OB Exam #3

The nurse in a prenatal unit is providing care for a patient who experienced PPROM at 32 weeks gestation. Which assessment does the nurse consider unnecessary? 1. Check for cervical dilation 2. Monitor for signs of infection 3. Assess for vaginal bleeding 4. Watch for fetal compromise

1. Check for cervical dilation

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient? 1. Methylergonovine 2. Fresh frozen plasma 3. Carboprost-tromethamine 4. Magnesium sulfate

3. Carboprost-tromethamine

The nurse is providing care to a patient who is in labor. The patient's membranes rupture spontaneously, and the nurse notices meconium-stained amniotic fluid. Which actions does the nurse immediately perform? Select all that apply. 1. Alert the neonatal team of a possible meconium aspiration neonate. 2. Promote fetal well-being by placing the patient on her left side. 3. Test the stained fluid for percentage of meconium content. 4. Administer oxygen to the mother to help prevent fetal hypoxia. 5. Notify the primary care provider about the presence of meconium.

1. Alert the neonatal team of a possible meconium aspiration neonate. 5. Notify the primary care provider about the presence of meconium.

A patient arrives at labor and delivery for the induction labor for her first child. The patient tells the nurse, "I can't believe how easy this is just to pick a day, sign a paper, and have a baby." Which action does the nurse take before the induction process? 1. Call the health care provider to validate patient understanding. 2. Check the patient's chart for an informed consent. 3. Explain the possible complications of induction to the patient. 4. Report an incidence of probable malpractice by the health care provider.

1. Call the health care provider to validate patient understanding.

The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss? 1. Contractions of the uterine myometrium 2. Factor VIII complex increases during gestation 3. Platelet activity increases before labor and delivery 4. Fibrin formation increases before the birth occurs

1. Contractions of the uterine myometrium

A patient at 34 weeks gestation is in labor with twins. The primary care provider decides the fetuses need to be delivered by cesarean. Which medical and nursing interventions will be in place for this delivery? Select all that apply. 1. Delivery is attended by two medical personnel. 2. The placement of a large-bore IV access is ensured. 3. The usual personnel to attend delivery is arranged. 4. A hospital with a Level II or III nursery is selected. 5. The FHR for the two fetuses is monitored alternately.

1. Delivery is attended by two medical personnel. 2. The placement of a large-bore IV access is ensured. 4. A hospital with a Level II or III nursery is selected.

The nurse is providing care to a patient who is at 41 weeks gestation. Which factor about the patient does the nurse consider as an indication of late-term or post-term pregnancy? 1. Fetus is identified as a male 2. Patient's multiparity status 3. Delivered two babies at 38 weeks 4. History of regular menstruation

1. Fetus is identified as a male

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply. 1. Foul-smelling lochia 2. Hot, red, painful breasts 3. Mild headache 4. Not sleeping well 5. Frequent, painful urination

1. Foul-smelling lochia 2. Hot, red, painful breasts 5. Frequent, painful urination

The nursing staff in a labor and delivery unit has noticed an increase in the number of patients experiencing placental abruption. The nurses begin to review demographics for the patients involved. Which risk factors will the nurses expect? Select all that apply. 1. Hypertensive disorders 2. Uterine fibroids 3. Cigarette smoking 4. Methamphetamine use 5. Abdominal trauma

1. Hypertensive disorders 2. Uterine fibroids 3. Cigarette smoking 4. Methamphetamine use 5. Abdominal trauma

The nurse is aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply. 1. Increases in maternal age 2. Prepregnancy obesity 3. Cesarean deliveries 4. Inability to pay for health care 5. Preexisting chronic medical conditions

1. Increases in maternal age 2. Prepregnancy obesity 3. Cesarean deliveries 5. Preexisting chronic medical conditions

A patient in labor receives high-level regional anesthesia, which inhibits her ability to push during the second state of labor. The primary care provider will use forceps to aid in the delivery of the fetus. Which fetal complications is the nurse aware of being related to a forceps birth? Select all that apply. 1. Intracranial hemorrhage 2. Cephalohematoma 3. Nerve injuries 4. Skin lacerations 5. Skull fracture

