Question 1

What are the complications and risks associated with cesarean births? (Select all that apply. )

Accepted Answer

A)  Pulmonary edema 
B)  Wound dehiscence 
C)  Hemorrhage 
D)  Urinary tract infections 
E)  Fetal injuries 
A)  Pulmonary edema 
B)  Wound dehiscence 
C)  Hemorrhage 
D)  Urinary tract infections 
E)  Fetal injuries A,B,C,D,E

Question 2

Women who are obese are at risk for several complications during pregnancy and birth.Which of these would the nurse anticipate with an obese client? (Select all that apply. )

Accepted Answer

A)  Thromboembolism 
B)  Cesarean birth 
C)  Wound infection 
D)  Breech presentation 
E)  Hypertension 
A)  Thromboembolism 
B)  Cesarean birth 
C)  Wound infection 
D)  Breech presentation 
E)  Hypertension A,B,C,E

Question 3

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor.Which information is the most important for the nurse to understand and share with the client?

Accepted Answer

A)  Because all women must be considered at risk for preterm labor and prediction is so variable,teaching pregnant women the symptoms of preterm labor probably causes more harm through false alarms. 
B)  Braxton Hicks contractions often signal the onset of preterm labor. 
C)  Because preterm labor is likely to be the start of an extended labor,a woman with symptoms can wait several hours before contacting the primary caregiver. 
D)  Diagnosis of preterm labor is based on gestational age,uterine activity,and progressive cervical change. 
A)  Because all women must be considered at risk for preterm labor and prediction is so variable,teaching pregnant women the symptoms of preterm labor probably causes more harm through false alarms. 
B)  Braxton Hicks contractions often signal the onset of preterm labor. 
C)  Because preterm labor is likely to be the start of an extended labor,a woman with symptoms can wait several hours before contacting the primary caregiver. 
D)  Diagnosis of preterm labor is based on gestational age,uterine activity,and progressive cervical change. D

Question 4

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity?

Accepted Answer

A)  Drugs can be efficaciously administered up to the designated beginning of term at 37 weeks gestation. 
B)  Tocolytic therapy has no important maternal (as opposed to fetal)contraindications. 
C)  The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids. 
D)  If the client develops pulmonary edema while receiving tocolytic therapy,then intravenous (IV)fluids should be given. 
A)  Drugs can be efficaciously administered up to the designated beginning of term at 37 weeks gestation. 
B)  Tocolytic therapy has no important maternal (as opposed to fetal)contraindications. 
C)  The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids. 
D)  If the client develops pulmonary edema while receiving tocolytic therapy,then intravenous (IV)fluids should be given.

Question 5

Which assessment is least likely to be associated with a breech presentation?

Accepted Answer

A)  Meconium-stained amniotic fluid 
B)  Fetal heart tones heard at or above the maternal umbilicus 
C)  Preterm labor and birth 
D)  Postterm gestation 
A)  Meconium-stained amniotic fluid 
B)  Fetal heart tones heard at or above the maternal umbilicus 
C)  Preterm labor and birth 
D)  Postterm gestation

Question 6

When would an internal version be indicated to manipulate the fetus into a vertex position?

Accepted Answer

A)  Fetus from a breech to a cephalic presentation before labor begins 
B)  Fetus from a transverse lie to a longitudinal lie before a cesarean birth 
C)  Second twin from an oblique lie to a transverse lie before labor begins 
D)  Second twin from a transverse lie to a breech presentation during a vaginal birth 
A)  Fetus from a breech to a cephalic presentation before labor begins 
B)  Fetus from a transverse lie to a longitudinal lie before a cesarean birth 
C)  Second twin from an oblique lie to a transverse lie before labor begins 
D)  Second twin from a transverse lie to a breech presentation during a vaginal birth

Question 7

A number of methods can be used for inducing labor.Which cervical ripening method falls under the category of mechanical or physical?

Accepted Answer

A)  Prostaglandins are used to soften and thin the cervix. 
B)  Labor can sometimes be induced with balloon catheters or laminaria tents. 
C)  Oxytocin is less expensive and more effective than prostaglandins but creates greater health risks. 
D)  Amniotomy can be used to make the cervix more favorable for labor. 
A)  Prostaglandins are used to soften and thin the cervix. 
B)  Labor can sometimes be induced with balloon catheters or laminaria tents. 
C)  Oxytocin is less expensive and more effective than prostaglandins but creates greater health risks. 
D)  Amniotomy can be used to make the cervix more favorable for labor.

Question 8

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation.What is the primary purpose of prostaglandin administration?

