Labor & Delivery OB Exam#3
A G2P1 woman is in labor attempting a VBAC, when she suddenly complains of light-headedness and dizziness. An increase in pulse and decrease in blood pressure is noted as a change from the vital signs obtained 15 minutes prior. The nurse should investigate further for additional signs or symptoms of which complication? A- Uterine rupture B- Hypertonic uterus C- Placenta previa D- Umbilical cord compression
A
A client has been admitted to the birthing suite in labor. She has been in labor for 12 hours and is dilated to 4 cm. The primary care provider notes that the client is in hypotonic labor. What does this mean? A- The uterine contractions may or may not be regular, but the quantity or quality or strength is insufficient to dilate the cervix. B- The uterine contractions are irregular, but the quantity or quality or strength is insufficient to dilate the cervix. C- The uterine contractions are regular, but the quantity or quality or strength is insufficient to dilate the cervix D- The uterine contractions may or may not be regular, but the quantity or quality or strength is sufficient to dilate the cervix.
A
A client in week 38 of her pregnancy has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? A- external cephalic version B- trial labor C- forceps birth D- vacuum extraction
A
A mother in labor with ruptured membranes comes to the labor and delivery unit. It is determined that the fetus is in a single footling breech presentation. The nurse assesses the mother for which complication associated with this fetal position? A- Cord prolapse B- Uterine atony C- Placental abruption D- Brachial plexus injury
A
A mother in the active phase of labor has been contracting for 4 hours. The contractions are occurring infrequently and not lasting very long. When the nurse palpates the uterus during a contraction it feels soft. The nurse should anticipate receiving which prescription from the obstetric provider? A- Administer oxytocin B- Place in side-lying position C- Prepare for epidural anesthesia D- Obtain internal monitoring
A
A nurse is L&D is caring for a pt who is in the 2nd stage of labor. Which of the following actions should the nurse take? A. promote active movement in & out of bed B. instruct the pt to take breaths & hold them for 10 sec while pushing C. assess maternal VS Q1hr D. assist the pt to the restroom
A
A nurse is caring for a pt who is in labor and asks her partner to perform effleurage. The pt has on a monitor belt for elcetronic fetal monitoring. Which of the following instructions should the nurse provide the pt's partner? A. lightly stroke the upper thighs B. steadily apply pressure to the sacrum C. gently massage the midabdominal area D. firmly squeeze both hips
A
A nurse is providing care for a pt who is in the 2nd stage of labor. The FH tracing indicates multiple variable decelerations. Which of the following actions should the nurse take? A. prepare an amnioinfusion B. place the pt in a supine position C. admin O2 2L/min via nasal cannula D. give a glucocorticord
A
A nurse is providing care to a pt who is in labor. A FHR tracing shows early decelerations. What actions should the nurse take? A. continue to monitor the FHR B. elevate the pt's legs C. increase the rate of the maintenance IV fluid D. admin O2 via facemask
A
A patient is experiencing dysfunctional labor that is prolonging the descent of the fetus. Which teaching should the nurse prepare to provide to this patient? A- Oxytocin therapy B- Fluid replacement C- Pain management D- Increasing activity
A
A pregnant womans amniotic membranes have ruptured. A prolapsed umbilical cord is suspected. What intervention would be the nurses highest priority? A. placing her in the knee-chest position B. covering the cord in sterile gauze soaked in saline C. preparing the woman for a c-section D. starting O2 via face mask
A
A pt is scheduled to receive a spinal anesthetic. Which action should the nurse plan to perform? A. infuse 500mL bolus of 0.9% NaCl immediately prior to the procedure B. assess the FHR pattern for 10min prior to the procedure C. position the pt upright & erect on the edge of the bed prior to the procedure D. monitor VS Q15min after anesthetic is placed
A
A pt who has had 2 previous c-sections is in active labor when she suddenly complains of pain between her scapulae. Which should be the nurses priority action? A. notify the HCP STAT B. observe for abnormally high uterine resting tone C. decrease the rate of nonadditive IV fluid D. reposition the pt w/ her hips slightly elevated
A
A pt who is 32 weeks pregnant phones the nurse at her OB office & complains of constant backache. She asks what pain reliver is safe for her to take. The best nursing response is: A. you should come into the office & let the dr check you B. acetaminophen is acceptable during pregnancy C. back pain is common at this time of pregnancy D. avoid medication because you are pregnant try taking a warm bath or using a heating pad on low
A
A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to: A- administer oxygen by mask. B- increase her intravenous fluid infusion rate. C- put firm pressure on the fundus of her uterus. D- tell the woman to take short, catchy breaths.
