Maternity Midterm

A pregnant client at 30 weeks' gestationant antcalls the clinic because she thinks that she may be in labor. To determine if the client is experiencing labor, which question(s) would be appropriate for the nurse to ask? Select all that apply. A. "Are you feeling any pressure or heaviness in your pelvis?" B. "Are you having contractions that come and go, off and on?" C. "Have you noticed any fluid leaking from your vagina?" D. "Are you having problems with heartburn?" E. "Have you been having any nausea or vomiting?"

A. "Are you feeling any pressure or heaviness in your pelvis?" B. "Are you having contractions that come and go, off and on?" C. "Have you noticed any fluid leaking from your vagina?" E. "Have you been having any nausea or vomiting?"

A nurse is teaching a woman about measures to prevent preterm labor in future pregnancies because the woman just experienced preterm labor with her most recent pregnancy. The nurse determines that the teaching was successful based on which statement by the woman? A. "I'll make sure to limit the amount of long distance traveling I do." B. "Stress isn't a problem that is related to preterm labor." C. "Separating pregnancies by about a year should be helpful." D. "I'll need extra iron in my diet so I have extra for the baby."

A. "I'll make sure to limit the amount of long distance traveling I do

A pregnant woman is discussing nonpharmacologic pain control measures with the nurse in anticipation of labor. After discussing the various breathing patterns that can be used, the woman decides to use slow-paced breathing. Which instruction would the nurse provide to the woman about this technique? A. "Inhale through your nose and exhale through pursed lips." B. "Inhale and exhale through your mouth about 4 times in 5 seconds." C. "Forcefully exhale every so often after inhaling and exhaling through your mouth." D. "Take a cleansing breath before but not after each contraction."

A. "Inhale through your nose and exhale through pursed lips."

During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate? A. "It's difficult to predict how your labor will progress, but we'll be there for you the entire time." B. "Since this is your first pregnancy, you can estimate it will be about 10 hours." C. "It will depend on how big the baby is when you go into labor." D. "Time isn't important; your health and the baby's health are key."

A. "It's difficult to predict how your labor will progress, but we'll be there for you the entire time."

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."

A pregnant woman comes to the labor and birth unit in labor. The woman tells the nurse, "Yesterday, I had this burst of energy and cleaned everything in sight, but I don't know why." Which response by the nurse would be most appropriate? A. "You had a burst of epinephrine, which is common before labor." B. "You were trying to get everything ready for your baby." C. "You felt your mind telling you that you were about to go into labor." D. "You were looking forward to the birth of your baby."

A. "You had a burst of epinephrine, which is common before labor."

The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth? A. 11 B. 7 C. 5 D. 3

A. 11

A 32-year-old black woman in her second trimester has come to the clinic for an evaluation. While interviewing the client, she reports a history of fibroids and urinary tract infection. The client states, "I know smoking is bad and I have tried to stop, but it is impossible. I have cut down quite a bit though, and I do not drink alcohol." Complete blood count results reveal a low red blood cell count, low hemoglobin, and low hematocrit. When planning this client's care,which factor(s) would the nurse identify as increasing the client's risk for preterm labor? Select all that apply.

A. African heritage C. History of fibroids D. Cigarette smoking E. History of urinary tract infections F. Complete blood count results

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next? A. Check the fetal heart rate. B. Perform a vaginal exam. C. Notify the primary care provider immediately. D. Change the linen saver pad

A. Check the fetal heart rate

A nurse is performing Leopold maneuvers on a pregnant woman. The nurse determines which information with the first maneuver? A. Fetal presentation B. Fetal position C. Fetal attitude D. Fetal flexion

A. Fetal presentation

A nurse is reading a journal article about cesarean births and the indications for them. Place the indications for cesarean birth below in the proper sequence from most frequent to least frequent. All options must be used. A. Labor dystocia B. Abnormal fetal heart rate tracing C. Fetal malpresentation D. Multiple gestation E. Suspected macrosomia

A. Labor dystocia B. Abnormal fetal heart rate tracing C. Fetal malpresentation D. Multiple gestation E. Suspected macrosomia

A pregnant client at 24 weeks' gestation comes to the clinic for an evaluation. The client called the clinic earlier in the day stating that she had not felt the fetus moving since yesterday evening. Further assessment reveals absent fetal heart tones. Intrauterine fetal demise is suspected. The nurse would expect to prepare the client for which testing to confirm the suspicion? A. Ultrasound B. Amniocentesis C. Human chorionic gonadotropin (hCG) level D. Triple marker screening