1. Intracranial hemorrhage 2. Cephalohematoma 3. Nerve injuries 4. Skin lacerations 5. Skull fracture

The nurse is providing care for a patient in the second phase of labor. After more than 4 hours of pushing, the nurse suspects fetal dystocia. Which is the greatest risk related to the nurse's suspected complication? 1. Neonatal asphyxia related to prolonged labor 2. Fetal injury confirmed by the presence of bruising 3. Greater risk for maternal lacerations 4. Increased consideration for a cesarean delivery

1. Neonatal asphyxia related to prolonged labor

A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient's medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply. 1. Neonatal macrosomia 2. Use of a vacuum extractor 3. Poor oral fluid intake 4. Urinary catheter during labor 5. Low-grade fever (101.3°F [38.5°C])

1. Neonatal macrosomia 2. Use of a vacuum extractor 3. Poor oral fluid intake 4. Urinary catheter during labor

A patient just learns that her unborn fetus has a life-threatening condition and is not expected to survive long term. Which does the nurse include in a plan of care to meet psychological needs of the patient and her partner? Select all that apply. 1. Provide time for the patient to talk about her feelings. 2. Encourage the patient's partner to be emotionally strong. 3. Facilitate referrals related to the fetal condition. 4. Monitor patient's condition and adjust visitors accordingly. 5. Ascertain if the patient and partner have previous crisis skills.

1. Provide time for the patient to talk about her feelings. 3. Facilitate referrals related to the fetal condition. 5. Ascertain if the patient and partner have previous crisis skills.

When assisting with a vacuum-assisted vaginal delivery, the nurse is aware that adherence to which guidelines for the vacuum device will minimize the nurse's liability in vacuum-assisted vaginal births? Select all that apply. 1. Pump up the vacuum manually to the pressure indicated on the pump. 2. Recognize that cup detachment (pop off) is a warning sign. 3. Understand that pressure should be released between contractions. 4. The procedure is timed from insertion of the cup into the vagina until the birth. 5. The cup should not be on the fetal head for longer than 5 to 10 minutes.

1. Pump up the vacuum manually to the pressure indicated on the pump. 2. Recognize that cup detachment (pop off) is a warning sign. 3. Understand that pressure should be released between contractions. 4. The procedure is timed from insertion of the cup into the vagina until the birth.

During a vaginal delivery, the primary care provider notices greenish yellow coloration on the fetal head during crowning. Intrapartum suctioning is performed as soon as the fetus's head is delivered. The nurse understands the aspiration of meconium will have which effects on the neonate's respiratory function? Select all that apply. 1. Result in airway obstruction 2. Contribute to pulmonary hypertension 3. Result in chemical pneumonitis 4. Cause surfactant dysfunction 5. Create strain on cardiac function

1. Result in airway obstruction 2. Contribute to pulmonary hypertension 3. Result in chemical pneumonitis 4. Cause surfactant dysfunction

The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus? 1. Scant amount of odorless lochia 2. Presence of headache, malaise, and chills 3. Pain or discomfort in the midline lower abdomen 4. Elevated temperature greater than 100.4°F (38°C)

1. Scant amount of odorless lochia

The nurse is providing care to a postpartum patient after an emergency cesarean due to eclampsia. The patient received spinal anesthesia prior to delivery. Magnesium sulfate is infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to administer calcium gluconate to the patient via IV push? 1. Serum magnesium level is 10 mg/dL. 2. Patella reflexes are rated at zero. 3. Respiratory rate is 18 breaths/min. 4. Urinary output remains at 30 mL/hr.

