OB practice questions exam 2

The birth attendant has ordered an ultrasound for a pregnant woman to determine the gestational age of the fetus. What other information may be obtained by this test? Select all that apply. Oxygen supply to fetus Location of the placenta Fetal heart rate related to fetal activity Fetal head size Fetal neural tube defects Gender of the fetus

Location of the placenta Fetal head size Gender of the fetus

Which complication occurs as a result of ineffective breathing patterns? Hiccups Nausea Flatus Hyperventilation

hyperventilation

An expectant mother in week 30 of her pregnancy reports to the nurse that she has been doing her kick counts several times a day and the fetus has been kicking at a rate of about 10 to 12 times per hour, on average. What is most likely indicated by this finding? The mother has been too active. The mother is not performing the counts correctly. The fetus is healthy. The fetus is not receiving enough nutrients.

the fetus is healthy

2. A client's maternal serum alpha-fetoprotein (MSAFP) levels are elevated. The nurse can anticipate that the next test done will be: A. amniocentesis. B. ultrasound. C. biophysical profile. D. chorionic villus sampling

ultrasound

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

uterus becomes globular (Placental separation is indicated by the uterus changing shape to globular and upward rising of the uterus.)

At what time is the laboring client encouraged to push? When the fetal head can be seen When the health care provider has arrived When the cervix is fully dilated When she feels the urge to push

when the cervix is fully dilated (To avoid birth trauma, the client is not encouraged to push until the cervix is fully dilated...IF they feel the urge to push but arent fully dilated then encourage them to breathe through it)

The nurse is caring for a client who is a primagravida. Which statement is best to improve the client's psyche? "You are doing a great job" "Your second pregnancy will be easier." "You will be pushing very soon." "You will be finished soon."

"you are doing a great job"

A fetus is assessed at 2 cm above the ischial spines. How would the nurse document the fetal station? -2 +4 0 +2

-2 (see study guide)

Fetal heart rate monitoring reveals baseline tachycardia in the fetus. Which rate would be most likely? 164 beats per minute 154 beats per minute 144 beats per minute 134 beats per minute

164 beats per min

Dilation follows effacement in the primiparous mother. To be fully dilated, the cervix should have a distance of what measurement? 7 to 8 cm 8 to 10 cm 12 to 14 cm 3 to 4 cm

8 to 10 cm

Although the time frame for labor differs with individual women, which time period would you find excessive for a nullipara woman? A.A latent phase of labor of 24 hours B.A deceleration phase of 2 hours C.A phase of maximum slope of 1.5 cm per hour D.A fetal descent slope of 1 cm per hour

A latent phase of labor of 24 hours Rationale: A latent phase typically does not last more than 6 hours in a woman having her first child.

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

cesarean

The maternal serum alpha fetoprotein blood test is performed on pregnant women to screen for which condition? fetal neural tube defects maternal bladder infections maternal diabetes sexually transmitted infections

fetal neural tube defects

The nurse is preparing a 38-year-old pregnant woman for an amniocentesis to determine if there are any congenital disorders or fetal abnormalities present. Which of the following is a nursing consideration before and during the testing? Monitor the woman's vital signs during the test and for one day afterward. Instruct the woman that minor bleeding and cramping normally occur within 24 hours. Use an external fetal heart monitor to ensure fetus is not in distress. Instruct the patient not to empty her bladder before the test.

Use an external fetal heart monitor to ensure fetus is not in distress.

A client in the latent phase of the first stage of labor is noted to be uncomfortable with intact membranes and mild contractions on assessment. The nurse should encourage the client to pursue which action? Bathroom privileges Complete bed rest Ambulation ad lib Up in chair TID

ambulation ad lib (To facilitate the first stage of labor, ambulation and movement will allow better fetal descent and help to speed the labor process)

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

degree of thinning

What term is used to describe the position of the fetal long axis in relation to the long axis of the mother? Fetal lie Fetal position Fetal presentation Fetal attitude

fetal lie

A labor nurse is caring for a client who is 7 cm dilated, 100% effaced, at a +1 station, and has a face presentation on examination. The nurse knows that teaching was understood when the birth partner makes which statement? "Our baby will come out with the back of the head first." "Our baby will come out face first." "Our baby will come out with the buttocks first." "Our baby will come out facing the hip."