A
A woman is 7 cm dilated and her contractions are 3 minutes apart. When she begins cursing at her birthing coach and the nurse, the nurse assesses the most likely explanation for the woman's change in behavior is that: A. labor has progressed to transition phase B. she lacked adequate preparation for labor C. woman would benefit from a different form of analgesia D. contractions have increased from mild to moderate intensity
A
A woman is in the hospital only 15 minutes when she begins to give birth precipitously. The fetal head begins to emerge as the nurse walks into the labor room. The nurse's best action would be to: A- place a hand gently on the fetal head to guide birth. B- ask her to push with the next contraction so birth is rapid. C- assess blood pressure and pulse to detect placental bleeding. D- attach a fetal monitor to determine fetal status.
A
After a birth complicated by a shoulder dystocia, the infant's Apgar scores were 7 at 1 minute and 9 at 5 minutes. The infant is now crying vigorously. The nurse in the birthing room should: a. palpate the infant's clavicles. b. encourage the parents to hold the infant. c. perform a complete newborn assessment. d. give supplemental oxygen with a small face mask.
A
Birth for the mulliparous pt w/ a fetus in a breech presentation is usually: A. c-section B. vaginal birth C. vacuumed extraction D. forceps-assisted birth
A
How should the nurse intervene to relieve perineal bruising & edema following delivery? A. place an ice pack on the area for 12 hrs B. place a warm pack on the area for 24 hrs C. admin aspirin to relieve inflammation D. change the perineal pad frequently
A
In caring for the woman with DIC, which order should the nurse anticipate? a. Administration of blood b. Preparation of the client for invasive hemodynamic monitoring c. Restriction of intravascular fluids d. Administration of steroids
A
It is necessary for the mother to have a forceps delivery. To reduce complications from this procedure, the nurse should A- empty the mother's bladder. B- provide pain medication C- have anesthesia provider present. D- call the neonatologist.
A
One hour postdelivery the nurse notes the new mother has saturated three perineal pads. The nurse should A. check the fundus for position & firmness B, report to the dr stat C. change the pads & shart the time D. time how long it takes to soak 1 pad
A
The dr performs an amniotomy on a laboring woman. What will be the nurses priority assessment immediately following this procedure? A. FHR B. fluid amt C. maternal BP D. DTRs
A
The husband of a woman in labor asks What does it mean when the baby is at -1 station? After giving an explanation what statement by the husband indicates that teaching was effective? A. fetal head is above the ischial spines B. fetal head is below the ischial spines C. fetal head is engaged in the mothers pelvis D. fetal head is visible at the perineum
A
The mother comes to her prenatal appointment. She tells the nurse that it feels like the baby is kicking on her bladder and it is harder to breathe. The nurse suspects the fetus is in breech position. Which procedure would the nurse implement to determine the position of the baby? A- Leopold maneuvers B- McRoberts maneuver C- Rubin maneuver D- Gaskin maneuver
A
The nurse is assisting the mother to push. The nurse suspects shoulder dystocia is present when which symptom is present? A- Turtle sign B- Continuous "0 station" C- Battle sign D- Continuous back pain
A
The nurse is assisting with a vaginal birth. The patient is fully dilated, 100% effaced and is pushing. The nurse observes the "turtle sign" with each push and there is no progress. What does the nurse suspect may be occurring with this fetus? A- Shoulder dystocia B- Umbilical cord prolapse C- Nuchal cord D- Breech position
A
The nurse is caring for a laboring mother. The mother continues to complain of back pain. The nurse instructs the mother the pain is occurring because the fetus is in which position? A- Occiput posterior B- Occiput transverse C- Left occiput anterior D- Right occiput anterior
A
The nurse is teaching an antepartum class to first-time mothers. A mother asks the nurse if she should stay in bed when her contractions start. How should the nurse respond? A- "No, walking actually shortens the first stage of labor." B- "No, but you need to only walk for 15 minute intervals." C- "Yes, you don't want to risk having your water break while you are walking." D- "Yes, it is important so monitoring can be done for you and the baby."
