Question 1

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labour.What finding indicates that preterm labour 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. D

Question 2

For a woman at 42 weeks of gestation,which finding would require more assessment by the nurse?

Accepted Answer

A)  Fetal heart rate of 116 beats/min 
B)  Cervix dilated 2 cm and 50% effaced 
C)  Score of 8 on the biophysical profile 
D)  One fetal movement noted in 1 hour of assessment by the mother 
A)  Fetal heart rate of 116 beats/min 
B)  Cervix dilated 2 cm and 50% effaced 
C)  Score of 8 on the biophysical profile 
D)  One fetal movement noted in 1 hour of assessment by the mother D

Question 3

The nurse should know that which statement is accurate?

Accepted Answer

A)  The terms preterm birth and low birth weight can be used interchangeably. 
B)  Preterm labour is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy. 
C)  Low birth weight is anything below 3500 g 
D)  Preterm birth accounts for 18 to 20% of all births. 
A)  The terms preterm birth and low birth weight can be used interchangeably. 
B)  Preterm labour is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy. 
C)  Low birth weight is anything below 3500 g 
D)  Preterm birth accounts for 18 to 20% of all births. B

Question 4

What finding should the nurse expect when evaluating the effectiveness of an oxytocin induction?

Accepted Answer

A)  Contractions lasting 80 to 90 seconds,2 to 3 minutes apart 
B)  The intensity of contractions are palpated to be moderate. 
C)  Labour to progress at least 2 cm/hr dilation 
D)  At least 80 mU/min of oxytocin will be needed to achieve cervical dilation. 
A)  Contractions lasting 80 to 90 seconds,2 to 3 minutes apart 
B)  The intensity of contractions are palpated to be moderate. 
C)  Labour to progress at least 2 cm/hr dilation 
D)  At least 80 mU/min of oxytocin will be needed to achieve cervical dilation.

Question 5

What should the nurse be aware of with regard to the process of inducing labour?

Accepted Answer

A)  Ripening the cervix usually results in a decreased success rate for induction. 
B)  Labour sometimes can be induced with laminaria tents. 
C)  Oxytocin is less expensive than prostaglandins and more effective but has greater health risks. 
D)  Amniotomy can be used to make the cervix more favourable for labour. 
A)  Ripening the cervix usually results in a decreased success rate for induction. 
B)  Labour sometimes can be induced with laminaria tents. 
C)  Oxytocin is less expensive than prostaglandins and more effective but has greater health risks. 
D)  Amniotomy can be used to make the cervix more favourable for labour.

Question 6

What should the nurse be aware of with regard to dysfunctional labour?

Accepted Answer

A)  Women who are underweight are more at risk. 
B)  Women experiencing precipitous labour often express feelings of disbelief about their labour. 
C)  Hypertonic uterine dysfunction is more common than hypotonic dysfunction. 
D)  Abnormal labour patterns are most common in older women. 
A)  Women who are underweight are more at risk. 
B)  Women experiencing precipitous labour often express feelings of disbelief about their labour. 
C)  Hypertonic uterine dysfunction is more common than hypotonic dysfunction. 
D)  Abnormal labour patterns are most common in older women.

Question 7

In evaluating the effectiveness of nitroglycerin for the treatment of preterm labour,what finding would alert the nurse to possible adverse effects?

Accepted Answer

A)  Urine output of 160 mL in 4 hours 
B)  Deep tendon reflexes 2+ and no clonus 
C)  Blood pressure of 80/46 
D)  Serum magnesium level of 0.80 mmol/L 
A)  Urine output of 160 mL in 4 hours 
B)  Deep tendon reflexes 2+ and no clonus 
C)  Blood pressure of 80/46 
D)  Serum magnesium level of 0.80 mmol/L

Question 8

The nurse providing care for a woman with preterm labour on nifedipine (Adalat)would include which intervention to identify adverse effects of the drug?

Accepted Answer

A)  Assessing deep tendon reflexes (DTRs) 
B)  Assessing for hypotension 
C)  Assessing for bradycardia 
D)  Assessing for hypoglycemia 
A)  Assessing deep tendon reflexes (DTRs) 
B)  Assessing for hypotension 
C)  Assessing for bradycardia 
D)  Assessing for hypoglycemia

Question 9

In planning for home care of a woman with preterm labour,the nurse needs to address which concern?