our baby will come out face first

A pregnant client is undergoing a fetal biophysical profile. Which parameter of the profile helps measure long-term adequacy of the placental function? Fetal heart rate Fetal breathing record Amniotic fluid volume Fetal reactivity

amniotic fluid volume

The client in active labor overhears the nurse state the fetus is ROA. The nurse should explain this refers to which component when the client becomes concerned? Fetal size Fetal attitude Fetal position Fetal station

fetal position

The nurse notices that during the nonstress test the fetal heart accelerated 20 beats per minute above baseline three times with fetal movement. The acceleration each lasted about 15 seconds before returning to baseline. This result is classified as: A. reactive. B. nonreactive

reactive (normal baseline, 2 accelerations of 15 x 15, and moderate variability)

A pregnant patient scheduled for an amniocentesis asks the nurse how the placenta is not punctured during the procedure. What should the nurse respond to the patient? "Placentas always form on the posterior uterine wall." "It would not be harmful even if it were punctured." "A uterus feels soft over the placenta site." "A sonogram to locate it will be done first."

a sonogram to locate it will be done first

A woman's primary care provider has told her he wants to use an episiotomy for birth. She asks the nurse what the purpose of this is. Which answer would be best? "It relieves pressure on the fetal head." "It is done primarily for the care provider's benefit." "It prevents distention of the bladder." "It aids contraction of the uterus following birth."

it relieves pressure on the fetal head

The nurse is monitoring a client who is in labor and notes the client is happy, cheerful, and "ready to see the baby." The nurse interprets this to mean the client is in which stage or phase of labor? Latent phase Stage three Transition phase Stage two

latent phase (The woman in labor undergoes numerous psychological adaptations during labor. During the latent phase, she is often talkative and happy, and yet anxious.)

The nurse assesses a client in labor and finds that the fetal long axis is longitudinal to the maternal long axis. How should the nurse document this finding? attitude lie presentation position

lie

Which assessment finding in a client reporting uterine contractions would be most consistent as an indicator of approaching labor? rupture of amniotic membranes development of a membrane further closing the cervix decrease in duration of contractions decrease in vaginal secretions

rupture of amniotic membranes

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: crowning. 0 station. -2 station. +2 station.

-2 station (see study guide)

The nurse is teaching a non-English speaking primigravida about the most common type of fetal presentation. Which presentation will the nurse prepare? Footling presentation drawing a hand-prepared diagram Occiput presentation using a PowerPoint presentation Breech presentation using a picture of the type Cephalic presentation using preprinted materials in her language

Cephalic presentation using preprinted materials in her language. (The most common presentation type is the cephalic presentation, and it is most appropriate to highlight the information using preprinted materials in her own language.)

If a fetus is in an ROA position during labor, how would the nurse understand the fetus to be positioned? In a longitudinal lie facing the left posterior Facing the right anterior abdominal quadrant In a common breech delivery position Presenting with the face as the presenting part

In a longitudinal lie facing the left posterior Rationale: ROA (right occiput anterior) means the occiput of the fetal head points toward the mother's right anterior pelvis; the head is the presenting part.

Which would be appropriate teaching about the force that propels the fetus through the vagina during labor? It is a combination of fundal and abdominal pressure. It is mainly gravitational from the superior fetal lie. It is cervical contractions beginning with full dilation. It is abdominal and perineal muscle contractions.

It is a combination of fundal and abdominal pressure. Rationale: "Bearing down" using abdominal muscles plus fundal contractions provide the power that moves the fetus forward.

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor? The contraction pains have been present for 5 hours, and the patterns are regular. The contraction pains are 2 minutes apart and 1 minute in duration. The client reports back pain, and the cervix is effacing and dilating. After walking for an hour, the contractions have not fully subsided.

The client reports back pain, and the cervix is effacing and dilating. (True labor is indicated when the cervix is changing. Contractions occur for weeks before true labor, and may occur close together. Contractions may also occur for a long time before true labor begins.)

Which description is best when documenting an accurate client contraction? The client's contractions are 5 minutes apart and last 45 seconds. The client's contractions last 30 seconds with rest between. The client states the contraction as an 8 on the pain scale. The client cries with each contraction and holds the support partner's hand.

The client's contractions are 5 minutes apart and last 45 seconds.