A
The nurse is teaching the mother about surgical incisions for a cesarean birth. What reason would the nurse give to the mother as to why a low transverse incision is preferable? A- The wound will be stronger. B- It requires less sutures. C- It leaves a better scar. D- There's less chance of bleeding.
A
The nurse observes on the fetal monitor a pattern of a 15-beat increase in the fetal heart rate that lasts 15-20 secs. What does this pattern indicate? A. a well oxygenated fetus B. compression of the umbilical cord C. compression of the fetal head D. uteroplacental insufficiency
A
The pregnant mother who has had no prenatal care comes to the labor and delivery department with ruptured membranes. The history of group B streptococcus (GBS) is unknown. The mother states she has no known drug allergies. The nurse will prepare to administer which drug to this mother? A- Penicillin G B- Vancomycin C- Cefdinir D- Doxycycline
A
Vaginal examination reveals the presenting part is the infants head, which is well flexed on the chest. What is this presentation? A. vertex B. military C. brow D. face
A
What are the 4 P's of the birth process? A. powers, passenger, passage, psyche B. powers, passenger, pathway, psyche C. powers, passes, pathway, physical D. powers, passenger, pathway, physical
A
What does meconium stained amniotic fluid indicate? A. fetal distress B. fetal maturity C. intact GI tract D. dehydration in the mother
A
When reviewing the prenatal record of a pt 42 weeks gestation the nurse recognizes that induction of labor is indicated based on the finding of: A. reduced amniotic fluid volume B. cervix 2 cm at last prenatal visit C. fundal height measured at the xyphoid process D. 1 pound weight gain at each of the last 2 weekly visits
A
Which assessment finding indicates a complication in the pt attempting a VBAC? A. complaint of pain between the scapulae B. change in fetal baseline from 128-123 bpm C. contractions Q3 minutes lasting 70 secs D. pain level of 6 on scale of 0-10 during acme of contraction
A
Which of the following findings should the nurse ID as the cause of late decelerations? A. uteroplacental insufficiency B. fetal head compression C. fetal ventricular septal defect D. umbilical cord compression
A
Group B streptococcus (GBS) infection presents a large risk to the neonate. Which factor should the nurse consider when developing a plan of care related to GBS? Select all that apply. A- Preterm labor clients receive prophylactic antibiotics. B- Antibiotics must be started 4 hours prior to labor to be effective. C- Mothers with previous GBS will be treated with prophylactic antibiotics. D- Erythromycin is the primary antibiotic to treat GBS. E Women are screened for GBS in the 32nd week of gestation.
A B C
A client appears to be resting comfortably 12 hours after giving birth to her first child. In contrast, she labored for more than 24 hours, the primary care provider had to use forceps to deliver the baby, and she had multiple vaginal examinations during labor. Based on this information what postpartum complication is the client at risk for developing? A- hemorrhage B- infection C- depression D- pulmonary emboli
B
A client is diagnosed w/ anaphylactoid syndrome. Which therapeutic intervention does the nurse suspect will be included in the plan of care? A. normal amniotic fluid B. initiation of CPR & other life support measures C. respiratory treatments w/ nebulizers D. internal fetal monitoring
B
A laboring client has been pushing without delivering the fetal shoulders. The primary care provider determines the fetus is experiencing shoulder dystocia. What intervention can the nurse assist with to help with the birth? A- positioning the woman prone B- McRoberts maneuver C- fundal pressure D- Lamaze position
B
A nurse in L&D is teaching about performing the McRoberts maneuver to relieve shoulder dystocia. Which of the following should the nurse include? A. position the pt on her hands & knees while in bed B. flex the pt's legs apart & raise her knees to her abdomen C. apply gentle pressure on the pt's fundus while she is lying supine D. push the fetus's anterior shoulder under the symphysis pubis externally
B
A nurse is assisting w/ the care of a pt who is in labor. The nurse observes late decelerations on the fetal monitor. Which of the following actions should the nurse take? A. decrease the rate of the pt's maintenance IV fluid B. place the pt in a left lateral position C. apply O2 at 2L/min via nasal cannula D. prepare the pt for an amniocentesis
B
A nurse is caring for a pt who is in labor. The nurse decides to switch from intermittent auscultation to continuous fetal monitoring. Which of the following data can only be obtained from continuous electronic fetal monitoring> A. determination of a baseline B. determination of variability C. presence of accelerations D. presence of decelerations