1. Serum magnesium level is 10 mg/dL.

The nurse is providing care for a patient who is at 42 weeks gestation. The patient's primary care provider is suggesting induction, but the patient is resistant. Which facts can the nurse provide if the patient asks about allowing labor to start spontaneously? Select all that apply. 1. Stillbirth or newborn death increases in pregnancies beyond 42 weeks. 2. There is a greater chance of developing complications because of larger fetal size. 3. Maternal death rate is higher if the pregnancy is continued beyond 42 weeks. 4. Post-term fetuses are prone to developmental delays related to uterine hypoxia. 5. Postmature fetuses have decreased subcutaneous fat and lack vernix and lanugo.

1. Stillbirth or newborn death increases in pregnancies beyond 42 weeks. 2. There is a greater chance of developing complications because of larger fetal size. 5. Postmature fetuses have decreased subcutaneous fat and lack vernix and lanugo.

The labor and delivery unit nurses are adopting methods to reduce the number of women who develop postpartum depression. Research from Dennis and Dowswell (2013) provides evidence-based suggestions regarding beneficial interventions. Which suggestions do the nurses consider? Select all that apply. 1. Telephone-based peer support 2. Partner report of symptoms 3. Interpersonal psychotherapy 4. Teaching for self-recognition of problems 5. Professionally based postpartum home visits

1. Telephone-based peer support 3. Interpersonal psychotherapy 5. Professionally based postpartum home visits

The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply. 1. The father exhibited depression during the pregnancy. 2. The birth of this fourth child was unexpected and unplanned. 3. The father expresses feeling bored and underappreciated in his job. 4. The father is recently estranged from his parents and siblings. 5. The mother experienced a prolonged labor and a cesarean birth.

1. The father exhibited depression during the pregnancy. 2. The birth of this fourth child was unexpected and unplanned. 4. The father is recently estranged from his parents and siblings.

A patient at 35 weeks gestation arrives at the prenatal clinic in physical distress. Assessment reveals hypotension, thready pulse, shallow respirations, pallor, cold and clammy skin, and anxiety. The nurse does not find evidence of vaginal bleeding but suspects placental abruption. For which reason does the nurse call for emergency transport to the hospital? Select all that apply. 1. The patient has all the symptoms of hypovolemia. 2. The patient reports a recent bout with nausea and vomiting. 3. The absence of blood can indicate a concealed hemorrhage. 4. The patient and fetus are at risk of death from hypovolemic shock. 5. The patient states a sudden onset of severe symptoms.

1. The patient has all the symptoms of hypovolemia. 3. The absence of blood can indicate a concealed hemorrhage. 4. The patient and fetus are at risk of death from hypovolemic shock. 5. The patient states a sudden onset of severe symptoms.

The nurse is conducting a staff education session about preeclampsia and eclampsia complications. Which statements by the nurse are accurate about HELLP syndrome? Select all that apply. 1. This syndrome destroys red blood cells. 2. This syndrome impacts the amount of platelets. 3. This syndrome decreases a patient's white blood cell (WBC) count. 4. This syndrome decreases a patient's blood urea nitrogen (BUN). 5. This syndrome increases liver enzymes.

1. This syndrome destroys red blood cells. 2. This syndrome impacts the amount of platelets. 5. This syndrome increases liver enzymes.

A patient who is pregnant expresses a desire to attempt a vaginal delivery after a cesarean birth 2 years before. The primary care provider initiates trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (CVAC) screening. The nurse is aware that which patient information will likely disqualify the patient for CVAC? 1. A low transverse uterine scar 2. Cesarean due to pelvic abnormalities 3. First labor needed to be induced 4. Patient asks multiple questions

2. Cesarean due to pelvic abnormalities

The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room? 1. Ask the patient how many peripads she considered to be "soaked." 2. Collect blood in calibrated, under-buttocks drapes for vaginal birth. 3. Place a basin at the foot of the delivery table to catch any blood. 4. Rely on the primary health care provider's estimate of blood loss.