Accepted Answer

A)  Nursing assessments will be different from those done in the hospital setting. 
B)  Restricted activity and medications will be necessary to prevent recurrence of preterm labour. 
C)  Prolonged bedrest is not supported in the literature as an effective intervention. 
D)  Home health care providers will be necessary. 
A)  Nursing assessments will be different from those done in the hospital setting. 
B)  Restricted activity and medications will be necessary to prevent recurrence of preterm labour. 
C)  Prolonged bedrest is not supported in the literature as an effective intervention. 
D)  Home health care providers will be necessary.

Question 10

What should the nurse be aware of with regard to the process of augmentation of labour?

Accepted Answer

A)  It is active management of labour instituted when the labour process is not satisfactory. 
B)  It relies on more invasive methods when oxytocin and amniotomy have failed. 
C)  It is a modern management term to cover up the negative connotations of forceps-assisted birth. 
D)  It uses vacuum cups to actively assist with the birth of the baby. 
A)  It is active management of labour instituted when the labour process is not satisfactory. 
B)  It relies on more invasive methods when oxytocin and amniotomy have failed. 
C)  It is a modern management term to cover up the negative connotations of forceps-assisted birth. 
D)  It uses vacuum cups to actively assist with the birth of the baby.

Question 11

In planning for an expected Caesarean birth for a woman who has given birth by Caesarean previously and who has a fetus in the transverse presentation,the nurse would include what information?

Accepted Answer

A)  Because this is a repeat procedure,the patient is at lower risk for complications. 
B)  Review the preoperative and postoperative procedures. 
C)  Recovery is quicker with a second or subsequent Caesarean birth. 
D)  Preoperative teaching is not required as the woman has not a Caesarean birth in the past. 
A)  Because this is a repeat procedure,the patient is at lower risk for complications. 
B)  Review the preoperative and postoperative procedures. 
C)  Recovery is quicker with a second or subsequent Caesarean birth. 
D)  Preoperative teaching is not required as the woman has not a Caesarean birth in the past.

Question 12

What should the nurse be aware of for the care management of preterm labour?

Accepted Answer

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

Question 13

What should the nurse be aware of in the use of tocolytic therapy to suppress uterine activity?

Accepted Answer

A)  The drugs can be given efficaciously up to the designated beginning of term at 37 weeks. 
B)  There are no important maternal (as opposed to fetal)contraindications. 
C)  Its most important function is to afford the opportunity to administer antenatal glucocorticoids. 
D)  If the patient develops pulmonary edema while on tocolytics,intravenous (IV)fluids should be given. 
A)  The drugs can be given efficaciously up to the designated beginning of term at 37 weeks. 
B)  There are no important maternal (as opposed to fetal)contraindications. 
C)  Its most important function is to afford the opportunity to administer antenatal glucocorticoids. 
D)  If the patient develops pulmonary edema while on tocolytics,intravenous (IV)fluids should be given.

Question 14

A pregnant woman's amniotic membranes rupture.Prolapsed cord is suspected.Which intervention would be the top priority?

Accepted Answer

A)  Place the woman in the knee-chest position. 
B)  Cover the cord in sterile gauze soaked in saline. 
C)  Prepare the woman for a Caesarean birth. 
D)  Start oxygen by face mask. 
A)  Place the woman in the knee-chest position. 
B)  Cover the cord in sterile gauze soaked in saline. 
C)  Prepare the woman for a Caesarean birth. 
D)  Start oxygen by face mask.

Question 15

Prostaglandin E? gel has been ordered for a pregnant woman at 43 weeks of gestation.The nurse knows that this medication will be administered for which reason?

Accepted Answer

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

Question 16

Which assessment findings are considered high priority indications for labour induction? Select all that apply.Express answer in small letters followed by a comma and a space-e.g.a,b,

Accepted Answer

A)  Pre-eclampsia less than 36 weeks 
B)  Significant but stable antepartum hemorrhage 
C)  41 weeks' gestation 
D)  Intrauterine growth restriction 
E)  Chorioamnionitis
F) Oligohydramnios 
A)  Pre-eclampsia less than 36 weeks 
B)  Significant but stable antepartum hemorrhage 
C)  41 weeks' gestation 
D)  Intrauterine growth restriction 
E)  Chorioamnionitis
F) Oligohydramnios

Question 17

Which should the nurse be aware of with regard to induction of labour?

Accepted Answer

A)  It can be achieved by external and internal version techniques. 
B)  It is also known as a trial of labour (TOL). 
C)  It is always done for medical reasons. 
D)  It is rated for inducibility by a Bishop score. 
A)  It can be achieved by external and internal version techniques. 
B)  It is also known as a trial of labour (TOL). 
C)  It is always done for medical reasons. 
D)  It is rated for inducibility by a Bishop score.