B
A nurse is preparing to perform Leopold maneuvers on a pt who is in labor. Which of the following actions should the nurse plan to take? A. ensure the pt has a full bladder B. stand at the pt's right side if the nurse is right handed C. assess the pt onto her back w/ knees extended D. palpate the outline of the fetus's head w/ the palms of the hands
B
A nurse observes a pattern of early decelerations on the fetal monitor. Which action should the nurse take? A. notify the provider B. document the findings & continue to monitor C. admin O2 via face mask D. assist w/ a sterile speculum exam
B
A primigravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. The nurse would assess the woman for which condition? A- a low-lying placenta B- fetopelvic disproportion C- contraction ring D- uterine bleeding
B
A pt who is in labor has received epidural analgesia. The pt's BP is 88/50 and the FHR shows late decelerations. Which action should the nurse take? A. assist the pt to the bathroom to empty bladder B. increase the rate of the primary IV infusion C. position the pt in a semi-Fowler's position D. provide glucose via oral hydration/IV
B
A pt with polyhydramnios was admitted to a labor birth recovery postpartum suite. Her membranes rupture & the fluid is clear and odorless but the FH monitor indicates bradycardia & variable decelerations. Which action should be taken next? A. perform Leopold maneuvers B. perform a vaginal exam C. apply warm saline soaks to the vagina D. place the pt in a high Fowler position
B
Best nursing intervention for late decelerations on the fetal monitor. A. decrease the rate of the pt's maintenance IV fluid B. place the pt in a left lateral position C. apply O2 at 2L/min via nasal cannula D. prepare the pt for an amniocentesis
B
During a difficult labor of an infant in the face presentation, the nurse notes the infant has a large amount of facial edema with bruising and ecchymosis. Which assessment would be the priority for this infant? A- ability to arch the eyebrows B- patent airway C- ability to swallow fluids D- palpation of the anterior fontanels
B
During the course of the birth process, the physician suspects that a shoulder dystocia is occurring and asks the nurse for assistance. Which priority action should be taken by the nurse in response to this request? a. Put pressure on the fundus. b. Ask the physician if he or she would like you to prepare for a surgical method of birth. c. Tell the client not to push until you prepare vacuum extraction device for physician. d. Reposition the client to facilitate birth.
B
It is determined that the presenting part of the fetus is the buttocks. At delivery the fetus's hips are flexed and the knees are extended. The nurse would record this presentation as: A, complete breech B. frank breech C. double footling D. buttocks presentation
B
Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with A. frequent episodes of maternal hypoglycemia B. congenital anomalies in the fetus C. polyhydramnios D. hyperemesis gravidarum
B
The fetus in a breech presentation is often born by c-section because:: A. the buttocks are much larger than the head B. compression of the umbilical cord is more likely C. internal rotation cannot occur if the fetus is breech D. postpartum hemorrhage is more likely if the pt delivers vaginally
B
The nurse assesses that the fetus of a woman is in an occiput posterior position. The nurse predicts the client will experience which situation related to this assessment? A- Shorter dilatational stage of labor B- Experience of additional back pain C- Need to have the baby manually rotated D- Necessity for vacuum extraction for birth
B
The nurse is assisting a primary care provider to attempt to manipulate the position of the fetus in utero from a breech to cephalic position. What does the nurse inform the client the procedure is called? A- internal rotation B- external rotation C- vaginal manipulation D- external version
B
The nurse is caring for a pt who is not certain if she is in true labor. How might the nurse attempt to stimulate cervical effacement & intensify contractions in the pt? A. by offering the pt warm fluids to drink B. by helping the pt to ambulate in the room C. by seating the pt upright in a straight-back chair D. by positioning the pt on her right side
B
The nurse is preparing a mother for a planned cesarean birth. The nurse ascertains that the mother has previously had a deep vein thrombosis. Heparin is ordered prophylactically. The nurse determines this medication will be administered: A- 1 hour after birth. B- 8 hours after birth. C- 14 hours after birth. D- 24 hours after birth.