A. Ultrasound

A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which conditions as appropriate indications? Select all that apply. A. active genital herpes infection B. placenta previa C. previous cesarean birth D. prolonged labor E. fetal distress

A. active genital herpes infection B. placenta previa C. previous cesarean birth E. fetal distress

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 30% D. contractions every 90 seconds E. strong desire to push

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

The fetus of a nulliparous woman is in a shoulder presentation. The nurse would prepare the client for which type of birth? A. cesarean B. vaginal C. forceps-assisted D. vacuum extraction

A. cesarean

A nurse is caring for several women in labor. The nurse determines that which woman is the latent phase of labor? A. contractions every 5 minutes, cervical dilation 3 cm B. contractions every 3 minutes, cervical dilation 6 cm C. contractions every 2 1/2 minutes, cervical dilation 8 cm D. contractions every 1 minute, cervical dilation 9 cm

A. contractions every 5 minutes, cervical dilation 3 cm

A nurse is taking a history on a woman who is at 20 weeks' gestation. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? Select all that apply. A. dull low backache B. viscous vaginal discharge C. dysuria D. constipation E. occasional cramping

A. dull low backache B. viscous vaginal discharge C. dysuria

When planning the care of a woman in the latent phase of labor, the nurse would anticipate assessing the fetal heart rate at which interval? A. every 30 to 60 minutes B. every 60 to 90 minutes C. every 15 to 30 minutes D. every 10 to 15 minutes

A. every 30 to 60 minutes

A nurse palpates a woman's fundus to determine contraction intensity. What would be most appropriate for the nurse to use for palpation? A. finger pads B. palm of the hand C. finger tips D. back of the hand

A. finger pads

A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A. frank B. full C. complete D. footling

A. frank

A pregnant client has received dinoprostone. Following administration of this medication, the nurse assesses the client and determines that the client is experiencing an adverse effect of the medication based on which client report? Select all that apply. A. headache B. nausea C. diarrhea D. tachycardia E. hypotension

A. headache B. nausea C. diarrhea

A nurse is providing care to a client in labor. A pelvic exam reveals a vertex presentation with the presenting part tilted toward the left side of the mother's pelvis and directed toward the anterior portion of the pelvis. When developing this client's plan of care, which intervention would the nurse include? A. implementing measures for a vaginal birth B. preparing the client for a cesarean birth C. assisting with artificial rupture of the membranes D. instituting continuous internal fetal monitoring

A. implementing measures for a vaginal birth

The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which phase? A. increment B. acme C. peak D. decrement

A. increment

A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which movements would the nurse include? Select all that apply. A. internal rotation B. abduction C. descent D. pronation E. flexion

A. internal rotation C. descent E. flexion

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. pelvic phase of the second stage. D. early phase of the third stage.

A. latent phase of the first stage.

A nurse is reading a journal article about the various medications used for pain relief during labor. Which drug would the nurse note as producing amnesia but no analgesia? A. midazolam B. prochlorperazine C. fentanyl D. meperidine

A. midazolam

A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply. A. nifedipine B. magnesium sulfate C. dinoprostone D. misoprostol E. indomethacin

A. nifedipine B. magnesium sulfate E. indomethacin

A nurse is conducting an in-service program for a group of nurses working in the labor and birth suite of the facility. After teaching the group about the factors affecting the labor process, the nurse determines that the teaching was successful when the group identifies which component as part of the true pelvis? Select all that apply. A. pelvic inlet B. cervix C. mid pelvis D. pelvic outlet E. vagina F. pelvic floor muscles

A. pelvic inlet C. mid pelvis D. pelvic outlet

A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which factors would the nurse include when discussing measures to promote coping for a positive labor experience? Select all that apply. A. presence of a support partner B. view of birth as a stressor C. low anxiety level D. fear of loss of control E. participation in a pregnancy exercise program

A. presence of a support partner C. low anxiety level E. participation in a pregnancy exercise program

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

The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. When reporting this suspicion, which finding(s) would the nurse include in the report? Select all that apply. A. significant difficulty breathing B. hypertension C. tachycardia D. pulmonary edema E. bleeding with bruising