The fetal-assessment technique of a rhythm strip refers to: a tracing of fetal heart rate and pattern. a fetal EKG, because it is effected by glucose stimulation. the rhythm of fetal heart rate compared to maternal pulse. the response of fetal heart rate to oxytocin-stimulated contractions.

a tracing of the fetal HR and pattern

The nurse is reviewing the uterine contraction pattern and identifies the peak intensity, documenting this as which phase of the contraction? decrement acme increment diastole

acme

As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next? Ask her to bear down with the next contraction. Assess fetal heart rate for fetal safety. Test a sample of amniotic fluid for protein. Elevate her hips to prevent cord prolapse.

assess FHR for fetal safety

Which precaution should the nurse take with a pregnant woman following an amniocentesis? Assess fetal heart rate and possible uterine contractions. Perform a vaginal examination for a ferning pattern. Assess for increased abdominal distention. Remind her not to raise her head for 4 hours.

assess fetal HR and possible uterine contractions

Which feature would alert the nurse that the client is in the transition phase of labor? enthusiasm in the client reduction of rectal pressure decrease in the bloody show beginning urge to bear down

beginning urge to bear down

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

blue (Amniotic fluid is alkaline and turns a Nitrazine swab blue.)

A nurse notes the digital readings of the electronic fetal monitor shows decreased beat-to-beat variability in a client who was just admitted to the unit. The nurse interprets this as indicating which system is mainly being affected in the fetus? Gastrointestinal system Genitourinary system Central nervous system Musculoskeletal system

central nervous system

A nulliparous client at 37 weeks gestation calls the labor and delivery unit to report she thinks she is in labor. The nurse predicts she is in true labor based on which answer to her assessment questions? Contraction, regular and lasting longer and stronger Contractions, irregular, lasting 15 to 20 seconds Bloody mucus in the toilet once earlier in the day Scant amount of thick, white vaginal discharge, no odor

contraction, regular and lasting longer and stronger

which cardinal movement of delivery is the nurse correct to document by station?

descent

The client is having her blood drawn for a Triple or Quad screen. For what does this test screen? (Select all that apply.) Pre-eclampsia Gestational diabetes Down's syndrome Neural tube defects Rubella

downs syndrome & neural tube

The nurse is measuring a contraction from the beginning of the increment to the end of the decrement for the same contraction. The nurse would document this as which finding? peak duration frequency intensity

duration

A young woman recently gave birth to a healthy 7 lb, 6 oz (3,304 g) baby girl. There were no complications during the birth, and the mother appears to be well. Which of the following should the nurse do to assess this client's psychological state after the pregnancy? Quiz the client on her knowledge of current events to make sure she is lucid. Refer the client to a psychologist who specializes in postpartum depression. Encourage the client to talk about her birthing experience with the nurse and others. Ask her about her family history related to mental illness.

encourage the client to talk abt her birthing experience

As a woman enters the second stage of labor, which would the nurse expect to assess? feelings of being frightened by the change in contractions falling asleep from exhaustion expressions of satisfaction with her labor progress reports of feeling hungry and unsatisfied

feelings of being frightened by the change in contractions

A client who is in her third trimester is to undergo an amniocentesis. When explaining the rationale for the test at this time, the nurse would include which information as the reason? Fetal lung maturity Structural abnormalities Anemia secondary to Rh isoimmunization Chromosomal abnormalities​

fetal lung maturity (key word is third trimester...amniocentesis would detect for structural abnormalities/chromosomal abnormalities BEFORE the third trimester)

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? complete footling full frank

frank (In a frank breech, the buttocks present first, with both legs extended up toward the face. In a full or complete breech, the fetus sits cross-legged above the cervix. In a footling breech, one or both legs are presenting.)

The obstetrician is examining a woman who is in early labor to determine the positioning of the fetus. The nurse knows that which of the following fetal attitudes would be the most advantageous for birth? Head flexed forward so much that the chin touches the sternum Fetus in complete extension with back arched Fetus in partial extension with brow presenting to birth canal Chin in moderately flexed military position

head flexed forward so much that it touches the sternum

A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention? Help the woman change positions. Prepare the woman for an emergency cesarean birth. Document the finding. Obtain assistance to check for a compressed umbilical cord.

help the woman change positions

The nurse is teaching a prenatal class on the difference between true and false labor contractions. The nurse determines the session is successful when the class correctly chooses which factor as an indication of true labor contraction? cause discomfort over the top of uterus subside when walking around and use the lateral position increase even if relaxing and taking a shower remain irregular with the same intensity

increase even if relaxing or showering

When the membranes of a pregnant patient rupture during labor, the nurse determines that the patient and fetus are in danger. What did the nurse assess at the time of membrane rupture? Meconium-stained amniotic fluid Blood-tinged vaginal discharge at full dilation Maternal pulse of 90 to 95 beats/min Fetus presenting in an LOA position

meconium-stained amniotic fluid (Meconium staining means that the fetus has lost rectal sphincter control, allowing meconium to pass into the amniotic fluid. It may indicate a fetus has or is experiencing hypoxia, which stimulates the vagal reflex and leads to increased bowel motility. The fetal presentation is not assessed during membrane rupture. The maternal pulse rate of 90 to 95 beats/min is expected during labor. Blood-tinged vaginal discharge at full dilation is an expected finding)

