OB test 2
A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage is: A)a form of biofeedback to enhance bearing down efforts during delivery B) light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus c) the application of pressure to the sacrum to relieve a backache D) performed to stimulate uterine activity by contracting a specific muscle group while other parts of the body rest
D) light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus
Epidural Block has just been given to your patient. The nurse notes that her sys blood pressure has dropped from 120 mm Hg to 96 mm Hg. The nurse's first action would be to:
increase the rate of IV fluids, and start o2 by mask
A nurse in labor room is preparing to care for pt. with hypertonic uterine dysfunction. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention would be to monitor the pitocin infusion closely provide pain relief measures prepare the client for an amniotomy promote ambulation every 30 mins
provide pain relief measure
In leopold's maneuver stop #1, you palpated a soft broad mass that moves with the rest of the body. The correct interpretation of this finding is:
the butt
A leopold's maneuver step #3 you palpated a hard round moveable mass at the supra pubic area. The correct interpretation is that the mass palpated is:
the mass is the head
Regarding how the fetus moves through the birth canal, nurses should be aware that: the fetal attitude describes the angle at which the fetus exits the uterus of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother the normal attitude of the fetus is called general flexion the transverse lie is preferred for vaginal birth
the normal attitude of the fetus is called general flexion
Her labor is induced. She is receiving oxytocin injection (Pitocin) intravenously. Which of these signs would be indicative of an problematic effect of this medication: fetal heart rate of 155 beats per min appearance of bloody show uterine contractions lasting more than 90 seconds radial pulse rate of 92 bpm
uterine contractions lasting more than 90 seconds
To promote comfort, a 24 y/o gravida 2, para 1 client is encouraged to assume certain positions while in labor and to avoid others. Which of the following should not be used during labor? a) Lateral positions b) Squatting positions c) Standing position d) Semi-fowlers position e) Supine position
e) supine position
The client observes the vaginal birth of her first born child by looking in the mirror. She says that after the birth of the baby's head, with the face looking at the floor the baby turned its head to the right on its own, without being touched. The nurse tells the client that this is a normal mechanism called: a) external rotation b) flexion c) extension d) internal rotation
external rotation
To adequately care for a laboring woman, the nurse should know which stage of labor varies the most in length? first second third foruth
first
A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Prior to initiation of the epidural the woman should be informed regarding the disadvantages of an epidural block. They include all except: (ability to move freely is limited, orthostatic hypotn and dizziness, higher rate of fever, gastric emptying is not delayed)
gastric emptying is not delayed
A primigravida client tells the nurse that about 2 weeks before going into labor she noticed her breathing became easier, but she had to go to the bathroom more frequently. The nurse tells the client that what she experienced is commonly called:
lightening
Signs that precede labor include (choose all that apply): lightening exhaustion bloody show rupture of membranes decreased fetal movement
lightening, bloody show, rupture of membranes
The slight overlapping of cranial bones or shaping of the fetal head during labor is called:
molding
Because the patient has received an oxytocic drug, it will be necessary to include which of these measures in her care?
