OB TEST #2 SUCCESS QUESTIONS

The childbirth education nurse is evaluating the learning of four women, 38 to 40 weeks' gestation, regarding when they should go to the hospital. The nurse determines that the teaching was successful when a client makes which of the following statements? Select all that apply.

The client who says, "When I go to the bathroom and see the mucous plug on the toilet tissue

While performing Leopold's maneuvers on a woman in labor, the nurse palpates a hard round mass in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass just above the symphysis. Which of the following is a reasonable conclusion by the nurse

The fetal lie is vertical

When during the latent phase of labor should the nurse assess the fetal heart pattern of a low-risk woman, G1 P0000? Select all that apply.

After vaginal exams. Before administration of analgesics. Periodically at the end of a contraction. Before ambulating.

A woman, G2 P0101, 5 cm dilated, and 30% effaced, is doing first-level Lamaze breathing with contractions. The nurse detects that the woman's shoulder and face muscles are beginning to tense during the contractions. Which of the following interventions should the nurse perform first?

Encourage the woman to perform the next level breathing.

The nurse is assessing a client who states, "I think I'm in labor." Which of the following findings would positively confirm the client's belie

Her cervix has dilated from 2 to 4 cm.

The nurse auscultates a fetal heart rate of 152 on a client in early labor. Which of the following actions by the nurse is appropriate?

Inform the mother that the rate is normal.

Which of the following actions is appropriate for the nurse to perform when caring for a Chinese-speaking woman in active labor?

Inquire regarding the woman's pain level.

The labor and delivery nurse performs Leopold's maneuvers. A soft round mass is felt in the fundal region. A flat object is noted on the left and small objects are noted on the right of the uterus. A hard round mass is noted above the symphysis. Which of the following positions is consistent with these findings?

Left occipital anterior (LOA)

The nurse is caring for an Orthodox Jewish woman in labor. It would be appropriate for the nurse to include which of the following in the plan of care?

Provide the woman with a long-sleeved hospital gown.

The childbirth educator is teaching a class of pregnant couples the breathing technique that is most appropriate during the second stage of labor. Which of the following techniques did the nurse teach the women to do?

Push down with an open glottis.

A nurse is teaching a class of pregnant couples the most therapeutic breathing technique for the latent phase of labor. Which of the following techniques did the nurse teach?

Slow chest breathing.

A woman who is in active labor is told by her obstetrician, "Your baby is in the flexed attitude." When she asks the nurse what that means, what should the nurse say?

The baby's chin is resting on its chest

After analyzing an internal fetal monitor tracing, the nurse concludes that there is moderate short-term variability. Which of the following interpretations should the nurse make in relation to this finding

The fetus has a healthy nervous system

A nurse is assisting an anesthesiologist who is inserting an epidural catheter. Which of the following positions should the nurse assist the woman into?

Fetal position.

A client is complaining of severe back labor. Which of the following nursing interventions would be most effective?

Provide direct sacral pressure.

A nurse has just performed a vaginal examination on a client in labor. The nurse palpates the baby's buttocks as facing the mother's right side. Where should the nurse place the external fetal monitor electrode?

Right upper quadrant (RUQ).

It is 4 p.m. A client, G1 P0000, 3 cm dilated, asks the nurse when the dinner tray will be served. The nurse replies:

"A heavy meal is discouraged. I can get clear fluids for you whenever you would like them, though."

A woman is in the transition phase of labor. Which of the following comments should the nurse expect to hear

"I can't stand this pain any longer!"

A gravid client at term called the labor suite at 7:00 p.m. questioning whether she was in labor. The nurse determined that the client was likely in labor after the client stated:

"I took a shower about a half hour ago. The contractions seem to hurt more since I finished."

The nurse sees the fetal head through the vaginal introitus when a woman pushes. The nurse, interpreting this finding, tells the client, "You are pushing very well." In addition, the nurse could also state which of the following?

"The baby is almost crowning."

A woman, 40 weeks' gestation, calls the labor unit to see whether or not she should go to the hospital to be evaluated. Which of the following statements by the woman indicates that she is probably in labor and should proceed to the hospital?