B
The nurse observes the pt bearing down w/ contractions & crying out, The baby is coming! What is the best nursing intervention? A. find the doctor B. stay with her & use call bell to get help C. send the woman's partner to locate a RN D. assist w/ deep breathing to slow labor process
B
The nurse preceptor explains that several factors are involved with the "powers" that can cause dystocia. She focuses on the dysfunction that occurs when the uterus contracts so frequently and with such intensity that a very rapid birth will take place. This is known as which term? A- hypertonic contractions B- precipitous labor C- hypotonic contractions D- none of the above
B
The postpartum mother who was delivered via cesarean section is preparing for discharge from the hospital. As part of the discharge teaching the nurse instructs the mother to make an appointment with her physician to have the staples removed in: A- 3 days. B- 6 days. C- 11 days. D- 14 days.
B
What marks the end of the 3rd stage of delivery? A. fully dilated cervix B. expulsion of the placenta & membranes C. birth of the infant D. engagement of the head
B
Which intervention would be most important when caring for the client with breech presentation confirmed by ultrasound? A- applying suprapubic pressure against the fetal back B- continuing to monitor maternal and fetal status C- noting the space at the maternal umbilicus D- auscultating the fetal heart rate at the level of the umbilicus
B
Which maternal condition always necessitates delivery by c-section? A. marginal placenta previa B. complete placenta previa C. ectopic pregnancy D. eclampsia
B
Which of the following strategies is a form of cutaneous stimulation? A. breathing technique B. counter pressure C. biofeedback D. use of a focal point
B
Which technique is least effective for the pt w/ persistent occiput posterior position? A. squatting B. lying supine & relaxing C. sitting/kneeling, leaning forward w/ support D. rocking the pelvis back & forth while on hands & knees
B
A client who is in labor & is receiving an infusion of oxytocin. The nurse should monitor the client for which of the following potential adverse effects? A. diarrhea B. thromboembolism C. fetal asphyxia D. oliguria
C
A nurse is assessing a pt who is in the 4th stage of labor. Which finding should the nurse expect? A. breast engorgement B. hypothermia C. urinary retention D. rupture of membranes
C
A nurse is assessing a pt who is postpartum following a vacuum assisted birth. For which of the following findings should the nurse monitor to identify a cervical laceration? A. continuous lochia flow & flaccid uterus B. report of increasing pain & pressure in perineal area C. slow trickle of bright vaginal bleeding & a firm fundus D. gush of rubra lochia when uterus is massaged
C
A nurse is caring for a client who is scheduled to receive IV oxytocin for the induction of labor. The pt has a Bishop score of 10. Which of the following findings should the nurse expect? A. the pt will require dinoprostone for ripening of cervix B. the pt will experience lower back pain during labor C. the pt will experience a successful induction of labor D. the pt will require a vacuum/forceps assisted delivery
C
A nurse is caring for a pt in active labor who has a meconium staining of the amniotic fluid. The nurse notes a reassuring FHR tracing. Which of the following actions should the nurse perform? A. prepare the pt for an ultrasound exam B. prepare the pt for an emergency c-section C. prepare equipment needed for newborn resuscitation D. perform endotracheal suctioning as soon as the fetal head is delivered
C
A nurse is caring for a pt in active labor whose fetus is in a persistent occiput posterior position. Which of the following actions should the nurse take to promote rotation of the fetal head? A. apply counterpressure to the pt's back B. place heat on the pt's lower back C. instruct the pt to squat during contractions D. encourage the pt to ambulate
C