2. Collect blood in calibrated, under-buttocks drapes for vaginal birth.

The nurse is assessing a patient at 26 weeks gestation. The patient has chronic hypertension and exhibited hypertension and proteinuria prior to 20 weeks gestation. Previous blood pressure (BP) readings have been in the range of 130 to 140/88 to 90 mm Hg. Due to superimposed preeclampsia, for which additional manifestations will the nurse immediately contact the health care provider? Select all that apply. 1. Laboratory report that shows an elevation of liver enzymes 2. Current blood pressure reading of 162/102 mm Hg 3. Evident pulmonary edema noted with auscultation. 4. Subjective report of severe headache and photophobia 5. Lack of response to verbal and tactile stimulation

2. Current blood pressure reading of 162/102 mm Hg 3. Evident pulmonary edema noted with auscultation. 4. Subjective report of severe headache and photophobia 5. Lack of response to verbal and tactile stimulation

The nurse is attending to a patient who just delivered a term fetus who was stillborn. Which nursing interventions will the nurse use to provide emotional support to the couple? Select all that apply. 1. Express the belief that a little angel was sent to heaven. 2. Cut a lock of the neonate's hair and get foot and hand prints. 3. Ask the parents what name they are giving their baby. 4. Inquire if the patient had any warning of fetal death. 5. Allow parents unlimited time to hold and touch the neonate.

2. Cut a lock of the neonate's hair and get foot and hand prints. 5. Allow parents unlimited time to hold and touch the neonate.

A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus. Which long-term effects may occur? Select all that apply. 1. Shoulder injury related to birth size 2. Development of metabolic syndrome 3. Impaired intellectual development 4. Changes in genetic expression 5. Increased risk for chronic illnesses

2. Development of metabolic syndrome 3. Impaired intellectual development 4. Changes in genetic expression 5. Increased risk for chronic illnesses

The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management? 1. Application of hot packs to the perineal area 2. Information applicable to medication therapy 3. Instructions to improve circulation by ambulating 4. Medicating for pain above level 4 on a 0 to 10 scale

2. Information applicable to medication therapy

A patient at 36 weeks gestation reports a constant dull backache, regular frequent contractions that are painless, and lower abdominal pressure. Physical examination reveals intact membranes and cervical dilation of 3 cm. Which order by the health care provider is unexpected by the nurse? 1. Administer antenatal steroids 2. Obtain fetal fibronectin levels 3. Beta-adrenergic agonist therapy 4. Monitor blood glucose levels

2. Obtain fetal fibronectin levels

The nurse educator is preparing a presentation on preterm labor (PTL) and birth (PTB). Which information does the nurse recognize as being inaccurate? 1. PTB is the leading cause of neonatal mortality and for antenatal hospitalization. 2. PTL is defined as regular uterine contractions resulting in cervical changes before 40 weeks gestation. 3. PTBs result in increased numbers of neonatal and infant deaths and long-term neurological impairment. 4. Average costs for premature/low birthweight infants are more than 10 times as high than for other newborns.

2. PTL is defined as regular uterine contractions resulting in cervical changes before 40 weeks gestation.

The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, "I think that my baby is deformed inside and we have to fix him." Which risk factor is most strongly related to possible postpartum psychosis (PPP)? 1. Separation from the baby's father 2. Personal history of bipolar disorder 3. Prolonged labor resulting in cesarean 4. Loss of first child from a heart defect

2. Personal history of bipolar disorder

The nurse in labor and delivery is preparing to initiate labor induction with the administration of oxytocin. After research about oxytocin, the nurse is aware of which fact about the drug? 1. Hypothalamus stimulation increases circulating oxytocin. 2. Synthetic oxytocin is identical to endogenous oxytocin. 3. The half-life of oxytocin is 1 hour, supporting close monitoring. 4. Action from IV oxytocin administration is less than 1 minute.

