OB Ch 13
Evidence-based practice applied to the clinical setting improves a. communication between health care professionals. b. client care and overall better outcomes. c. cost-effectiveness of therapeutic treatments. d. ability to carry out a research study by nurses
ANS: ?
The most intense time during labor is during the a. latent phase. b. active phase. c. membranes breaking. d. placental expulsion phase.
ANS: ?
A client is in the third stage of labor. Which finding would alert the nurse that the placenta is separating? A. uterus becomes globular B. fetal head at vaginal opening C. umbilical cord shortens D. mucous plug is expelled
ANS: A
A nurse is caring for several women in labor. The nurse determines that which woman is the latent phase of labor? A. contractions every 5 minutes, cervical dilation 3 cm B. contractions every 3 minutes, cervical dilation 6 cm C. contractions every 2 1/2 minutes, cervical dilation 8 cm D. contractions every 1 minute, cervical dilation 9 cm
ANS: A
A nurse is describing how the fetus moves through the birth canal. Which component would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A. sutures B. fontanelles C. frontal bones D. biparietal diameter
ANS: A
A nurse is providing care to a client in labor. A pelvic exam reveals a vertex presentation with the presenting part tilted toward the left side of the mother's pelvis and directed toward the anterior portion of the pelvis. When developing this client's plan of care, which intervention would the nurse include? A. implementing measures for a vaginal birth B. preparing the client for a cesarean birth C. assisting with artificial rupture of the membranes D. instituting continuous internal fetal monitoring
ANS: A
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? A. frank B. full C. complete D. footling
ANS: A
A pregnant woman comes to the labor and birth unit in labor. The woman tells the nurse, "Yesterday, I had this burst of energy and cleaned everything in sight, but I don't know why." Which response by the nurse would be most appropriate? A. "You had a burst of epinephrine, which is common before labor B. "You were trying to get everything ready for your baby." C. "You felt your mind telling you that you were about to go into labor." D. "You were looking forward to the birth of your baby."
ANS: A
Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: A. latent phase of the first stage. B. active phase of the first stage. C. pelvic phase of the second stage. D. early phase of the third stage.
ANS: A
During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate? A. "It's difficult to predict how your labor will progress, but we'll be there for you the entire time." B. "Since this is your first pregnancy, you can estimate it will be about 10 hours." C. "It will depend on how big the baby is when you go into labor D. "Time isn't important; your health and the baby's health are key."
ANS: A
The fetus of a nulliparous woman is in a shoulder presentation. The nurse would prepare the client for which type of birth? A. cesarean B. vaginal C. forceps-assisted D. vacuum extraction
ANS: A
The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which phase? A. increment B. acme C. peak D. decrement
ANS: A
When determining the frequency of contractions, the nurse would measure which period of time? a. Start of one contraction to the start of the next contraction b. Beginning of one contraction to the end of the same contraction c. Peak of one contraction to the peak of the next contraction d. End of one contraction to the beginning of the next contraction
ANS: A
Which observation would suggest that placental separation is occurring? a. Uterus stops contracting altogether. b. Umbilical cord pulsations stop. c. Uterine shape changes to globular. d. Maternal blood pressure drops.
ANS: A
A nurse is providing care to a woman in labor. The nurse determines that the client is in the active phase based on which assessment findings? Select all that apply. A. cervical dilation of 6 cm B. contractions every 2 to 3 minutes C. cervical effacement of 30% D. contractions every 90 seconds E. strong desire to push
ANS: A, B
Which interventions are underutilized in promoting a normal birth? Select all that apply. a. Oral nutrition and fluids in labor b. Open-glottis pushing in the second stage of labor c. Skin-to-skin contact after birth for infant bonding d. Routine artificial rupture of membranes (amniotomy) e. Labor induction with intravenous Pitocin f. Routine episiotomy to shorten labor length
ANS: A, B, C
A nurse is conducting an in-service program for a group of nurses working in the labor and birth suite of the facility. After teaching the group about the factors affecting the labor process, the nurse determines that the teaching was successful when the group identifies which component as part of the true pelvis? Select all that apply. A. pelvic inlet B. cervix C. mid pelvis D. pelvic outlet E. vagina F. pelvic floor muscles
ANS: A, C, D
A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which movements would the nurse include? Select all that apply. A. internal rotation B. abduction C. descent D. pronation E. flexion
ANS: A, C, E
A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which factors would the nurse include when discussing measures to promote coping for a positive labor experience? Select all that apply. A. presence of a support partner B. view of birth as a stressor C. low anxiety level D. fear of loss of control E. participation in a pregnancy exercise program