monitoring her BP
Analgesia is not administered prior to the establishment of effective labor primarily because it might:
prolong labor
Because cervical effacement and dilation are not progressing in a patient in labor, Dr. Smith orders IV administration of oxytocin (Pitocin),. Why must the nurse monitor the patient's fluid intakes and output closely during oxytocin administration? a)Oxytocin causes water intoxication b) Oxytocin causes excessive thirst c) Oxytocin is toxic to the kidneys d) Oxytocin has a diuretic effect
a) oxytocin causes water intoxication
The nurse recognizes that a woman is in true labor when she states: a) I passed some thick, pink mucus when I urinated this morning b) My bag of waters just broke c) The contractions in my uterus are getting stronger and closer together d) My baby dropped and I have to urinate more frequently now
C) the contractions in my uterus are getting stronger and closer together
The hormone that acts to facilitate the development of uterine contractions is: A. Estrogen B. Pitocin C. Prostaglandin D. Progesterone is based on the knowledge that:
C. Prostaglandins
Vaginal examination in the laboring client reveals the anterior fontanel is toward the rectum. The nurse should chart that the baby is in which position? a) occipital posterior b) transverse c) occipital anterior d) breech
c) occipital anterior
The process of taking-up the cervical canal by the uterine walls and changing into a paper thin circular structure is known as:
effacement
The nurse expects which maternal cardiovascular finding during labor: Increased cardiac output Decreased pulse rate Decreased WBC count Decreased blood pressure
increased cardiac output
A primigravida patient is admitted to the labor delivery area. Assessment reveals that she is in the early part of the first stage of labor. Her pain is likely to be most intense: a) around the pelvic girdle b) Around the pelvic girdle and in the upper arms c) Around the pelvic girdle and at the perineum d) At the perineum
a) around the pelvic girdle
With regard to nerve block analgesia and anesthesia, nurse should be aware that: a) most local agents are related chemically to cocaine and end in the suffix caine b) local perineal infiltration anesthesia is effective when epinephrine is added, but it can be injected only once c) a pudendal nerve block is designed to relieve pain form uterine contractions d) a pudendal nerve block, if done correctly, does not significantly lessen the bearing down reflex
a) most local agents are related chemically to cocaine adn end in the suffix caine
Breathing patterns are taught to laboring women. Which breathing pattern would the nurse support for the woman and her coach during the latent phase of the first stage of labor with a couple had attended Lamaze classes? a) Slow-paced breathing b) Deep abdominal breathing c) Modified-paced breathing d) Patterned-paced breathing
a) slow-paced breathing
A woman who has a history of sexual abuse may have a number of traumatic memories triggered during labor. She may fight the labor process and react with pain or anger. Alternately, she may become a passive player and emotionally absent herself from the process. The nurse is in a unique position of being able to assist the client to associate the sensations of labor with the process of childbirth and not the past abuse. The nurse can implement a number of care measures to help her client view the childbirth experience in a positive manner. Which intervention is key for the nurse to use while providing care? a) Tell the client to relax and that it wont hurt much b) Limit the number of procedures that invade her body c) Reassure the client that as the nurse you know what is best d) Allow unlimited care providers to be with the client
b) limit the number of procedures that invade her body
Labor is a series of events affected by the coordination of the five essential factors. One of these is the passenger (fetus). Which are the other four factors? a) Contractions, passageway, placental position and function, pattern of care b) Contractions, maternal response, placental position, psychological response c) Passageway, contractions, placental position and function, psychological response d) Passageway, placental position and function, paternal response, psychological response
c) Passageway, contractions, placental position and function, psychological response
With regard to the turns and other adjustments of the fetus during the birth process, known as the mechanism of labor, nurses should be aware that: a) the seven critical movements must progress in a more or less orderly sequences b) Asynclitism sometimes is achieved by means of Leppold maneuver c) The effects of the forces determining descent are modified by the shape of the women's pelvis and the size of the fetal head d) At birth that baby is said to acheive "restitution"; that is, a return to the C-shape of the womb
c) The effects of the forces determining descent are modified by the shape of the women's pelvis and the size of the fetal head
For which of the following women would administration of IV analgesia seem most appropriate? a) primigravida at 3cm dilation, complete effacement, contractions moderate intensity, duration 40s, occuring every 6-7 minutes b) multigravida at 9cm, contractions of strong intensity, duration 90s, occurring every 3 minutes c) multigravida at 6cm, contractions strong intensity, duration 80s, occurring every 3-4 minutes d) primigravida completely dilated at station +3 with strong contractions occurring every 3 minutes