Question 18

Which should nurses be aware of with regard to the psychological complications and risks of forced Caesarean births?

Accepted Answer

A)  Mothering success is hampered for the woman who has an unplanned Caesarean birth. 
B)  Most women are not able to breastfeed in the side-lying position. 
C)  The psychological outcomes are the same as for women who go through scheduled Caesarean births. 
D)  Some couples (and individuals)have sexual worries;the women worry about sexual attractiveness,and the men worry about hurting their partners. 
A)  Mothering success is hampered for the woman who has an unplanned Caesarean birth. 
B)  Most women are not able to breastfeed in the side-lying position. 
C)  The psychological outcomes are the same as for women who go through scheduled Caesarean births. 
D)  Some couples (and individuals)have sexual worries;the women worry about sexual attractiveness,and the men worry about hurting their partners.

Question 19

A woman is having her first child.She has been in labour for 15 hours.Two hours ago,her vaginal examination revealed the cervix to be dilated to 6 cm and 100% effaced,and the presenting part was at station 0.Five minutes ago,her vaginal examination indicated that there had been no change.What abnormal labour pattern is associated with this description?

Accepted Answer

A)  Primary prolonged latent phase 
B)  Protracted active phase 
C)  Secondary arrest of active phase 
D)  Protracted descent 
A)  Primary prolonged latent phase 
B)  Protracted active phase 
C)  Secondary arrest of active phase 
D)  Protracted descent

Question 20

A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and says that they are very painful.Her cervix is dilated 2 cm and has not changed in 3 hours.The woman is crying and wants an epidural.What is the likely status of this woman's labour?

Accepted Answer

A)  She is exhibiting hypotonic uterine dysfunction. 
B)  She is experiencing a normal latent stage. 
C)  She is exhibiting hypertonic uterine dysfunction. 
D)  She is experiencing pelvic dystocia. 
A)  She is exhibiting hypotonic uterine dysfunction. 
B)  She is experiencing a normal latent stage. 
C)  She is exhibiting hypertonic uterine dysfunction. 
D)  She is experiencing pelvic dystocia.

Exam 20: Labour and Birth at Risk

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

For a woman at 42 weeks of gestation,which finding would require more assessment by the nurse?

The nurse should know that which statement is accurate?

What finding should the nurse expect when evaluating the effectiveness of an oxytocin induction?

What should the nurse be aware of with regard to the process of inducing labour?

What should the nurse be aware of with regard to dysfunctional labour?

In evaluating the effectiveness of nitroglycerin for the treatment of preterm labour,what finding would alert the nurse to possible adverse effects?

The nurse providing care for a woman with preterm labour on nifedipine (Adalat)would include which intervention to identify adverse effects of the drug?

In planning for home care of a woman with preterm labour,the nurse needs to address which concern?

What should the nurse be aware of with regard to the process of augmentation of labour?

In planning for an expected Caesarean birth for a woman who has given birth by Caesarean previously and who has a fetus in the transverse presentation,the nurse would include what information?

What should the nurse be aware of for the care management of preterm labour?

What should the nurse be aware of in the use of tocolytic therapy to suppress uterine activity?

A pregnant woman's amniotic membranes rupture.Prolapsed cord is suspected.Which intervention would be the top priority?

Prostaglandin E? gel has been ordered for a pregnant woman at 43 weeks of gestation.The nurse knows that this medication will be administered for which reason?

Which assessment findings are considered high priority indications for labour induction? Select all that apply.Express answer in small letters followed by a comma and a space-e.g.a,b,

Which should the nurse be aware of with regard to induction of labour?

Which should nurses be aware of with regard to the psychological complications and risks of forced Caesarean births?

A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and says that they are very painful.Her cervix is dilated 2 cm and has not changed in 3 hours.The woman is crying and wants an epidural.What is the likely status of this woman's labour?

Contemporary Perinatal and Pediatric Nursing in Canada

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Perinatal Nursing in Canada

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Health Assessment

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Infertility, Contraception, and Abortion

Preconception, Genetics, Conception, and Fetal Development

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Labour and Birth Processes

Nursing Care of the Family During Labour and Birth

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Fetal Health Surveillance During Labour

Maternal Physiological Changes

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Nursing Care of the Newborn and Family

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The Newborn at Risk: Acquired and Congenital Problems

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