"The contractions are about a minute long and I am unable to talk through them

A low-risk 38-week gestation woman calls the labor unit and says, "I have to come to the hospital right now. I just saw pink streaks on the toilet tissue when I went to the bathroom. I'm bleeding." Which of the following responses should the nurse make first?

"You sound frightened."

To decrease the possibility of a perineal laceration during delivery, the nurse performs which of the following interventions prior to the delivery?

. Massages the perineum with mineral oil.

The health care practitioner orders the following medication for a laboring client: Stadol 0.5 mg IV STAT for pain. The drug is on hand in the following concentration: Stadol 2 mg/mL. How many mL of medication will the nurse administer? Calculate to the nearest hundredth.

0.25 ML

During the third stage, the following physiological changes occur. Please place the changes in chronological order.

31. Hematoma forms behind the placenta. 42. Membranes separate from the uterine wall. 13. The uterus contracts firmly. 24. The uterine surface area dramatically decreases.

A nurse determines that a client is carrying a fetus in the vertical lie. The nurse's judgment should be questioned if the fetal presenting part is which of the following?

Scapula.

One hour ago, a multipara was examined with the following results: 8 cm, 50% effaced, and +1 station. She is now pushing with contractions and the fetal head is seen at the vaginal introitus. The nurse concludes that the client is now:

10 cm dilated, 100% effaced, and +5 station

A nurse is educating a pregnant woman regarding the moves a fetus makes during the birthing process. Please place the following cardinal movements of labor in the order the nurse should inform the client that the fetus will make:

11 52 33 44 25

The physician writes the following order for a newly admitted client in labor: Begin a 1000 mL IV of D5 1/2 NS at 150 mL/hr. The IV tubing states that the drop factor is 10 gtt/mL. Please calculate the drip rate to the nearest whole. _______ gtt/min

25 GTT/MIN

The nurse is interpreting the results of a fetal blood sampling test. Which of the following reports would the nurse expect to see?

pH of 7.30.

A primigravida is pushing with contractions. The nurse notes that the woman's perineum is beginning to bulge and that there is an increase in bloody show. Which of the following actions by the nurse is appropriate at this time?

Continue to provide encouragement during each contraction.

Immediately following administration of an epidural anesthesia, the nurse must monitor the mother for which of the following?

Drop in blood pressure.

Which of the following responses is the primary rationale for the inclusion of the information taught in childbirth education classes

Knowledge learned at childbirth education classes helps to break the feartension- pain cycle

In addition to breathing with contractions, which of the following actions can help a woman in the first stage of labor to work with her pain?

Performing effleurage.

A client in labor, G2 P1001, was admitted 1 hour ago at 2 cm dilated and 50% effaced. She was talkative and excited at that time. During the past 10 minutes she has become serious, closing her eyes and breathing rapidly with each contraction. Which of the following is an accurate nursing assessment of the situation?

The client is exhibiting an expected behavior for labor.

An ultrasound report states, "The fetal head has entered the pelvic inlet." What does the nurse interpret this statement to mean?

The fetal head has entered the true pelvis

While evaluating the fetal heart monitor tracing on a client in labor, the nurse notes that there are fetal heart decelerations present. Which of the following assessments must the nurse make at this time

The relationship between the decelerations and the labor contractions

A woman had a baby by normal spontaneous delivery 10 minutes ago. The nurse notes that a gush of blood was just expelled from the vagina and the umbilical cord lengthened. What should the nurse conclude?

The woman is about to deliver the placenta.

A pregnant woman is discussing positioning and the use of leg stirrups for delivery with a labor nurse. Which of the following client responses indicates that the client understood the information? Select all that apply.

When the client says, "I heard that for doctors to deliver babies safely, it is essential to have the mother's legs up in stirrups

Which of the following nonpharmacological interventions recommended by nurse midwives may help a client at full term to go into labor? Select all that apply.

Engage in sexual intercourse. Ingest evening primrose oil. Massage the breast and nipples.

A client in labor is talkative and happy. How many centimeters dilated would a maternity nurse suspect that the client is at this time?

2 cm.

The nurse is assessing the fetal station during a vaginal examination. Which of the following structures should the nurse palpate?

Ischial spines.