A. significant difficulty breathing B. hypertension D. pulmonary edema E. bleeding with bruising

A nurse is conducting a class for a group of nurses who are newly hired for the labor and birth unit. After teaching the group about fetal heart rate patterns, the nurse determines the need for additional teaching when the group identifies which finding as indicating normal fetal acid- base status? Select all that apply. A. sinusoidal pattern B. recurrent variable decelerations C. fetal bradycardia D. absence of late decelerations E. moderate baseline variability

A. sinusoidal pattern B. recurrent variable decelerations C. fetal bradycardia

A nurse is describing how the fetus moves through the birth canal. Which component would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A. sutures B. fontanelles C. frontal bones D. biparietal diameter

A. sutures

A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect? A. uterine hyperstimulation B. headache C. blurred vision D. hypotension

A. uterine hyperstimulation

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

Which positions would be most appropriate for the nurse to suggest as a comfort measure to a woman who is in the first stage of labor? Select all that apply. A. walking with partner support B. straddling with forward leaning over a chair C. closed knee-chest position D. rocking back and forth with foot on chair E. supine with legs raised at a 90-degree angle

A. walking with partner support B. straddling with forward leaning over a chair D. rocking back and forth with foot on chair

Which suggestion by the nurse about pushing would be most appropriate to a woman in the second stage of labor? A. "Lying flat with your head elevated on two pillows makes pushing easier." B. "Choose whatever method you feel most comfortable with for pushing." C. "Let me help you decide when it is time to start pushing." D. "Bear down like you're having a bowel movement with every contraction.

B. "Choose whatever method you feel most comfortable with for pushing."

A woman telephones the prenatal clinic and reports that her water just broke. Which suggestion by the nurse would be most appropriate? A. "Call us back when you start having contractions." B. "Come to the clinic or emergency department for an evaluation." C. "Drink 3 to 4 glasses of water and lie down." D. "Come in as soon as you feel the urge to push."

B. "Come to the clinic or emergency department for an evaluation."

A pregnant woman at 31-weeks' gestation calls the clinic and tells the nurse that she is having contractions sporadically. Which instructions would be most appropriate for the nurse to give the woman? Select all that apply. A. "Walk around the house for the next half hour." B. "Drink two or three glasses of water." C. "Lie down on your back." D. "Try emptying your bladder." E. "Stop what you are doing and rest."

B. "Drink two or three glasses of water. D. "Try emptying your bladder." E. "Stop what you are doing and rest."

After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching? A. "Holding a pillow against my incision will help me when I cough." B. "I'm going to have to wait a few days before I can start breastfeeding." C. "I guess the nurses will be getting me up and out of bed rather quickly." D. "I'll probably have a tube in my bladder for about 24 hours or so.

B. "I'm going to have to wait a few days before I can start breastfeeding."

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."

A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately? A. respiratory rate of 16 breaths per minute B. 1+ deep tendon reflexes C. urine output of 45 mL/hour D. alert level of consciousness

B. 1+ deep tendon reflexes

When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage? A. Regular contractions B. Cervical dilation C. Fetal movement through the birth canal D. Placental separation

B. Cervical dilation

A woman receives magnesium sulfate as treatment for preterm labor. The nurse assess and maintains the infusion at the prescribed rate based on which finding? A. Respiratory rate-16 breaths/minute B. Decreased fetal heart rate variability C. Urine output 22 mL/hour D. Absent deep tendon reflexes

B. Decreased fetal heart rate variability

A nurse is conducting a continuing education program for a group of nurses working in the perinatal unit. After reviewing information about the maternal bony pelvis with the group, the nurse determines that the teaching was successful based on which statement by the group? A. The bony pelvis plays a lesser role during labor than soft tissue. B. The pelvic outlet is associated with the true pelvis. C. The false pelvis lies below the imaginary linea terminalis. D. The false pelvis is the passageway through which the fetus travels.

B. The pelvic outlet is associated with the true pelvis.

A woman's amniotic fluid is noted to be cloudy. The nurse interprets this finding as: A. normal. B. a possible infection. C. meconium passage. D. transient fetal hypoxia.