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? buttocks shoulders brow occiput

occiput (With a vertex presentation, a type of cephalic presentation, the fetal presenting part is the occiput. The shoulders are the presenting part when the fetus is in a shoulder presentation. The brow or sinciput is the presenting part when a fetus is in a brow presentation. The buttocks are the presenting part when a fetus is in a breech presentation.)

A nurse is educating a group of nursing students about the etiology of labor. Which of the following should the nurse explain as the hormone produced by the posterior pituitary? Oxytocin Relaxin Progesterone Estrogen

oxytocin

A group of nursing students are preparing a presentation which will illustrate various components of the birthing process. When presenting the pelvis, the students should point out that it is often referred to as which term? Psyche Passageway Powers Passenger

passageway (The passageway is one of the 4 Ps and involves the pelvis, both bony pelvis and the soft tissues, cervix, and vagina. The passenger refers to the fetus. The primary powers are the involuntary contractions of the uterus, whereas the secondary powers come from the maternal abdominal muscles. The psyche refers to the mother's mental state.)

Assessment for surfactant level via LS ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to: Promote maturation of lung alveoli. Increase lung resistance on inspiration. Encourage immunologic competence of lung tissue. Prevent alveoli from collapsing on expiration.

prevent alveoli from collapsing on expiration

A patient you care for in labor asks you what causes labor to begin. Which of the following statements is a possible explanation? Progesterone levels rise at term to initiate contractions. The ovary releases additional estrogen at term. Prostaglandins may be the causative factor of labor. Calcium is drawn from bones to block relaxation fibers.

prostaglandins may be the causative factor

A nurse is coaching a woman during the second stage of labor. Which action should the nurse encourage the client to do at this time? Push with contractions and rest between them. Begin pushing as soon as the cervix has dilated to 8 cm. Hold the breath while pushing during contractions. Pant while pushing.

push w contractions and rest between them

The nurse is assessing the read-out of the external fetal monitor and notes late decelerations. Which action should the nurse prioritize at this time? reposition the client on either side notify the health care provider do nothing, this is benign palpate for bladder fullness

reposition the client on either side (Deceleration may be related to compression on the maternal abdominal aorta and inferior vena cava and repositioning the woman to either her right or left side will remove the pressure and allow the blood flow to resume)

A patient comes to the birthing suite and informs the nurse that "the baby is coming" and "I feel like I have to have a bowel movement." It is likely that the woman is which of the following stages of labor? first stage third stage fourth stage second stage

second stage (When a woman states "I feel a lot of pressure" or "I want to have a bowel movement", it is likely she is in the second stage of labor and the baby will be born soon.)

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? "If I try to talk to my partner during a contraction, I can't." "I'm feeling contractions mostly in my back." "The contractions slow down when I walk around." "My contractions are about 6 minutes apart and regular."

the contractions slow down when i walk around

A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? The end of the first trimester The end of the second trimester The end of the third trimester The end of the fourth trimester

the end of the second trimester

A pregnant client arrives to the clinic for a prenatal visit appearing uncomfortable. During the assessment, the nurse determines the client is experiencing fairly strong contractions at 12:05 p.m., 12:10 p.m., 12:15 p.m., and 12:20 p.m. What can the nurse conclude from these findings? The client can be sent home. The frequency of the contractions is every 5 minutes. The duration of the contractions is every 5 minutes. The client is in active labor.

the frequency of contractions is every 5 minutes

A client in her third trimester is scheduled for a nonstress test. What is the purpose of the nonstress test for the client? To determine if the client is ready for delivery To determine the well-being of the fetus To determine if the client has pregnancy-induced hypertension To determine if the baby is Rh positive

to determine the well being of the fetus

A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure? To aid the woman as she pushes during labor To prevent supine hypotension syndrome To decrease the heart rate of the fetus To prevent the woman from falling out of bed

to prevent supine hypotension syndrome

An 8-month-pregnant client comes to the clinic complaining that she has not felt the baby move for the past 48 hours. Other than checking the fetal heart tones, the nurse can also anticipate which fetal study? A. Amniocentesis B. Multiple-marker study C. Blood flow assessment D. Ultrasonography

ultrasonography