2. Synthetic oxytocin is identical to endogenous oxytocin.

When performing a physical assessment on a patient during the initial prenatal visit, the nurse notes spongy gums prone to bleeding during the oral exam. Which comment by the nurse is appropriate? 1. "Oral bleeding can contribute to anemia." 2. "Dental problems can interfere with nutrition." 3. "Periodontal disease is a risk factor for preterm labor" 4. "You need dental care because pregnancy causes dental problems."

3. "Periodontal disease is a risk factor for preterm labor"

The nurse is providing care to a patient who is diagnosed with dystocia related to hypertonic uterine dysfunction. Which medical intervention does the nurse implement for this patient? 1. Explain to the family that the patient needs rest before labor continues. 2. Assist the patient to relax by providing back and neck massage. 3. Administer morphine to decrease contractions and promote uterine rest. 4. Discuss how the patient's fear is interfering with the progression of labor.

3. Administer morphine to decrease contractions and promote uterine rest.

The nurse is providing care for a primip patient in active labor. Cervical dilation has progressed 0.5 cm in 2 hours. Intrauterine pressure catheter reading is 20 mm Hg. Which action does the nurse anticipate next? 1. Rupture of uterine membranes by the nurse 2. Preparation for a cesarean delivery due to signs of fetal distress 3. Augmentation of labor with oxytocin per health care provider's order 4. Medicating the patient with pain medication to promote uterine rest

3. Augmentation of labor with oxytocin per health care provider's order

The nurse in a labor and delivery department carefully assesses postpartum patients for signs of complications related to hemorrhage. Which factor makes it most difficult to identify the risk of hemorrhage through vital sign evaluation? 1. Blood pressure may be elevated from prenatal conditions. 2. Respirations are increased due to activity of labor. 3. Changes in blood pressure may not be an immediate sign. 4. Heart rate may increase with intensity of labor.

3. Changes in blood pressure may not be an immediate sign.

The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take? 1. Continue to apply ice to the area for 24 hours. 2. Monitor vital signs and report any abnormal readings. 3. Contact the primary care provider for further evaluation. 4. Relieve pressure by placing patient in a side-lying position.

3. Contact the primary care provider for further evaluation.

The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol? 1. Increased patient restlessness. 2. Manifestations of severe pain. 3. Development of abnormal vital signs. 4. Patient requests water for extreme thirst.

3. Development of abnormal vital signs.

The nurse is teaching a prenatal class. For which reason does the nurse emphasize the importance of managing maternal fear during labor? 1. Fear promotes feelings of exhaustion. 2. Mothers cannot enjoy the actual birth. 3. Dystocia is associated with extreme fear. 4. Fear during labor causes postpartum depression.

3. Dystocia is associated with extreme fear.

The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient? 1. Prescriptions for antidepressant/antipsychotic drugs 2. Discharge to home with 24-hour observation in place 3. Immediate hospitalization in a psychiatric unit 4. Prescribed neonate visits during in-patient treatment

3. Immediate hospitalization in a psychiatric unit

The nurse is assessing a patient who is 36 hours postpartum following a cesarean delivery. Which findings cause the nurse to conclude that a wound infection is developing? Select all that apply. 1. Temperature increase from 99.8°F to 100.5°F 2. Incisional tenderness with palpation 3. Increased margins of incisional redness 4. Notably warm skin around the incision 5. Serosanguinous drainage from the suture line

3. Increased margins of incisional redness 4. Notably warm skin around the incision

A patient who is in the third trimester of pregnancy is informed that she will need a cesarean hysterectomy and bladder reconstruction due to a placenta defect. Which medical condition does the nurse explain to the patient? 1. Placenta accreta 2. Placenta increta 3. Placenta percreta 4. Placenta previa

3. Placenta percreta

A patient who is at 39 weeks gestation is scheduled for amniotomy. The nurse is aware that which criteria must be met before the procedure? 1. Ultrasound indicates the umbilical cord is away from the cervix. 2. The nurse must have certification to perform the procedure. 3. The fetal head is currently engaged in the maternal pelvis. 4. Prior amniotic fluid leakage must be validated before the procedure.