B. a possible infection.

A pregnant woman admitted to the labor and birth suite undergoes rapid HIV testing and is found to be HIV-positive. Which action would the nurse expect to include when developing a plan of care for this woman? Select all that apply. A. administrating of penicillin G at the onset of labor B. avoiding scalp electrodes for fetal monitoring. C. refraining from obtaining fetal scalp blood for pH testing. D. administering antiretroviral therapy at the onset of labor. E. electing for the use of forceps-assisted birth

B. avoiding scalp electrodes for fetal monitoring B. avoiding scalp electrodes for fetal monitoring C. refraining from obtaining fetal scalp blood for pH testing

A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as the major change occurring during this stage? A. regular contractions B. cervical dilation (dilatation) C. fetal movement through the birth canal D. placental separation

B. cervical dilation (dilatation)

A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse prepares the client for this monitoring based on the understanding that which criterion must be present? A. intact membranes B. cervical dilation of 2 cm or more C. floating presenting fetal part D. a neonatologist to insert the electrode

B. cervical dilation of 2 cm or more

When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? A. extent of opening to its widest diameter B. degree of thinning C. passage of the mucous plug D. fetal presenting par

B. degree of thinning

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. fetopelvic disproportion

A nurse is completing the assessment of a woman admitted to the labor and birth suite. Which information would the nurse expect to include as part of the physical assessment? Select all that apply. A. current pregnancy history B. fundal height measurement C. support system D. estimated date of birth E. membrane status F. contraction pattern

B. fundal height measurement E. membrane status F. contraction pattern

Which assessment finding will alert the nurse to be on the lookout for possible placental abruption during labor? A. macrosomia B. gestational hypertension C. gestational diabetes D. low parity

B. gestational hypertension

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 nurse is describing the risks associated with post-term pregnancies as part of an inservice presentation. The nurse determines that more teaching is needed when the group identifies which factor as an underlying reason for problems in the fetus? A. aging of the placenta B. increased amniotic fluid volume C. meconium aspiration D. cord compression

B. increased amniotic fluid volume

A nurse is explaining to a group of nurses new to the labor and birth unit about methods used for cervical ripening. The group demonstrates understanding of the information when they identify which method as a mechanical one? A. herbal agents B. laminaria C. membrane stripping D. amniotomy

B. laminaria

A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which event has most likely occurred? A. cervical dilation B. lightening C. bloody show D. Braxton Hicks contractions

B. lightening

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 nurse is assessing a woman after birth and notes a second-degree laceration. The nurse interprets this as indicating that the tear extends through which area? A. skin B. muscles of perineal body C. anal sphincter D. anterior rectal wall

B. muscles of perineal body

A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration? A. early decelerations B. variable decelerations C. prolonged decelerations D. late deceleration

B. variable decelerations

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she is not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? A. "I'm feeling contractions mostly in my back." B. "My contractions are about 6 minutes apart and regular." C. "The contractions slow down when I walk around." D. "If I try to talk to my partner during a contraction, I can't.

C. "The contractions slow down when I walk around."

A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as: A. +2 station. B. 0 station. C. -2 station. D. crowning.

C. -2 station.

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

A nurse is preparing to auscultate the fetal heart rate of a pregnant woman at term admitted to the labor and birth suite. Assessment reveals that the fetus is in a cephalic presentation. At which area on the woman's body would the nurse best hear the sounds? A. At the level of the woman's umbilicus B. In the area above the woman's umbilicus C. In the woman's lower abdominal quadrant D. At the upper outer quadrant of the woman's abdomen

C. In the woman's lower abdominal quadrant

A pregnant woman with a fetus in the cephalic presentation is in the latent phase of the first stage of labor. Her membranes rupture spontaneously. The fluid is green in color. Which action by the nurse would be appropriate? A. Check the pH to ensure the fluid is amniotic fluid. B. Prepare to administer an antibiotic. C. Notify the health care provider about possible meconium. D. Check the maternal heart rate.

C. Notify the health care provider about possible meconium.

A nurse is conducting a class for a group of nurses new to the labor and birth unit about labor and the passage of the fetus through the birth canal. As part of the class, the nurse explains that specific diameters of the fetal skull can affect the birth process. Which diameter would the nurse identify as being most important in affecting the birth process? Select all that apply. A. Occipitofrontal B. Occipitomental C. Suboccipitobregmatic D. Biparietal E. Diagonal conjugate

C. Suboccipitobregmatic D. Biparietal

When applying the ultrasound transducer for continuous external electronic fetal monitoring, the nurse would place the transducer at which location on the client's body to record the FHR? A. over the uterine fundus where contractions are most intense B. above the umbilicus toward the right side of the diaphragm C. between the umbilicus and the symphysis pubis D. between the xiphoid process and umbilicus

C. between the umbilicus and the symphysis pubis

The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which part as the presenting part? A. occiput B. face C. buttocks D. shoulder

C. buttocks

A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? A. asphyxia B. clavicular fracture C. cephalhematoma D. central nervous system injury

C. cephalhematoma

A nurse is assisting with the birth of a newborn. The fetal head has just emerged. Which action would be performed next? A. suctioning of the mouth and nose B. clamping of the umbilical cord C. checking for the cord around the neck D. drying of the newborn

C. checking for the cord around the neck

A client has not received any medication during her labor. She is having frequent contractions about 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. perineal phase of the first stage of labor. C. late active phase of the first stage of labor. D. early phase of the third stage of labor.