A nurse is caring for women from four different countries. Which of the women is most likely to request that her head be kept covered throughout her hospitalization

Arabic woman.

Which of the following actions would the nurse expect to perform immediately before a woman is to have regional anesthesia? Select all that apply.

Assess fetal heart rate. Infuse 1,000 mL of Ringer's lactate.

A nurse describes a client's contraction pattern as: frequency every 3 min and duration 60 sec. Which of the following responses corresponds to this description?

Contractions lasting 1 minute followed by a 120-second rest period.

A client is in the second stage of labor. She falls asleep immediately after a contraction. Which of the following actions should the nurse perform as a result?

Cover the woman's perineum with a sheet.

A gravid client, G3 P2002, was examined 5 minutes ago. Her cervix was 8 cm dilated and 90% effaced. She now states that she needs to move her bowels. Which of the following actions should the nurse perform first?

Evaluate the progress of labor.

During delivery, the nurse notes that the baby's head has just been delivered. The nurse concludes that the baby has just gone through which of the following cardinal moves of labor?

Extension.

The practitioner is performing a fetal scalp stimulation test. Which of the following fetal responses would the nurse expect to see?

Fetal heart acceleration

An obstetrician is performing an amniotomy on a gravid woman in transition. Which of the following assessments must the nurse make immediately following the procedure?

Fetal heart rate.

A woman has just arrived at the labor and delivery suite. To report the client's status to her primary health care practitioner, which of the following assessments should the nurse perform? Select all that apply

Fetal heart rate. Contraction pattern. Vital signs.

The nurse documents in a laboring woman's chart that the fetal heart is being "assessed via intermittent auscultation." To be consistent with this statement, the nurse, using a Doppler electrode, should assess the fetal heart at which of the following times?

For 1 minute immediately after contractions.

A woman has decided to hire a doula to work with her during labor and delivery. Which of the following actions would be appropriate for the doula to perform? Select all that apply

Give the woman a back rub.

A client who is 7 cm dilated and 100% effaced is breathing at a rate of 50 breaths per minute during contractions. Immediately after a contraction, she complains of tingling in her fingers and some light-headedness. Which of the following actions should the nurse take at this time?

Have the woman breathe into a bag.

During a vaginal examination, the nurse palpates fetal buttocks that are facing the left posterior and are 1 cm above the ischial spines. Which of the following is consistent with this assessment?

LSP −1 station.

When performing Leopold's maneuvers, the nurse notes that the fetus is in the left occiput anterior position. Which is the best position for the nurse to place a fetoscope to hear the fetal heartbeat?

Left lower quadrant.

A client is in the third stage of labor. Which of the following assessments should the nurse make/observe for? Select all that apply.

Lengthening of the umbilical cord Uterus rising in the abdomen and feeling globular

Upon examination, a nurse notes that a woman is 10 cm dilated, 100% effaced, and −3 station. Which of the following actions should the nurse perform during the next contraction?

Monitor for signs of rectal pressure.

The nurse is caring for a nulliparous client who attended Lamaze childbirth education classes. Which of the following techniques should the nurse include in her plan of care? Select all that apply.

Muscle relaxation. Pelvic rocking. Abdominal massage.

The nurse enters a laboring client's room. The client is complaining of intense back pain with each contraction. The nurse concludes that the fetus is likely in which of the following positions?

Occiput posterior.

While caring for a client in the transition phase of labor, the nurse notes that the fetal monitor tracing shows average short-term and long-term variability with a baseline of 142 beats per minute (bpm). What should the nurse do

Provide caring labor support.

Which of the following pictures depicts a fetus in the ROP position?

RIGHT SIDE..HEAD DOWN,,,,FACING OUTWARDS OF TUMMY

A nurse is teaching childbirth education classes to a group of pregnant teens. Which of the following strategies would promote learning by the young women?

Utilizing visual aids like movies and posters during the classes.

A woman who states that she "thinks" she is in labor enters the labor suite. Which of the following assessments will provide the nurse with the most valuable information regarding the client's labor status?

Vaginal examination.

A G1 P0, 8 cm dilated, is to receive pain medication. The health care practitioner has decided to order an opiate analgesic with an analgesic-potentiating medication. Which of the following medications would the nurse expect to be ordered as the analgesic-potentiating medication?