c) multigravida at 6cm, contractions strong intensity, duration 80s, occurring every 3-4 minutes
A laboring woman received merperidine (Demerol) IV 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate? a) Fentanyl (sublimaze) b) Promethazine (phenergan) c) Naloxone (narcan) d) Nalbuphine (nubain)
c) narcan
A multiparous client who has been in labor for 2 hours states that she feels the urge to move her bowels. How should the nurse respond? a) let the client get up to use the potty b) allow the pt to use a bedpan c) perform a pelvic exam d) check the fetal heart rate
c) perform a pelvic exam
A 25 year old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9lb, 7 oz boy after augmentation of labor with oxytocin. She puts on her call light and asks for her nurse right away, stating "I'm bleeding a lot." The most likely cause of postpartum hemorrhage in this woman is: a) Retained placental fragments b) Unrepaired vaginal lacerations c) Uterine atony d) Puerperal infection
c) uterine atony
A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the newborn, the nurse assists in delivering the placenta. Which observation would indicate that the placenta has separated from the uterine wall and is ready for delivery? a) The umbilical cord shortens in length and changes in color b) A soft and boggy uterus c) Maternal complaints of severe uterine cramping d) Changes in the shape of the uterus
d) changes in the shape of the uterus
A client arrives at the hospital in the second stage of labor. The fetus' head is crowning, the client is bearing down, and the birth appears imminent. The nurse should: a) transfer her immediately by stretcher to the bathing unit b) tell her to breathe through her mouth and not to bear down c) instruct the client to pant during contractions and to breath through her mouth (i think) d) support the perineum with the hand to prevent tearing and tell the client to pant
d) support the perineum with the hand to prevent tearing and tell the client to pant
Your client is in early labor, and you are discussing the pain relief options she is considering. She states that she wants an epidural "no matter what!" Your best response is: a) Ill make sure you get your epidural b) You may only have an epidural if your doctor allows it c) You may only have an epidural if you are going to deliever vaginally d) The type of analgesia or anesthesia use is determined in part by the stage of your labor and method of birth
d) the type of analgesia or anesthesia use is determined in part by the stage of your labor and method of birth
The nurse in charge is caring for a patient who is in the first stage of labor. What is the shortest but most difficult part of this stage? a) Active phase b) Complete phase c) Latent phase d) Transitional phase
d) transitional phase
clt. adm. 39 weeks gestation for induction of labor. Doc uses prostaglandin gel the nurse should adm. stadol prior to the prostaglandin gel tell the clt. that the labor will be more painful elevate the clt. hips for 30 mins after gel is inserted insert a foley cath prior to insertion of the gel
elevate the clt. hips for 30 mins after gel is inserted
The valsalva maneuver can be described as the process of making a forceful bearing-down attempt while holding one's breath with a closed glottis and tightening the abdominal muscles. During the second stage of labor, when the woman is ready to push, this is considered the optimal method to enhance movement of the fetus down the birth canal. a) True b) False
false
Ischial spines are at which station. -2 0 -1 -4
0
A nurse is monitoring a client in labor who is receiving pitocin and notes that the client is experiencing hypertonic uterine contractions. List in order of priority the actions that the nurse takes
1. stop of pitocin infusion 2. perform a vaginal examination 3. reposition the client 4. check the client's blood pressure and heart rate 5. administer oxygen by face mask at 8 to 10 L/min
The period encompassing the first 1-2 hours after birth often is referred to as the ___ stages of labor
4th
When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman's risk for ____ has increased a) Intrauterine infection b) Hemorrhage c) Precipitous labor d) Supine by potension
A) intrauterine infection
Which description of the phases of the second stage of labor is accurate?
Descent phase: significant increase in contractions, Ferguson reflux activated, average duration varies
The most critical nursing action in caring for the newborn immediately after birth is: a) Keeping the airway clear b) Fostering parent-newborn attachment c) Drying the newborn and wrapping the infant in a blanket
a) keeping the airway clear
When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal: a) Lie b) Presentation c) Attitude d) Position
C) attitude
Nurses should be aware that all reputable childbirth methods attempt to meet all these goals except: a) Increase the womans sense of control b) Prepare a support person to help in labor c) Guarantee a pain free childbirth d) Learn distraction techniques
C) guarantee a pain free childbirth
A pregnant woman brings a list of her routine medications to her first prenatal visit. The nurse would be most concerned about any medications classified in which risk category? A B C D
D
Which test is performed to determine if membranes are ruptured?