C. late active phase of the first stage of labor

A nurse is providing care to a woman in labor. After assessment of the fetus, the nurse documents the fetal lie. Which term would the nurse use? A. flexion B. extension C. longitudinal D. cephalic

C. longitudinal

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 woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered? A. butorphanol B. fentanyl C. naloxone D. promethazine

C. naloxone

A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse likely include as the most common? A. macrosomia B. breech presentation C. persistent occiput posterior position D. multifetal pregnancy

C. persistent occiput posterior position

A nurse is reviewing the medical record of a pregnant client. The nurse suspects that the client may be at risk for dystocia based on which factors? Select all that apply. A. plan for pudendal block anesthetic use B. multiparity C. short maternal stature D. Body mass index 30.2 E. breech fetal presentation

C. short maternal stature D. Body mass index 30.2 E. breech fetal presentation

A nurse is providing care to a woman during the third stage of labor. Which finding would alert the nurse that the placenta is separating? A. boggy, soft uterus B. uterus becoming discoid shaped C. sudden gush of dark blood from the vagina D. shortening of the umbilical cord

C. sudden gush of dark blood from the vagina

A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A. supine B. lithotomy C. upright D. knee-chest

C. upright

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. uterine rupture

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

C. uterine stimulants

A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman makes which statement? A. "I'll sit down to rest for 30 minutes." B. "I'll try to move my bowels." C. "I'll lie down with my legs raised." D. "I'll drink several glasses of water."

D. "I'll drink several glasses of water."

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."

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching? A. "The warmth and buoyancy of the water has a nice relaxing effect." B. "I can stay in the bath for as long as I feel comfortable." C. "My cervix should be dilated more than 5 cm before I try using this method." D. "The temperature of the water should be at least 105? (40.5?)

D. "The temperature of the water should be at least 105? (40.5?)."

A client states, "I think my water broke! I felt this gush of fluid between my legs." The nurse tests the fluid with nitrazine paper and confirms membrane rupture if the swab turns: A. yellow. B. olive green. C. pink. D. blue.

D. blue

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? A. supine B. side-lying C. sitting D. knee-chest

D. knee-chest

A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? A. heart rate increase from 76 bpm to 90 bpm B. blood pressure rise from 110/60 mm Hg to 120/74 C. white blood cell count of 12,000 cells/mm3 D. respiratory rate of 10 breaths/minute

D. respiratory rate of 10 breaths/minute

The nurse is reviewing the physical examination findings for a client who is to undergo labor induction. Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction? A. posterior position B. firm C. closed D. shortened

D. shortened

A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which finding would require immediate intervention? A. fetal heart rate of 150 beats/minute B. contractions every 2 minutes, lasting 45 seconds C. uterine resting tone of 14 mm Hg D. urine output of 20 mL/hour

D. urine output of 20 mL/hour

Effacement of the cervix is from 0% to 40%

Latent phase

Five P's of Labor

Passenger, passageway, powers, position, and psychological response

first stage of labor

The first stage ends when the cervix is dilated to 10 cm in diameter and is large enough to permit the passage of a fetal head of average size.

The android pelvis

considered the male-shaped pelvis and is characterized by a funnel shape. It occurs in approximately 20% of women .The pelvic inlet is heart shaped and the posterior segments are reduced in all pelvic plane

False labor is characterized by

contractions that are irregular and weak, often slowing down with walking or a position change.

During the active phase, the cervix usually dilates

from 6 to 10 cm, with 40% to 100% effacement taking place.

True labor contractions begin

in the back and radiate around toward the front of the abdomen.

The gynecoid pelvis

is considered the true female pelvis, occurring in about 40% of all women; it is less common in men .Vaginal birth is most favorable with this type of pelvis because the inlet is round and the outlet is roomy

Women with a platypelloid pelvis usually

require cesarean birth.

The true pelvis is made up of three planes:

the pelvic inlet, mid pelvis, and pelvic

effacement

thinning of the cervix during labor