Vistaril (hydroxyzine). OR PHENERGAN

Which of the following pictures depicts a fetus in the frank breech position?

WITH BOTH FEET UP!!!

A client enters the labor and delivery suite stating that she thinks she is in labor. Which of the following information about the woman should the nurse note from the woman's prenatal record before proceeding with the physical assessment? Select all that apply

Weight gain. Ethnicity and religion. Age. Gravidity and parity.

Which of the following pictures depicts a fetus in the LSA position

AGAINST LEFT SIDE FACING INWARDS OF TUMMY

A nurse is assessing the vital signs of a client in labor at the peak of a contraction. Which of the following findings would the nurse expect to see?

Hypertension.

The nurse is providing acupressure to provide pain relief to a woman in labor. Where is the best location for the acupressure to be applied? Select all that apply.

On the medial aspect of the lower leg.\ At the top one third of the sole of the foot

A woman, G1 P0000, 40 weeks' gestation, entered the labor suite stating that she is in labor. Upon examination it is noted that the woman is 2 cm dilated, 30% effaced, contracting every 12 min × 30 sec. Fetal heart rate is in the 140s with good variability and spontaneous accelerations. What should the nurse conclude when reporting the findings to the primary health care practitioner?

The woman is in early labor and could be sent home.

A nurse concludes that a woman is in the latent phase of labor. Which of the following signs/symptoms would lead a nurse to that conclusion?

The woman talks and laughs during contractions

The nurse is performing a vaginal examination on a client in labor. The client is found to be 5 cm dilated, 90% effaced, and station −2. Which of the following has the nurse palpated?

Thin cervix.

The nurse is interpreting the fetal monitor tracing below. Which of the following actions should the nurse take at this time?

Provide caring labor support.

A nurse is coaching a woman who is in the second stage of labor. Which of the following should the nurse encourage the woman to do?

Take a slow cleansing breath before bearing down.

A midwife advises a mother that her obstetric conjugate is of average size. How should the nurse interpret that information for the mother?

The anterior to posterior diameter of the pelvis will accommodate a fetus with an average-sized head

A multipara, LOA, station +3, who has had no pain medication during her labor, is now in stage 2. She states that her pain is 6 on a 10-point scale and that she wants an epidural. Which of the following responses by the nurse is appropriate?

The baby is going to be born very soon. It is really too late for an epidural."

The nurse wishes to assess the variability of the fetal heart rate. Which of the following actions is recommended prior to performing this assessment?

Insert an internal fetal monitor electrode.

A client, G2 P1001, 5 cm dilated and 40% effaced, has just received an epidural. Which of the following actions is important for the nurse to take at this time?

Place a wedge under the woman's side.

On examination, it is noted that a full-term primipara in active labor is right occipitoanterior (ROA), 7 cm dilated, and +3 station. Which of the following should the nurse report to the physician?

Descent is progressing well.

When would the nurse expect to see the fetal heart changes noted on the monitor tracing shown below?

During fetal movement.

When would the nurse expect to see the monitor tracing shown below?

During second stage of labor.

A woman is in the second stage of labor with a strong urge to push. Which of the following actions by the nurse is appropriate at this time?

Encourage the woman to grunt during contractions.

The nurse is assessing an internal fetal heart monitor tracing of an unmedicated, fullterm gravida who is in transition. Which of the following heart rate patterns would the nurse interpret as normal?

Baseline of 140 to 150 with decelerations to 100 that mirror each of the contractions.

A nurse is caring for a laboring woman who is in transition. Which of the following signs/symptoms would indicate that the woman is progressing into the second stage of labor? Select all that apply

Bulging perineum. Increased bloody show. Uncontrollable urge to push.

A woman is in active labor and is being monitored electronically. She has just received Stadol 2 mg IM for pain. Which of the following fetal heart responses would the nurse expect to see on the internal monitor tracing?

Decreased variability.

On vaginal examination, it is noted that a woman with a well-functioning epidural is in the second stage of labor. The station is −2 and the baseline fetal heart rate is 130 with no decelerations. Which of the following nursing actions is appropriate at this time?

Delay pushing until the baby descends further and the mother has a strong urge to push.