OB Exam #1
A woman arrives at labor and delivery with contractions every 2-3 minutes lasting 30-45 seconds reporting that she "thinks my water broke". On exam, the RN notes the presenting part is difficult to determine. What intervention should the LPN anticipate?
Use of an ultrasound to determine fetal position
Jane and her husband have attended childbirth preparation classes and they feel very hopeful and optimistic about having a natural childbirth. As Jane progresses to 8cm dilation, she can no longer endure the pain at the peak of each contraction and she begs the nurse for an epidural. How can the nurse best help Jane?
Support Jane's decision and call the obstetrician to discuss the epidural with Jane
The structure to supply the fetus with nutrients is which of the following?
Placenta
The nurse is explaining functions of the amniotic fluid to a prenatal class. The nurse knows the class understands when one of the women states the following as a function of amniotic fluid:
"It helps cushion the baby."
Opiods are often used in labor for pharmacologic pain management. A patient in the transition phase of labor is requesting fentanyl (Sublimaze) for pain. How should the nurse respond to her request?
"Pain medication given now might cause the baby to have slow respirations and is not recommended, lets try to focus and breathe."
What is the normally accepted fetal heart rate range?
110-160 bpm
A pregnant woman, multipara, has been in labor for several hours. She cries out that her contractions are getting harder and that she can't do this. The patient is really irritable, nauseated, annoyed, and fearful of being left alone. Considering the client's behavior, the nurse would expect the cervix to be dilated how many centimeters?
8 to 10
An overweight teenaged girl comes in for a routine physical exam. She reports that there have been no changes in her health since her last visit, so you are astounded to observe Chadwick's sign during her pelvic exam. A subsequent enzyme immunoassay (EIA) indicates that she is almost certainly pregnant but she denies it. Which task of pregnancy does she need help with?
Accepting the pregnancy
Susan is in labor with her second child. She knows that she will want epidural anesthesia and she has already signed her consent form. What must the nurse do before Susan receives the epidural?
Administer a fluid bolus through the IV line to reduce the risk of hypotension
The nurse should administer Rhogam (Rh immune globulin) to the pregnant woman who is Rh o(D)-, after which of the following tests?
Amniocentesis
The LPN is assisting in a vaginal exam of a woman with clear vaginal fluid leaking at 37 weeks gestation. The RN is using a speculum and performs a nitrazine paper test for rule out rupture of membranes. If the test is positive, what color will the nitrazine turn?
Blue
The laboring patient is on continuous fetal monitoring when the nurse notes a decrease in the fetal heart rate with variable deceleration to 75 bpm. What is the initial nursing intervention?
Change the position of the patient
After two babies and a divorce in her early twenties, a patient had a tubal ligation. Now at 38, she is newly married to a man with no children of his own. She has had the ligation reversed so that she can try to get pregnant. What is the most important risk the nurse should warn her about?
Ectopic pregnancy
During the active phase of labor, the nurse should evaluate the labor pattern how often?
Every 30 minutes
At which time during a woman's labor might the nurse assist with a pudendal block?
Just before delivery
In treating a pregnant patient with severe hypertension, the physician determines that the baby must be delivered as soon as possible and orders an amniocentesis for the patient. The nurse can tell the patient the doctor will be determining the baby's readiness for delivery by evaluating which parameter?
Level of fetal surfactants
Which occurrence after birth should be reported immediately to the RN?
Maternal tachycardia and falling blood pressure
The mechanical method most used for cervical ripening is which of the following?
Membrane stripping
During her 12 week prenatal check-up, the patient informs you on interview she has developed bumps on the dark part of her nipples. She wants to know what these bumps are. What is the appropriate answer?
Montgomery's tubercles, secrete lubricant for the nipples
The four essential components of labor are known as the "four P's". Which of the four P's involves the pelvis?
Passageway
The role of the LPN nurse in labor and delivery is which of the following?
Provide care to the patient under the supervision of an RN
Which of the following signs signify that the second stage of labor has begun?
The urge to push occurs
The provider is admitting a patient to ripen her cervix for induction of labor. The order is for prostaglandin E2. The nurse is preparing to administer the medication via which route?
Vaginal
What are the two fetal membranes?
chorion and amnion
