OB Exam 2

The nurse is assessing the emotional health of a patient receiving care for early labor. Which question should the nurse ask? a. "How do you like the birthing room?" b. "Do you want to get up and walk around to take your mind off of the contractions?" c. "What are your expectations for your current pregnancy?" d. "Have you chosen a name for the baby yet?"

"What are your expectations for your current pregnancy?"

A patient having labor induced is exhibiting hypertonicity systole uterine contractions. Which action should the nurse take? Ask the patient to bear down. Stop oxytocin infusion. Turn the patient to the right side. Prepare for imminent delivery.

Stop oxytocin infusion.

The electronic monitor shows repetitive variable decelerations in the fetal heart rate of a patient in labor. Which health problem should the nurse anticipate? a. Fetal transverse lie b. Umbilical cord compression c. Breech presentation d. Fetal hypoglycemia

Umbilical cord compression

The nurse is assessing the fetus of a patient in labor. Which action should the nurse take when the fetal heart is located? count for 60 seconds before, during, and just after a contraction Count for 30 seconds just after a contraction. Count for 15 seconds during a contraction. Count for 90 seconds before and during a contraction.

count for 60 seconds before, during, and just after a contraction

the nurse monitors the fetal heart monitor of a patient in labor. For which reason should the nurse provide no further action at this time? Bradycardia Recurrent late decelerations Early decelerations Sinusoidal patterns

early decel

The nurse is preparing to assess fetal heart rate with a Doppler. At which maternal location should the nurse place the diaphragm of the device? Midline Top of the umbilicus Bottom of the symphysis Left side of the abdomen

midline The Doppler diaphragm should be placed on the abdomen, halfway between the umbilicus and symphysis and in the midline to assess the fetal heart rate. Fetal heart rate is not assessed by placing the Doppler at the bottom of the symphysis, top of the umbilicus, or left side of the abdomen.

The fetus of a patient in the first stage of labor is in the occiput posterior position. In which way should the nurse position the patient? a. on hands and knees b. sitting c. squatting d. standing

on hands and knees When the fetus is in the persistent occiput posterior position, side-lying or hands and knees positions can promote fetal head rotation. Standing, squatting, and sitting in an upright position may all be beneficial during labor, but are not the best positions for a patient whose fetus is in the occiput posterior position.

A patient in labor is diagnosed with preeclampsia. For which potential health problem should the nurse monitor the patient? a.

seizures preeclampsia can cause several health problems in the patient in labor, including seizure activity. Preeclampsia does not cause hydramnios, myocardial infarction, or diabetes mellitus.

A patient with clinical depression is in labor. Which behavior should the nurse expect for this patient? a. Trouble concentrating b. Hallucinations and delusions c. Short-lived and intense feelings of nervousness d. Continual and excessive worrying

trouble concentrating

A patient in the first stage of labor is diagnosed with preeclampsia. Which patient statement should indicate the need for further teaching about fetal heart rate assessment? a. "If you can't find the baby's heartbeat, you're going to move the Doppler until you hear it." b. "You're going to put gel on my belly so you can hear the baby's heartbeat clearly." c. "You're going to listen to my baby's heartbeat every 5 minutes." d. "When you listen to my baby's heartbeat, you're going to take my pulse."

"You're going to listen to my baby's heartbeat every 5 minutes." Fetal heart rate should be monitored every 15 minutes for a high-risk patient in the first stage of labor. The other patient statements are correct.

The nurse reviews information received during handoff communication. Which patient should the nurse identify as having the greatest risk for a prolapsed umbilical cord? a. 38 weeks' gestation, 3 cm dilated, 80% effaced, 0 station, intact membranes b. 40 weeks' gestation, 5 cm dilated, 100% effaced, -2 station, ruptured membranes c. 40 weeks' gestation, 5 cm dilated, 100% effaced, -2 station, intact membranes d. 39 weeks' gestation, 9 cm dilated, 100% effaced, +1 station, ruptured membranes

40 weeks' gestation, 5 cm dilated, 100% effaced, -2 station, ruptured membranes Prolapse is more likely to occur in a patient with an abnormal fetal presentation, such as high station. Rupture of amniotic membranes also increases the risk of cord prolapse. The chance of a prolapsed cord is less if the presenting fetal part is engaged.

A patient asks how the baby's condition is determined during labor. Which information should the nurse provide? a. Pain is assessed in the patient's abdomen. b. An electronic fetal monitor is used to assess the fetus's heart rate. c. Blood serum diagnostics are performed every shift. d. A pelvic exam will be performed every 2 hours

An electronic fetal monitor is used to assess the fetus's heart rate.

The nurse is monitoring a low-risk patient who is in labor. Which action should the nurse take first? a. Prepare patient for telemetry. b. Assess fetal heart tones. c. Insert internal pressure catheter. d. Apply fetal scalp electrode.

Assess fetal heart tones.

The nurse is preparing to assess fetal heart tones. For which fetal position should the heart tones be assessed on the lower maternal abdominal quadrant? a. Transverse lie b. Feet presentation c. Breech presentation d. Cephalic presentation

Cephalic presentation

A patient in labor experiences trickling of amniotic fluid during contractions. Which action should the nurse take? Position the patient on the left side. Clean up the leaking fluid. Document the patient's pain level. Decrease the epidural dose.

Clean up the leaking fluid.

The nurse is preparing to perform Leopold maneuvers on a patient in labor. For which reason should the nurse complete this assessment? a. Measure fetal flexion b. Determine fetal size c. Determine fetal age d. Determine fetal position

Determine fetal position

The nurse is preparing to assess a patient in labor. Which action should the patient complete first in preparation for Leopold maneuvers? a. Declare when a contraction begins. b. Bend the knees. c. Empty the bladder. d. Place a pillow behind the shoulders.

Empty the bladder.

The nurse is observing a patient's electronic fetal monitor. Which finding should require immediate intervention? a. Variable decelerations that recover to baseline b. Accelerations c. Early decelerations with contractions d. Late decelerations with minimal variability

Late decelerations with minimal variability

The nurse is assessing fetal heart rate in a pregnant patient. Which part of the abdomen should be used if the fetus is in cephalic presentation? a. Above the umbilicus b. Upper quadrant c. Lower quadrant d. Below the umbilicus

Lower quadrant When the fetus is in a cephalic presentation, the fetal heart rate (FHR) is best heard in the lower quadrant of the maternal abdomen. In a breech presentation, the FHR is heard at or above the maternal umbilicus. In a transverse lie position, the FHR may be heard best just above or just below the maternal umbilicus. Fetal heart rate is never assessed in the upper maternal abdomen.

The nurse is assessing the fetal heart rate in a patient with polyhydramnios. Which outcome should the nurse expect? a. The fetal heartbeat is absent. b. The fetal heartbeat indicates tachycardia. c. The fetal heartbeat is difficult to hear. d. The fetal heartbeat is irregular.

The fetal heartbeat is difficult to hear.

A patient in labor has painless vaginal bleeding. Which action should the nurse make a priority? a. administer oxygen by face mask b. assess fetal heart rate c. assess fetal presentation d. place in side lying position

assess fetal heart rate

A patient who has been in labor for 1 hour starts to panic and demands a cesarean birth. Which action should the nurse take? a. Provide ice chips. b. Call the surgical staff. c. Administer an anxiolytic. d. reassure the patient

reassure the patient The patient in labor may have increased anxiety and feel out of control, which requires extra reassurance and support. The patient should be reassured that everything is progressing normally. The healthcare provider determines the need for a cesarean birth and prescribes antianxiety medication. Ice chips are unlikely to help with feelings of anxiety.