A nurse is caring for a pt in the latent phase of labor who is receiving oxytocin via continuous IV infusion. The pt is having contractions Q2min that last 100-110 sec and the FHR is reassuring. Which of the following actions should the nurse take? A. decrease the infusion rate of the maintenance IV fluid B. admin O2 via nonrebreather mask C. decreased the dose of oxytocin by half D. admin terbutaline 0.25 SQ
C
A nurse is caring for a pt who has an epidural for pain relief. Which of the following is a complication of the epidural block? A. N/V B. tachycardia C. hypotention D. resp depression
C
A nurse is caring for a pt who is in the 1st stage of labor. Which of the following findings should the nurse ID as a cause for concern? A. pink mucoid vaginal discharge B. brownish vaginal discharge C. contractions lasting 100 sec D. contractions occuring Q4-5mins
C
A nurse is caring for a pt who is receiving IV oxytocin for the induction of labor & notes repetitive early decelerations of the electronic EHR tracing. Which of the following actions should the nurse take? A. increase the rate of IV fluid infusion B. discontinue the infusion of oxytocin C. re-evaluate the FHR tracing in 15mins D. request a prescription for an amniofusion
C
A nurse is caring for a pt who just had a spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing & a prolapsed umbilical cord. Which of the following actions should the nurse take first? A. place the pt in an extreme Trendelenburg position B. increase the IV fluid infusion rate C. manually apply upward pressure intravaginally on the presenting part D. admin 8-10L/min of O2 via nonrebreather face mask
C
A nurse is planning care for a pt who is scheduled to have prostaglandin E2 gel inserted for cervical ripening. Which of the following actions should the nurse take? A. assess FHR and contraction pattern Q15min after insertion B. thaw the frozen gel in warm water prior to insertion C. maintain the pt in a side-lying position for 30min after insertion D. initiate an oxytocin infusion for induction 1hr after gel insertion
C
A nursing instructor is teaching students about fetal presentations during birth. The most common cause for increased incidence of shoulder dystocia is: A- longer lengths of labor. B- increased number of overall pregnancies. C- increasing birth weight. D- poor quality of prenatal care.
C
A pregnant pt w/ premature rupture of membranes is at higher risk for postpartum infection. Which assessment data indicate a potential infection? A. FHR 150bom B. maternal temp 99F C. cloudy amniotic fluid, w/ strong odor D. lowered maternal pulse & decreased respiratory rates
C
A woman with a history of crack cocaine use disorder is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect? A- amniotic fluid embolism B- shoulder dystocia C- uterine rupture D- umbilical cord prolapse
C
Immediately after giving birth to a full-term infant, a client develops dyspnea and cyanosis. Her blood pressure decreases to 60/40 mm Hg, and she becomes unresponsive. What does the nurse suspect is happening with this client? A- placental separation B- aspiration C- amniotic fluid embolism D- congestive heart failure
C
Labor dystocia is an abnormal progression of labor. It is the most common cause of primary cesarean birth. When is it most common for labor dystocia to occur? A- Fourth stage of labor B- Third stage of labor C- Second stage of labor D- First stage of labor
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 dilatio
C
The fetus of a pregnant patient is in a breech presentation. Where will the nurse auscultate fetal heart sounds? A- Low in the abdomen B- Left lateral abdomen C- High in the abdomen D- Right lateral abdomen
C
The nurse is caring for a woman in the 1st stage of labor. What will the nurse remind the pt about contractions during this stage of labor? A. they get the infant positioned for delivery B. they push the infant into the vagina C. they dilate & efface the cervix D. they get the mother prepared for true delivery
C
The nursing student demonstrates an understanding of dystocia with which statement? A- "Dystocia is diagnosed at the start of labor." B- "Dystocia is not diagnosed until after the birth." C- "Dystocia is diagnosed after labor has progressed for a time." D- "Dystocia cannot be diagnosed until just before birth."