3. The fetal head is currently engaged in the maternal pelvis.

The nurse is providing care for a patient who is admitted for cervical ripening. The health care provider has prescribed the use of a hygroscopic dilator. Which conclusion is the nurse likely to draw from the prescribed method of cervical ripening? 1. This method is quicker than hormonal ripening. 2. The patient has a history of cesarean childbirth. 3. The method may be indicative of fetal demise. 4. This patient is being treated for active herpes.

3. The method may be indicative of fetal demise.

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits. Which patient does the nurse identify as having the highest-risk pregnancy? 1. The patient who is 16 years of age just diagnosed with gestational diabetes 2. The patient with preexisting hypertension who is currently pregnant with twins 3. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension 4. The patient who is 28 years of age who delivered a premature neonate 3 years prior

3. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension

A patient undergoes chorionic villa sampling to rule out the presence of a genetic disorder. Following the procedure, the patient experiences iatrogenic PPROM. Which explanation does the nurse provide to promote patient understanding? 1. The rupture of the membranes is from a bacterial infection. 2. The membranes ruptured because the test caused fetal death. 3. The premature rupture of the membranes is a known risk to the test. 4. The membranes ruptured due to the presence of a genetic disorder.

3. The premature rupture of the membranes is a known risk to the test.

The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected? 1. "If your nipples are cracked, you will need to stop breastfeeding." 2. "Pump your milk and throw it away until the infection is gone." 3. "The baby gave you an infection and needs to be on antibiotics." 4. "Continuing to breastfeed will help clear up the condition."

4. "Continuing to breastfeed will help clear up the condition."

A patient at 30 weeks gestation is exhibiting signs of preterm labor and delivery. The health care provider (HCP) informs the patient that nothing can be done to disrupt this process. The patient is in distress and states, "Why can't something be done to save my baby?" The nurse understands the HCP's decision is likely based on which finding? 1. Ruptured membranes caused an infection. 2. The patient is unstable due to hemorrhage. 3. Fetal age is incompatible with survival. 4. A fetal heartbeat could not be obtained.

4. A fetal heartbeat could not be obtained.

The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately? 1. The uterus is displaced. 2. The uterine fundus is boggy. 3. Small clots are expressed with massage. 4. Peripad weighs 100 g within 15 minutes.

4. Peripad weighs 100 g within 15 minutes.

The nurse in a prenatal clinic is assessing a patient who is at 37 weeks gestation for twins. The patient reports increased discomfort and increased lower pelvic pressure. Which action does the nurse take with this patient? 1. After examination, assures the patient of the absence of contractions 2. Explains to the patient that increased discomfort is expected with twins 3. Performs a digital cervical examination to determine if dilation is occurring 4. Sends the patient to the hospital to be checked for possible signs of labor

4. Sends the patient to the hospital to be checked for possible signs of labor

The nurse is assisting the primary care provider with a vacuum-assisted delivery because of a prolonged second stage of labor. The nurse will inform the primary care provider when which guideline of the procedure is met? 1. Extension of the episiotomy is performed. 2. Signs of fetal compromise have resolved. 3. Patient is under full anesthesia status. 4. The "three-pull rule" has been achieved.

4. The "three-pull rule" has been achieved.

The nurse is interviewing a new patient who is in the first trimester of her second pregnancy. The patient shares that her first child was born at 36 weeks gestation. Which information does the patient share that places the patient at risk for a second premature birth? 1. The first labor was induced due to unresponsive management of hypertension. 2. The health care provider induced labor at the patient's request to avoid holiday interruptions. 3. Labor was induced when the fetus moved from a posterior to an anterior position. 4. The premature labor and birth was unexpected and followed a normal pregnancy.

4. The premature labor and birth was unexpected and followed a normal pregnancy.