ANS: A, C, E
A client is admitted to the labor and birthing suite in early labor. On review of her prenatal history, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal birth. Which pelvic shape would the nurse have noted? A. platypelloid B. gynecoid C. android D. anthropoid
ANS: B
A nurse is conducting a continuing education program for a group of nurses working in the perinatal unit. After reviewing information about the maternal bony pelvis with the group, the nurse determines that the teaching was successful based on which by which statement by the group? A. The bony pelvis plays a lesser role during labor than soft tissue. B. The pelvic outlet is associated with the true pelvis. C. The false pelvis lies below the imaginary linea terminalis. D. The false pelvis is the passageway through which the fetus travels
ANS: B
A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as the major change occurring during this stage? A. regular contractions B. cervical dilation (dilatation) C. fetal movement through the birth canal D. placental separation
ANS: B
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which symptom? A. increased energy level with alternating strong and weak contractions B. moderately strong contractions every 4 minutes, lasting about 1 minute C. contractions noted in the front of abdomen that stop when she walks st D. pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds
ANS: B
A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which event has most likely occurred? A. cervical dilation B. lightening C. bloody show D. Braxton Hicks contractions
ANS: B
A woman telephones the prenatal clinic and reports that her water just broke. Which suggestion by the nurse would be most appropriate? A. "Call us back when you start having contractions." B. "Come to the clinic or emergency department for an evaluation." C. "Drink 3 to 4 glasses of water and lie down." D. "Come in as soon as you feel the urge to push."
ANS: B
As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is a. discomfort level is greater with false labor. b. progressive cervical changes occur in true labor. c. there is a feeling of nausea with false labor. d. there is more fetal movement with true labor.
ANS: B
When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? A. extent of opening to its widest diameter B. degree of thinning C. passage of the mucous plug D. fetal presenting part
ANS: B
Which fetal lie is most conducive to a spontaneous vaginal birth? a. Transverse b. Longitudinal c. Perpendicular d. Oblique
ANS: B
A client has not received any medication during her labor. She is having frequent contractions about every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: A. latent phase of the first stage of labor. B. perineal phase of the first stage of labor. C. late active phase of the first stage of labor. D. early phase of the third stage of labor.
ANS: C
A nurse is providing care to a woman in labor. After assessment of the fetus, the nurse documents the fetal lie. Which term would the nurse use? A. flexion B. extension C. longitudinal D. cephalic
ANS: C
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? A. "I'm feeling contractions mostly in my back." B. "My contractions are about 6 minutes apart and regular." C. "The contractions slow down when I walk around." D. "If I try to talk to my partner during a contraction, I can't."
ANS: C
A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A. supine B. lithotomy C. upright D. knee-chest
ANS: C
Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station? A. -2 B. -1 C. 0 D. +1
ANS: C
Assessment of a woman in labor reveals that the fetus is in a cephalic presentation and engagement has occurred. The nurse interprets this finding to indicate that the presenting part is at which station? A. -2 B. -1 C. 0 D. +1
ANS: C
Physiologic preparation for labor would be demonstrated by a. a decrease in Braxton Hicks contractions felt by mother. b. weight gain and an increase in appetite by mother. c. lightening, when the fetus drops into true pelvis. d. fetal heart rate accelerations and increased movements.
ANS: C
The nurse is reviewing the medical record of a woman in labor and notes that the fetal t position is documented as LSA. The nurse interprets this information as indicating which part as the presenting part? A. occiput B. face C. buttocks D. shoulder
ANS: C
Which assessment would indicate that a woman is in true labor? a. Membranes are ruptured and fluid is clear. b. Presenting part is engaged and not floating. c. Cervix is 4 cm dilated, 90% effaced. d. Contractions last 30 seconds every 5 to 10 minutes.
ANS: C
A nurse is conducting a class for a group of nurses new to the labor and birth unit about labor and the passage of the fetus through the birth canal. As part of the class, the nurse explains that specific diameters of the fetal skull can affect the birth process. Which diameter would the nurse identify as being most important in affecting the birth process? Select all that apply. A. Occipitofrontal B. Occipitomental C. Suboccipitobregmatic D. Biparietal E. Diagonal conjugate
ANS: C, D
A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? A. heart rate increase from 76 bpm to 90 bpm B. blood pressure rise from 110/60 mm Hg to 120/74 C. white blood cell count of 12,000 cells/mm3 D. respiratory rate of 10 breaths/minute
ANS: D
A laboring woman is admitted to the labor and birth suite at 4-cm dilation. She would be in which phase of labor? a. Latent b. Active c. Late d. Early
ANS:?