C
What are the potential side effects of an epidural anesthetic for a laboring pt. Which of the following effects is a side effect? A. newborn resp depression at birth B. impaired ability of the neonate to maintain body temp C. impaired placental perfusion D. decreased FHR variability
C
What contraction duration and interval does the nurse recognize could result in fetal compromise? A. duration shorter than 30 seconds, interval longer than 75 seconds B. duration shorter than 90 seconds, interval longer than 120 seconds C. duration longer than 90 seconds, interval shorter than 60 seconds D. duration longer than 60 seconds, interval shorter than 90 seconds
C
What is the best nursing action to implement when late decelerations occur? A. reposition the pt to supine B. decrease the flow of IV fluids C. increase O2 to 10 L/min D. prepare to increase oxytocin drip
C
What is the function of contractions during the 2nd stage of labor? A. align the infant into the proper position for delivery B. dilate & efface the cervix C. push the infant out of the mothers body D. separate the placenta from the uterine wall
C
What is the most important nursing intervention during the 4th stage of labor? A. monitor the frequency & intensity of contractions B. provide comfort measures C. assess for hemorrhage D. promote bonding
C
What is the nurse primarily concerned about maintaining in the initial care of the newborn? A. fluid intake B. feeding schedule C. thermoregulation D. parental bonding
C
When reviewing the medical record of a postpartum client, the nurse notes that the client has experienced a third-degree laceration. The nurse understands that the laceration extends to which area? A- superficial structures above the muscle B- through the perineal muscles C- through the anal sphincter muscle D- through the anterior rectal wall
C
Which factor should alert the nurse to the potential for a prolapsed umbilical cord? A. oligohydramnios B. pregnancy at 38 wks of gestation C. presenting part at a station of 3 D. meconium-stained amniotic fluid
C
Which intervention would be most effective if the FHR drops following a spontaneous rupture of the membranes? A. apply O2 at 8-10L/min B. stop the Pitocin infusion C. position the pt in the knee-chest position D. increase the main line infusion to 150 mL/hr
C
While caring for a laboring woman the nurse notices a pattern of variable decelerations in FHR w/ uterine contractions. What is the nurses initial action? A. stop the oxytocin infusion B, increase the IV flow rate C. reposition the woman on her side D. start O2 via nasal cannula
C
While discussing L&D during a prenatal visit, a primigravida asks the nurse when she should go to the hospital. The best response is: A. when you feel increased fetal movement B. when contractions are 10 mins apart C. when membranes have ruptured D. when abdominal/groin discomfort occurs
C
Why is it important for the nurse to thoroughly assess maternal bladder and bowel status during labor? A- If the woman has a full bladder, labor may be uncomfortable for her B- If the woman's bladder is distended, it may rupture. C A full bladder or rectum can impede fetal descent. D- A full rectum can cause diarrhea.
C
Why is the relaxation phase between contractions important? A. Laboring woman needs to rest B. Uterine muscles fatigue w/out relaxation C. Contractions can interfere w/ fetal oxygenation D. Infant progresses toward delivery at these times
C
A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment postbirth? A extensive lacerations B- monitor for a cardiac anomaly C- assess for cleft palate D- brachial plexus assessment
D
A laboring client in the latent phase is experiencing uncoordinated irregular contractions of low intensity. How should the nurse respond to complains of constant cramping pain? A. you are only 2cm dilated so you should rest & save your energy for when the contractions get stronger B. let me take off the monitor belts & help you get into a more comfortable position C. you must breathe more slowly & deeply so there is greater O2 supply for your uterus, that will decrease the pain D. I have notified the dr that you are having a lot of discomfort. let me rub your back & see if that helps
D
A laboring client is experiencing dysfunctional labor or dystocia due to the malfunction of one or more of the "four Ps" of labor. Which scenario best illustrates a power problem? A- The fetus is macrosomic. B- The mother is fighting the contractions. C- The mother has a small pelvic opening. D- Uterine contractions are weak and ineffective.
D
A nurse is caring for a pt who is at 39 weeks & shows signs of labor. Which finding will alert the nurse that the pt is in true labor. A. contractions felt in upper abdomen B. sm amount of bloody discharge C. contractions occurring Q2-10min D. changes in cervical dilation/effacement
D
A nurse is caring for a pt who is in active labor & receiving an oxytocin infusion. The nurse notes tachysytole w/ a Category I FHR tracing. Which of the following actions should the nurse take? A. discontinue oxytocin infusion and apply O2 B. increase oxytocin infusion rate by 2mu/min C. admin terbutaline 0.25 SQ D. reposition the pt in a side-lying position & continue to monitor
D
A nurse is caring for a pt who is in labor. Which method will determine the frequency of the pt's contractions? A. palpating the firmness of the uterus during a contraction B. calculating the time from the end of each contraction to the beginning of the next C. measuring the time from the beginning of a contraction to the end of that same contraction D. evaluating the time from the beginning of a contraction to the beginning of the next contraction
D
A nurse is monitoring the FHR tracings. Which of the following findings should the nurse report to the provider? A. baseline FHR 110-130/min B. moderate baseline variability C. accelerations in response to fetal stim D. late decelerations w/ fetal bradycardia
D
A pregnant woman G2P1 tells the nurse she desires a VBAC (vaginal birth after c-section) w/ this pregnancy. What is the primary concern regarding complications for this pt during labor & birth? A. eclampsia B. placental abruption C. CHF D. uterine rupture
D
A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an "arrested descent." The woman asks, "Why is this happening?" Which response is the best answer to this question? A- "Maybe your uterus is just tired and needs a rest." B- "It is likely that your body has not secreted enough hormones to soften the ligaments so your pelvic bones can shift to allow birth of the baby." C- "Maybe your baby has developed hydrocephaly and the head is too swollen." D- "More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."