Fern test
Immediately after a delivery, the nurse-midwife assesses the neonate's head for signs of molding. Which factors determine the type of molding? Fetal body flexion or extension Maternal age, body frame, and weight Maternal and paternal ethnic backgrounds Maternal parity and gravidity
Fetal body flexion, or extension
Which description of the four stages of labor is correct for both definition and duration? A: First stage: onset of regular uterine contractions to full dilation: less than 1 hour to 20 hours B: Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours C: Third stage: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first timer) D: Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour
First stage: onset of regular uterine contractions to full dilation: less than 1 hour to 20 hours
The fetus is most likely to be damaged by the pregnant women's ingestion of drugs during the
First triemester
The patient is in labor. The nurse review the copy of her antepartum records sent by her O.B's office. The records indicate that her pelvic sturcture is ________ the type most favorable for vaginal delievery
Gynecoid
LIst 4 critical factors in labor (the 5 Ps)
Passenger, Passageway, Powers, positions, psychological response
While admitting a woman to a labor unit, the nurse needs to obtain information from her regarding all of the following except:
Rubella titer
-Upon checking a laboring patient, the nurse determines her cervix to be 50% effaced and dilated to 3cm What would be the lease appropriate action at this time?
Send the patient home, she is not in true labor
The nurse has received a report about a woman in labor. The woman's last vaginal examination was recorded as 3cm, 30%, and -2. The nurse's interpretation of this assessment is: A: The cervix is effaced 3cm, dilated 30%, and presenting part is 2cm above the ischial spines B: The cervix is 3cm dilated, effaced 30%, and the presenting part is 2cm above the ischial spines C: The cervix is effaced 3cm, dilated 30%, and the presenting part is 2cm below the ischial spines D: The cervix is dilated 3cm, effaced 30%, and the presenting part is 2cm below the ischial spines
The cervix is 3cm dilated, effaced 30%, and the presenting part is 2cm above the ischial spines
Prior to administration of an epidural anesthetic, what explanation should the nurse give to the woman and her partner:
The medication is placed through a tube in your back. It keeps the pain from your uterus from reaching your brain
The client has delivered a healthy infant and is now being taken to the recovery room. Which clinical observation is most critical for the nurse to make at this time?
Vaginal bleeding
A pregnant woman comes to the clinic for her first prenatal visit and the nurse is taking her health history. The nurse would be most concerned if the woman gave a history of use of which medication? Synthroid, a thyroid supplement Amoxicillin, an antibiotic Valproic acid, an anti seizure medication Acetaminophen, an over-the-counter pain reliever
Valproic acid, an antiseizure medicatiom
A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has documented that the fetus is at -1 station. The nurse determines that the fetal presenting part is: A)1cm above the ischial spine b) 1 fingerbreadth below the symphysis pubis c) 1 inch below the coccyx d) 1 inch below the iliac crest
a) 1cm above the ischial spine
In order to provide an environment that is conducive to bonding for a couple that has just delivered a baby, it is most important to have: a) A quiet room and time to be together b) A home like environment with all of the medical equipment hidden from view c) Adequate time following the birth for the mother to rest before having to care for the baby. d) Time for the parents to be alone together before interacting with the baby
a) A quiet room and time to be together
The nurse would anticipate that the parents would have the most difficulty bonding to which of the following infants? a) An infant who sleeps a lot b) An infant who does not resemble either parent c) An infant who is alert and hyperactive d) An infant who has the undesired sex
a) an infant who sleeps a lot
The breathing technique that the mother should be instructed to use as the fetus' head is crowning is: a)blowing b) slow chest c) shallow d) accelerated-decelerated
a) blowing
A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure is to use: a) counter pressure against the sacrum b) pant-blow (breaths and puffs) breathing techniques c) effleurage d) biofeedback
a) counter pressure against the sacrum
Fetal presentation refers to which of the following description? a) Fetal body part that enters the maternal pelvis first b) Relationship of the presenting part to the maternal pelvis c) Relationship of the long axis of the fetus to the long axis of the mother d) A classification according to the fetal part
