman change her position

Which action is a priority when caring for a woman during the fourth stage of labor? A) assessing the uterine fundus B) offering fluids as indicated C) encouraging the woman to void D) assisting with perineal care

A) assessing the uterine fundus

A nurse is providing care to a woman in labor. The nurse determines that the client is in the active phase based on which assessment findings? Select all that apply A) cervical dilation of 6 cm B) contractions every 2 to 3 minutes C) cervical effacement of 90% D) contractions every 90 seconds E) strong desire to push

A) cervical dilation of 6 cm B) contractions every 2 to 3 minutes

A nurse notes a pregnant woman has just entered the second stage of labor. Which interaction should the nurse prioritize at this time to assist the client? A) encouraging the woman to push when she has a strong desire to do so B) alleviating perineal discomfort with the application of ice packs C) palpating the woman's fundus for position and firmness D) completing the identification process of the newborn with the mother

A) encouraging the woman to push when she has a strong desire to do so

Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: A) latent phase of the first stage. B) active phase of the first stage. C) transition phase of the first stage. D) perineal phase of the second stage.

A) latent phase of the first stage.

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect? A) respiratory depression B) urinary retention C) abdominal distention D) hyperreflexia

A) respiratory depression

A client is in the third stage of labor. Which finding would alert the nurse that the placenta is separating? A) uterus becomes globular B) fetal head at vaginal opening C) umbilical cord shortens D) mucous plug is expelled

A) uterus becomes globular

After describing continuous internal electronic fetal monitoring to a laboring woman and her partner, which statement by the woman would indicate the need for additional teaching? A) "This type of monitoring is the most accurate method for our baby." B) "Unfortunately, I'm going to have to stay quite still in bed while it is in place." C) "This type of monitoring can only be used after my membranes rupture." D) "You'll be inserting a special electrode into my baby's scalp."

B) "Unfortunately, I'm going to have to stay quite still in bed while it is in place."

The fetus of a woman in labor is determined to be in a persistent occiput posterior position. Which intervention would the nurse prioritize? A) Side-lying position B) Pain relief measures C) Immediate cesarean birth D) Oxytocin administratian

B) Pain relief measures

A client is admitted to the labor and birthing suite in early labor. On review of her prenatal history, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal birth. Which pelvic shape would the nurse have noted? A) platypelloid B) gynecoid C) android D) anthropoid

B) gynecoid

A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which symptom? A) increased energy level with alternating strong and weak contractions B) moderately strong contractions every 4 minutes, lasting about 1 minute C) contractions noted in the front of abdomen that stop when she walks D) pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds

B) moderately strong contractions every 4 minutes, lasting about 1 minute

A nursing student correctly identifies the most desirable position to promote an easy birth as which position? A) breech B) occiput anterior C) face and brow D) shoulder dystocia

B) occiput anterior

Assessment of a woman in labor reveals that the fetus is in a cephalic presentation and engagement has occurred. The nurse interprets this finding to indicate that the presenting part is at which station? A) -2 B) -1 C) 0 D) +1

C) 0

The nursing instructor is preparing a group of nursing students for their clinical phase and is questioning them on the various assessment skills they will need. The instructor determines the session is successful when the students correctly choose which time interval to assess the fetal heart rate of clients who are in the active phase of labor? A) every 2 to 4 hours B) every 45 to 60 minutes C) every 15 to 30 minutes D) every 10 to 15 minutes

C) every 15 to 30 minutes

When palpating the fundus during a contraction, the nurse notes that it feels like a chin. The nurse interprets this finding as indicating which type of contraction? A) intense B) strong C) moderate D) mild

C) moderate

A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: A) latent phase of the first stage of labor. B) active phase of the first stage of labor. C) transition phase of the first stage of labor. D) pelvic phase of the second stage of labor.

C) transition phase of the first stage of labor.

A nurse is explaining the use of effleurage as a pain relief measure during labor. Which statement would the nurse most likely use when explaining this measure? A) "This technique focuses on manipulating body tissues." B) "The technique requires focusing on a specific stimulus." C) "This technique redirects energy fields that lead to pain." D) "The technique involves light stroking of the abdomen with breathing."

D) "The technique involves light stroking of the abdomen with breathing."