D
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? A- sedatives B- tocolytics C- uterine stimulants D- corticosteroids
D
At 1 & 5 mins of life a newborns Apgar score is 9. What does the nurse understand that a score of 9 indicates? A. newborn will require resuscitation B. newborn may have physical disabilities C. newborn will have above average intelligence D. newborn is in stable condition
D
At a prenatal visit a primigravida asks the nurse how she will know her labor has started. The nurses knows that what indicates the beginning of true labor? A. contractions that are relieved w/ walking B. discomfort in the abdomen & groin C. a decrease in vaginal discharge D. regular contractions becoming more frequent & intense
D
The nurse formulates the nursing diagnosis for a woman in the 4th stage of labor. What is the most appropriate nursing Dx? A. pain related to increasing frequency & intensity of contractions B. fear related to the probable need for c-section C. dysuria related to prolonged labor & decreased intake D. risk for injury related to hemorrhage
D
The nurse is caring for a client who is in the latent phase of labor & is experiencing low back pain. Which of the following actions should the nurse take? A. instruct the pt to pant during contractions B. position the pt supine w/ legs elevated C. encourage the pt to soak in a warm bath D. apply pressure to the pt's sacral area during contractions
D
The nurse is monitoring the uterine contractions of a woman in labor. The nurse determines the woman is experiencing hypertonic uterine dysfunction based on which contraction finding? A- well coordinated B- poor in quality. C- brief. D- erratic.
D
The obstetric provider has informed the nurse that she will be performing an amniotomy on the pt to induce labor. What is the nurses highest priority intervention after the amniotomy is performed? A. applying clean linens under the woman B. Take the pts VS C. performing a vaginal exam D. assess the FHR
D
What does the nurse note when measuring the frequency of a laboring womans contractions? A. how long the pt states the contractions last B. Time between the end of one contraction & the beginning of the next C. Time between the beginning & end of one contraction D. The time between the beginning of one contraction & the beginning of the next
D
What is the most appropriate statement from the nurse when coaching the laboring woman w/ a fully dilated cervix to push? A. at the beginning of a contraction hold your breath & push for 10 secs B. take a deep breath & push between contractions C. begin pushing when a contraction starts & continue for the duration of the contraction D. at the beginning of a contraction take 2 deep breaths & push w/ the 2nd exhalation
D
Which assessment finding indicates uterine rupture? A. fetal tachycardia occurs B. the pt becomes dyspneic C. labor progresses unusually quickly D. contractions abruptly stop during labor
D
Which finding by the nurse on a vaginal exam would be a concern if a spontaneous rupture of the membranes occure? A. cephalic presentation B. left occiput position D. dilation 2 cm D. presenting part at 3 station
D
Which finding would lead the nurse to suspect that the fetus of a woman in labor is in hypertonic uterine dysfuction? A- lack of cervical dilation past 2 cm B- fetal buttocks as the presenting part C- reports of severe back pain D- contractions most forceful in the middle of uterus rather than the fundus
D
Which nursing action should be irritated 1st when there is evidence of prolapsed cord? A. notify the HCP B. apply a scalp electrode C. prepare the mom for emergency c-section D. reposition the mom w/ her hips higher than her head
D
While assessing a patient who is the the 4th stage of labor, the nurse suspects bladder distention. Which of the following findings should the nurse anticipate w/ bladder distention? A. fundus is at midline B. fundus is below the umbilicus C. bladder is resonant w/ percussion D. bladder fluctuates w/ palpation
D
Why should the nurse encourage the mother to void during the 4th stage of labor? A. full bladder could interfere w/ cervical dilation B. full bladder could obstruct progress of infant thru birth canal C. full bladder could obstruct the passage of placenta D. full bladder could predispose the mother to uterine hemorrhage
D