a) fetal body part that enters the maternal pelvis first
Several assessments can be made while performing a sterile vaginal examination (SVE) during labor, which of the following is least likely to be determined: a) Fetal presentation b) Fetal lie c) Cervical dilation d) Station
a) fetal presentation
In the recovery room, if a woman is asked either to raise her legs (knees extended) off the bed or to flex her knees, place her feet flat on the bed, and raise her buttocks well off the bed, most likely she is being tested to see whether she: a) Has recovered from epidural or spinal anesthesia b) Has hidden bleeding underneath her c) Has regained some flexibility d) Is a candidate to go home after 6 hours
a) has recovered from epidural or spinal anesthesia
During the period of induction of labor, a client should be observed carefully for signs of: a) Severe pain b) Uterine tetany c) Hypoglycemia d) Umbilical cord prolapse
b) uterine tetany
With regard to a womans intake and output during labor, nurses should be aware that: a) The tradition of restricting the laboring woman to clear liquids and ice chips is being challenged because regional anesthesia is used more often than general anesthesia b) IV fluids usually are necessary to ensure that the laboring woman stays hydrated c) Routine use of an enema empties the rectum and is very helpful for producing a clean, clear delivery d) When a nulliparous woman experiences the urge to defecate, it often means birth will follow quickly
a) the tradition of restricting the laboring woman to clear liquids and ice chips is being challenged because regional anesthesia is used more often than general anesthesia
Which of the following fetal positions is most favorable for birth? a) Vertex presentation b) Transverse lie c) Frank breech presentation d) Posterior position of the fetal head
a) vertex presentation
A laboring client is to have a pudendal block. The nurse plans to tell the client that once the block is working she: a) will nott feel the episiotomy b) may lose bladder sensation c) may lose the ability to push d) will no longer feel contractions
a) will not feel the episiotomy
Following influence cervical dilation? choose all that apply: a)strong uterine contractions b) the force of the presenting fetal part against the cervix c) the size of the female d) the pressure applied by the amniotic sac e) scarring of the cervix
a, b, d, e
The most intense portion of the uterine contraction is termed the: increment decrement acme peak
acme
A woman in labor is breathing into a mouthpiece just before the start of her regular contractions. As she inhales, a valve opens and gas is released. She continues to inhale the gas slowly and deeply until the contraction starts to subside. When the inhalation stops, the valve closes. This procedure is:
an application of nitrous oxide
Concerning the third stage of labor, nurses should be aware that: a) the placenta eventually detaches itself from a flaccid uterus b) an expectant or active approach to managing this stage of labor reduces the risk of complications c) it is important that the dark, roughened maternal surface of the placenta appears before the shiny fetal surface d) the major risk for women during the third stage is a rapid heart rate
an expectant or active approach to managing this stage of labor reduces the risk of complicaitons
Conscious relaxation is associate with which method of childbirth preparation? a) Grandly dick-read method b) Lamaze method c) Bradley method d) Psychopropylactic method
b) Lamaze
A patient has requested a saddle block with delivery. After administration of the anesthesia the most immediate nursing intervention is to monitor: a) Fetal heart rate b) Maternal blood pressure c) Frequency of contractions d) Progress of labor
b) Maternal blood pressure
True labor can be differentiated from false labor in that in true labor, contractions will: a) occur immediately after the membranes rupture b) bring about progressive cervical dilation c) be less uncomfortable if client is in side-lying position d) stop when the client is encouraged to walk around
b) bring about progressive cervical dilation
The fundus of your patient is firm, midline, and at the level of the umbilicus. Lochia is saturating more than one peripad per hour. Nursing intervention is based on the knowledge that: a) If the fundus is firm there is no cause to suspect hemorrhage at all b) Excessive bleeding may be caused by lacerations of the birth canal. c) Clots should be expressed from the uterus d) Oxytocin should be added to the IV fluid
b) excessive bleeding may be caused by lacerations of the birth canal
