OB ch. 13

D

The nurse is caring for a client in active labor. Which assessment finding requires health care provider notification? a. Hyperventilation b. Elevated WBC count c. Nausea d. Gross proteinuria

C

A client in the third stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm? a. to reduce boggy nature of the uterus b. to remove pieces left attached to uterine wall c. to constrict the uterine blood vessels d. to lessen the chances of conducting an episiotomy

D

A new dad is alarmed at the shape of his newborn's head. When responding to the dad, the nurse reminds him this is due to: a. extreme pressure in the vaginal vault. b. a congenital defect. c. prolonged labor. d. cranial bones overlapping at the suture lines.

A, D, E, C, B

A nurse is caring for a woman in labor and understands that as the fetus travels through the birth canal, the fetus makes positional changes. List the cardinal movements of labor in the correct order that the nurse would expect the fetus to move. All options must be used. a. engagement b. explusion c. extension d. flexion e. internal rotation

B

A client gave birth to a child 3 hours ago and noticed a triangular-shaped gap in the bones at the back of the head of her newborn. The attending nurse informs the client that it is the posterior fontanelle. The client is anxious to know when the posterior fontanelle will close. Which time span is the normal duration for the closure of the posterior fontanelle? a. 4 to 6 weeks b. 8 to 12 weeks c. 12 to 14 weeks d. 14 to 8 weeks

B

The nurse is caring for a client in labor and notes the woman's cervix is approximately 1 cm in length. How should the nurse document this finding? a. 0% effaced. b. 50% effaced. c. 75% effaced. d. 100% effaced.

A

The nurse is caring for a client who is late in her pregnancy. What assessment finding should the nurse attribute to the role of prostaglandins? a. The cervix is softening b. The uterus is relaxing c. The cervix is dilating d. The perineum is relaxing

B

The nurse is preparing to teach a group of new parents about the labor process. When detailing the differences between the various presentations, which one should the nurse point out seldom happens? a. Breech b. Shoulder c. Oblique lie d. Transverse lie

B

The nurse is monitoring a client and notes: contractions every 2 to 3 minutes, duration 45 to 60 seconds, strong intensity, cervix 10 cm, 100% effaced, fetal head crowns when client pushes. The nurse determines the client is currently in which stage or phase of labor? a. Transition b. Second c. Third d. Active

C

A primagravida has an office appointment in her 39th week of pregnancy. Which assessment data is most definitive of the onset of labor? a. The mother reports frequent urination. b. The fetal head is engaged in the pelvis. c. Cervical ripening is noted on examination. d. Expulsion of the mucous plug.

C

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? a. The contraction pains are 2 minutes apart and 1 minute in duration. b. The contraction pains have been present for 5 hours, and the patterns are regular. c. The client reports back pain, and the cervix is effacing and dilating. d. After walking for an hour, the contractions have not fully subsided.

B

A client in her third trimester of pregnancy arrives at a health care facility with a report of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities, along with an increase in vaginal discharge. What should the nurse do next? a. Notify the health care provider. b. Continue to monitor the client. c. Assess the client's blood pressure. d. Prepare the client for birth.

C, D, E

A nurse is caring for a client in her fourth stage of labor. Which assessments would indicate normal physiologic changes occurring during the fourth stage of labor? Select all that apply. a. decrease in the pulse rate b. increase in the blood pressure c. decreased intra-abdominal pressure d. well-contracted uterus in the midline e. mild uterine cramping and shivering

E, B, C, A, D

Place the following stages of labor in order from what occurs first to last. All options must be used. a. second stage b. active stage c. transition stage d. third stage e. latent stage

A

The following nursing note was documented in the client's record by the labor room nurse. In which postion was the client born? Date: 2/18/17 Time: 0912 Vaginal birth of a live male in the vertex presentation, ROA position. -D. Smith, RN a. With the occiput facing the right anterior quadrant of the pelvis b. Rear facing with the occiput facing the posterior quadrant of the pelvis c. With the right side presenting, and the occiput facing the anterior quadrant d. With the brow facing the right anterior quadrant of the pelvis

B

The nurse is assessing a client who has given birth within the past hour. The nurse would expect to find the woman's fundus at which location? a. between the umbilicus and symphysis pubis b. at the level of the umbilicus c. one fingerbreadth below the umbilicus d. 2 cm above the umbilicus

A

The nurse is caring for a nullipara client at 40 weeks' gestation. After assessing the client, the health care provider states that the fetus is at a -4 station. Which statement by the client requires clarification by the nurse? a. "The health care provider states my labor is imminent." b. "The health care provider will reassess me next week, if I make it." c. "I hope that the end of my pregnancy will be uneventful." d. "I will go home and pack my bag and await the labor process to begin."

C

The nurse is caring for four clients within the labor and delivery unit. Which client does the nurse anticipate will be sent home? a. The primigravid who is effaced, having intense contractions but at irregular intervals and dilation is 6 cm b. The multiparous who just experienced lightening and is having contractions 7 minutes apart. c. The primigravid who has a thinning cervix and a dilation of 3 cm d. The multiparous who is effaced with dilation of 4 cm.

C

Which cardinal movement allows the fetus to travel through the birth canal most efficiently? a. Extension b. External rotation c. Flexion d. Engagement

C

With which findings would the nurse anticipate a diagnosis of false labor? a. Regular contractions 8 minutes apart b. A feel of pressure in the pelvic region c. Cervical dilation of 1 cm d. Softening of the cervix

D

At which point along the birth canal must the fetal head extend for successful passage? a. At the level of the iliac crest b. At the level of the ischial spines c. At the level of the pelvic inlet d. At the level of the symphysis pubis

A

During the examination, the health care provider mentions the fetus has a good attitude. The nurse explains to the parents that this means: a. the posture of the fetus is with all joints flexed for birth. b. the fetus is cooperating with the labor. c. the fetus is presenting head first. d. the posture of the fetus is with arms at its side and legs straight.

B

During the fourth stage of labor, which mother typically experiences the strongest afterpains? a. The primigravid who delivers a 6 lb (2,688 g) newborn b. A multipara who is breast-feeding c. A primigravid whose breast milk has not come in d. A multigravid with twins who decided to formula feed

C

During which phase of labor would the nurse anticipate providing the most emotional support for the mother? a. Active phase of labor b. Final phase of labor c. Transition phase of labor d. Latent phase of labor

A

In which manner is the fetal status best assessed during the active and transition stage of labor? a. Fetal heart rate at the peak of a contraction b. Fetal movement on the tocometer c. Fetal heart rate between contractions d. Fetal kicks over a one minute period

A

The nurse is appraising the post birth laboratory results of a client and discovers the WBC is 22,000 cells/mcL. The nurse predicts which action should be prioritized in response? a. None, a normal variation due to labor b. An abnormal finding, needs antibiotics c. Occurs in clients after a cesarean birth d. Further testing is required to determine source.