Accepted Answer

A)  To enhance uteroplacental perfusion in an aging placenta 
B)  To increase amniotic fluid volume 
C)  To ripen the cervix in preparation for labor induction 
D)  To stimulate the amniotic membranes to rupture 
A)  To enhance uteroplacental perfusion in an aging placenta 
B)  To increase amniotic fluid volume 
C)  To ripen the cervix in preparation for labor induction 
D)  To stimulate the amniotic membranes to rupture

Question 9

A woman is having her first child.She has been in labor for 15 hours.A vaginal examination performed 2 hours earlier revealed the cervix to be dilated to 5 cm and 100% effaced,and the presenting part of the fetus was at station 0;however,another vaginal examination performed 5 minutes ago indicated no changes.What abnormal labor pattern is associated with this description?

Accepted Answer

A)  Prolonged latent phase 
B)  Protracted active phase 
C)  Secondary arrest 
D)  Protracted descent 
A)  Prolonged latent phase 
B)  Protracted active phase 
C)  Secondary arrest 
D)  Protracted descent

Question 10

In planning for home care of a woman with preterm labor,which concern should the nurse need to address?

Accepted Answer

A)  Nursing assessments are different from those performed in the hospital setting. 
B)  Restricted activity and medications are necessary to prevent a recurrence of preterm labor. 
C)  Prolonged bed rest may cause negative physiologic effects. 
D)  Home health care providers are necessary. 
A)  Nursing assessments are different from those performed in the hospital setting. 
B)  Restricted activity and medications are necessary to prevent a recurrence of preterm labor. 
C)  Prolonged bed rest may cause negative physiologic effects. 
D)  Home health care providers are necessary.

Question 11

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant?

Accepted Answer

A)  Assessing the infant for signs of trauma 
B)  Administering prophylactic antibiotic agents to the infant 
C)  Applying a cold pack to the infant's scalp 
D)  Measuring the circumference of the infant's head 
A)  Assessing the infant for signs of trauma 
B)  Administering prophylactic antibiotic agents to the infant 
C)  Applying a cold pack to the infant's scalp 
D)  Measuring the circumference of the infant's head

Question 12

What is a maternal indication for the use of forceps-assisted birth?

Accepted Answer

A)  Wide pelvic outlet 
B)  Maternal exhaustion 
C)  History of rapid deliveries 
D)  Failure to progress past station 0 
A)  Wide pelvic outlet 
B)  Maternal exhaustion 
C)  History of rapid deliveries 
D)  Failure to progress past station 0

Question 13

Which statement related to the induction of labor is most accurate?

Accepted Answer

A)  Can be achieved by external and internal version techniques 
B)  Is also known as a trial of labor (TOL) 
C)  Is almost always performed for medical reasons 
D)  Is rated for viability by a Bishop score 
A)  Can be achieved by external and internal version techniques 
B)  Is also known as a trial of labor (TOL) 
C)  Is almost always performed for medical reasons 
D)  Is rated for viability by a Bishop score

Question 14

Which description most accurately describes the augmentation of labor?

Accepted Answer

A)  Is part of the active management of labor that is instituted when the labor process is unsatisfactory 
B)  Relies on more invasive methods when oxytocin and amniotomy have failed 
C)  Is a modern management term to cover up the negative connotations of forceps-assisted birth 
D)  Uses vacuum cups 
A)  Is part of the active management of labor that is instituted when the labor process is unsatisfactory 
B)  Relies on more invasive methods when oxytocin and amniotomy have failed 
C)  Is a modern management term to cover up the negative connotations of forceps-assisted birth 
D)  Uses vacuum cups

Question 15

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM)doses of betamethasone.What is the purpose of this pharmacologic intervention?

Accepted Answer

A)  To stimulate fetal surfactant production 
B)  To reduce maternal and fetal tachycardia associated with ritodrine administration 
C)  To suppress uterine contractions 
D)  To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy 
A)  To stimulate fetal surfactant production 
B)  To reduce maternal and fetal tachycardia associated with ritodrine administration 
C)  To suppress uterine contractions 
D)  To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy

Question 16

The induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus.The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction.What are appropriate indications for induction? (Select all that apply?)

Accepted Answer

A)  Rupture of membranes at or near term 
B)  Convenience of the woman or her physician 
C)  Chorioamnionitis (inflammation of the amniotic sac) 
D)  Postterm pregnancy 
E)  Fetal death 
A)  Rupture of membranes at or near term 
B)  Convenience of the woman or her physician 
C)  Chorioamnionitis (inflammation of the amniotic sac) 
D)  Postterm pregnancy 
E)  Fetal death

Question 17

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor,which finding alerts the nurse to possible side effects?