Through vaginal examination, the nurse determines that a woman is 4 cm dilated and the external fetal monitor shows uterine contractions every 3 ½ to 4 minutes. The nurse reports this as: a) First stage, latent phase b) First stage, active phase c) First stage, transition phase d) Second stage, latent phase
b) first stage, active phase
A nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse would monitor the client closely for the risk of uterine rupture if which of the following occurred? a)hypotonic contractions b) forceps delivery c) shultz delivery d) weak bearing down efforts
b) forceps delivery
The nurse expects to administer an oxytocic to a woman after expulsion of her placenta to: a) Relieve pain b) Stimulate uterine contraction c) Prevent infection d) Facilitate rest and relaxation e) Administering eye drops and vitamin K
b) stimulate uterine contractions
Four minutes after the birth of the patient's baby, there is a sudden gush of blood from her vagina and about 8 inches of umbilical cord slides out of her vagina. What should the nurse do? a) Place the bed in Trendelenberg position (head down) b) watch for the emergence of the placenta c) Give IV oxytocin to stop the bleeding d) Roll her onto her side
b) watch for the emergence of the placenta
A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus' head is: a) not yet engaged b) entering the pelvic inlet c) below the ischial spines d) visible at the vaginal opening
below the ischial spines
The nurse recognizes that a woman is in true labor when she states: a) "I passed some thick, pink mucus when I urinated this morning" b) "My bag of waters just broke" c) "The contractions in my uterus are getting stronger and closer together" d) "My baby dropped and I have to urinate more frequently now"
c) "The contractions in my uterus are getting stronger and closer together"
When the fetal presenting part is at the woman's perineurium and birth Is imminent, the baby is said to be at which station? a) 0 b) +2 c) +5 d) -5
c) +5
During the active phase of labor, your patient receives Demoral 25 mg IV; following the administration of Demerol, the nurse should: a) Decrease sensory stimulation in the environment to promote action of the drug b) Assess fetal status c) Assess maternal blood pressure d) Leave the patient alone so that she can rest quietly
c) assess maternal blood pressure
A nulliparous woman who has just begun the second stage of her labor most likely: a) experiences a strong urge to bear down b) shows perineal bulging c) feels tired yet relieved that the worst is over d) shows an increase in bright red bloody show
c) feels tired yet relieved that the worst is over
Because the risk for childbirth complications may be revealed, nurses should know that the point of maximal intensity (PMI) of the fetal heart rate (FHR) is: a) usually directly over the fetal abdomen b) in a vertex position, heard above the mothers umbilicus c) heard lower and closer to the midline of the mother's abdomen as the fetus descends and rotates internally d) in a breech position, heard below the mothers umbilicus
c) head lower and closer to the midline of the mother's abdomen as the fetus descends and rotates internally
During anesthetic management of the morbidly obese woman in labor, the nurse must remain alert for complications specific to this type of client. Which is not a concern for the L&D nurse? a) Failed epidural placement b) Accidental dural puncture c) Inadequate pain relief d) Difficult intubation
c) inadequate pain relief
When palpating the patient's abdomen, the nurse has difficulty locating the fundus because it is "boggy" or uncontracted. The first nursing action should be to: a) Notify the physician b) Start oxytocin c) Massage the fundus d) Catheterize the client
c) massage the fundus
According to professional standards (AWHONN, 2007), the nonanesthestis registered nurse caring for a woman with an epidural is permitted to perform all actions except: a) monitor status of the woman and fetus b) initiate epidural anesthesia c) replace empty infusion bags with the same medication and concentrate d) stop the infusion and initiate emergency measures
c) replace empty infusion bags with the same medications and concetrate
The nurse knows that the second stage of labor, the descent phase, has begun when: a) The amniotic membranes rupture b) The cervix cannot be felt during a vaginal examination c) The woman experiences a strong urge to bear down d) The presenting part is below the ischial spines
c) the woman experiences a strong urge to bear down
The nurse observes the client's amniotic fluid and decides that it appears normal because it is: a) clear and dark amber in color b) milky, greenish yellow, containing shreds of mucus c) clear, almost colorless, and containing little white specks d) cloudy, greenish yellow, and containing little white specks
clear, almost colorless, and containing little white specks
A new mother asks the nurse when the "soft spot" on her son's head will go away. The nurses answer is based on the knowledge that the anterior fontanel closes after birth by: a) 2 months b) 8 months c) 12 months d) 18 months
d) 18mo
Maternity nurse often have to answer questions about the many, sometimes unusual ways people have tried to make the birthing experience more comfortable. For instance, nurses should be aware that: a) Music supplied by the support person has to be discouraged because it could disturb others and upset the hospital routine b) Women in labor can benefit from sitting in a bathtub, but they must limit immersion to no longer than 15 minutes at a time c) Effleurage is permissible but counter pressure is almost always counterproductive d) Electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins
d) Electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins
A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively, she states that she did not attend childbirth classes. The most important nursing action is to: a) Notify the woman's health care provider b) Administer the prescribed narcotic analgesic c) Assure her that her labor will be over soon d) Assist her with simple breathing and relaxation instructions
d) assist her with simple breathing and relaxation instructions
All of the following are characteristics of true labor except? a) Fetus presenting part is engaged b) Cervical effacement c) Contractions that increase in intensity d) Irregular contractions
d) irregular contractions
A nurse is monitoring a client in active labor and notes that the client is having contractions every 3 minutes that lasts 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 BPM. Which of the following nursing actions is most appropriate? a) Encourage the client's coach to continue to encourage breathing exercises b) Encourage the client to continue pushing with each contraction c) Continue monitoring the fetal heart rate d) Notify the physician or the nurse mid-wife
d) notify the physician or the nurse midwife
The nurse is preparing a patient for an epidural anesthetic. The patient's husband says "my sister had medicine put in her back when she had a baby, and she had a headache for a week afterwards." The nurse explains that his sister probably and a spinal anesthetic, and that with regard to headaches, the difference between a spinal and an epidural is that the spinal anesthetic: a) Can lead to hypertension which results in headache b) Use a medication that cuase headache as a side effect c) Lasts longer than an epidural so the side effects are greater d) Penetrates the dura and allows a small amount of cerebrospinal fluid to "leak out," which can cause headache
d) penetrates the dura and allows a small amount of cerebrospinal fluid to "leak out,"which can cause headache
A primigravida in active labor is about 9 days post-term. The client desires a bilateral pudendal block anesthesia before delivery. After the nurse explains this type of anesthesia to the client, which of the following locations identified by the client as the area of relief would indicate to the nurse that the teaching was effective? a) Back b) Abdomen c) Fundus d) Perineum
d) perineum
A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as signs of: a) Hematoma b) Placenta previa c) Uterine atony d) Placental separation
d) placental separation
The patients contractions are every 2 to 3 minutes, lasting 90 seconds, and are very strong. A vaginal examination reveals the client is 9 cm dilated and +2 station with ROP presentation. The nurse can best promote comfort during this transition phase by: a) Applying pressure to the patient's sacrum b) Washing her perineum c) Encouraging her to void d) Placing a cool cloth behind her neck
d) placing a cool cloth behind her neck
In the transition phase of labor the patient wants to know why she has pain in other places if it is her cervix that is stretching and opening. The nurse understands that the primary reason for the extra discomfort is: a) distention of the vagina b) pressure of the presenting part in the floor of the perineum c) muscle tension in the arms and legs d) referred pain from the uterus
d) referred pain from the uterus
You performed the leopold's maneuver and found the following: breech presentation, fetal back at the right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) best in which location? a) Left lower quadrant b) Right lower quadrant c) Left upper quadrant d) Right upper quadrant
d) right upper quadrant
When a client entered the fourth stage of labor? a) When the baby is being expelled b) After the baby is being expelled c) When contractions first reach 60-90 seconds long d) Soon after the placenta is delivered
d) soon after the placenta is delievered