Accepted Answer

A)  Urine output of 160 ml in 4 hours 
B)  DTRs 2+ and no clonus 
C)  Respiratory rate (RR)of 16 breaths per minute 
D)  Serum magnesium level of 10 mg/dl 
A)  Urine output of 160 ml in 4 hours 
B)  DTRs 2+ and no clonus 
C)  Respiratory rate (RR)of 16 breaths per minute 
D)  Serum magnesium level of 10 mg/dl

Question 18

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor.Her labor is being controlled with tocolytic medications.She asks when she might be able to go home.Which response by the nurse is most accurate?

Accepted Answer

A)  "After the baby is born." 
B)  "When we can stabilize your preterm labor and arrange home health visits." 
C)  "Whenever your physician says that it is okay." 
D)  "It depends on what kind of insurance coverage you have." 
A)  "After the baby is born." 
B)  "When we can stabilize your preterm labor and arrange home health visits." 
C)  "Whenever your physician says that it is okay." 
D)  "It depends on what kind of insurance coverage you have."

Question 19

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor.Which finding indicates that preterm labor is occurring?

Accepted Answer

A)  Estriol is not found in maternal saliva. 
B)  Irregular,mild uterine contractions are occurring every 12 to 15 minutes. 
C)  Fetal fibronectin is present in vaginal secretions. 
D)  The cervix is effacing and dilated to 2 cm. 
A)  Estriol is not found in maternal saliva. 
B)  Irregular,mild uterine contractions are occurring every 12 to 15 minutes. 
C)  Fetal fibronectin is present in vaginal secretions. 
D)  The cervix is effacing and dilated to 2 cm.

Question 20

Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline?

Accepted Answer

A)  Assess deep tendon reflexes (DTRs). 
B)  Assess for dyspnea and crackles. 
C)  Assess for bradycardia. 
D)  Assess for hypoglycemia. 
A)  Assess deep tendon reflexes (DTRs). 
B)  Assess for dyspnea and crackles. 
C)  Assess for bradycardia. 
D)  Assess for hypoglycemia.

Exam 32: Labor and Birth Complications

What are the complications and risks associated with cesarean births? (Select all that apply. )

Women who are obese are at risk for several complications during pregnancy and birth.Which of these would the nurse anticipate with an obese client? (Select all that apply. )

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor.Which information is the most important for the nurse to understand and share with the client?

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity?

Which assessment is least likely to be associated with a breech presentation?

When would an internal version be indicated to manipulate the fetus into a vertex position?

A number of methods can be used for inducing labor.Which cervical ripening method falls under the category of mechanical or physical?

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation.What is the primary purpose of prostaglandin administration?

In planning for home care of a woman with preterm labor,which concern should the nurse need to address?

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant?

What is a maternal indication for the use of forceps-assisted birth?

Which statement related to the induction of labor is most accurate?

Which description most accurately describes the augmentation of labor?

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM)doses of betamethasone.What is the purpose of this pharmacologic intervention?

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor,which finding alerts the nurse to possible side effects?

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor.Her labor is being controlled with tocolytic medications.She asks when she might be able to go home.Which response by the nurse is most accurate?

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor.Which finding indicates that preterm labor is occurring?

Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline?

21st Century Maternity and Womens Health Nursing

Community Care: the Family and Culture

Nursing and Genomics

Assessment and Health Promotion

Violence Against Women

Reproductive System Concerns

Sexually Transmitted and Other Infections

Contraception and Abortion

Infertility

Problems of the Breast

Structural Disorders and Neoplasms of the Reproductive System

Conception and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care of the Family During Pregnancy

Maternal and Fetal Nutrition

Labor and Birth Processes

Maximizing Comfort for the Laboring Woman

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Postpartum Physiologic Changes

Nursing Care of the Family During the Postpartum Period

Transition to Parenthood

Physiologic and Behavioral Adaptations of the Newborn

Nursing Care of the Newborn and Family

Newborn Nutrition and Feeding

Assessment of High Risk Pregnancy

Hypertensive Disorders

Hemorrhagic Disorders

Endocrine and Metabolic Disorders

Medical-Surgical Disorders

Mental Health Disorders and Substance Abuse

Postpartum Complications

Nursing Care of the High Risk Newborn

Acquired Problems of the Newborn

Hemolytic Disorders and Congenital Anomalies

Perinatal Loss, bereavement, and Grief

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