Question 1

Nurses should be aware that the induction of labor:

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 done 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 done for medical reasons. 
D)  Is rated for viability by a Bishop score. D

Question 2

With regard to the process of inducing labor, nurses should be aware that:

Accepted Answer

A)  Ripening the cervix usually results in a decreased success rate for induction. 
B)  Labor sometimes can be induced with balloon catheters or laminaria tents. 
C)  Oxytocin is less expensive than prostaglandins and more effective but creates greater health risks. 
D)  Amniotomy can be used to make the cervix more favorable for labor. 
A)  Ripening the cervix usually results in a decreased success rate for induction. 
B)  Labor sometimes can be induced with balloon catheters or laminaria tents. 
C)  Oxytocin is less expensive than prostaglandins and more effective but creates greater health risks. 
D)  Amniotomy can be used to make the cervix more favorable for labor. B

Question 3

Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance:

Accepted Answer

A)  The terms preterm birth and low birth weight can be used interchangeably. 
B)  Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy. 
C)  Low birth weight is anything below 3.7 pounds. 
D)  In the United States early in this century, preterm birth accounted for 18% to 20% of all births. 
A)  The terms preterm birth and low birth weight can be used interchangeably. 
B)  Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy. 
C)  Low birth weight is anything below 3.7 pounds. 
D)  In the United States early in this century, preterm birth accounted for 18% to 20% of all births. B

Question 4

With regard to the process of augmentation of labor, the nurse should be aware that it:

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 5

A pregnant woman's amniotic membranes have ruptured. Prolapsed cord is suspected. What intervention would be the top priority?

Accepted Answer

A)  Placing the woman in the knee-chest position 
B)  Covering the cord in sterile gauze soaked in saline 
C)  Preparing the woman for a cesarean birth 
D)  Starting oxygen by face mask 
A)  Placing the woman in the knee-chest position 
B)  Covering the cord in sterile gauze soaked in saline 
C)  Preparing the woman for a cesarean birth 
D)  Starting oxygen by face mask

Question 6

Prepidil (prostaglandin gel) has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes that this medication will be administered to:

Accepted Answer

A)  Enhance uteroplacental perfusion in an aging placenta. 
B)  Increase amniotic fluid volume. 
C)  Ripen the cervix in preparation for labor induction. 
D)  Stimulate the amniotic membranes to rupture. 
A)  Enhance uteroplacental perfusion in an aging placenta. 
B)  Increase amniotic fluid volume. 
C)  Ripen the cervix in preparation for labor induction. 
D)  Stimulate the amniotic membranes to rupture.

Question 7

In evaluating the effectiveness of oxytocin induction, the nurse would expect:

Accepted Answer

A)  Contractions lasting 80 to 90 seconds, 2 to 3 minutes apart. 
B)  The intensity of contractions to be at least 110 to 130 mm Hg. 
C)  Labor to progress at least 2 cm/hr dilation. 
D)  At least 30 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 to be at least 110 to 130 mm Hg. 
C)  Labor to progress at least 2 cm/hr dilation. 
D)  At least 30 mU/min of oxytocin will be needed to achieve cervical dilation.

Question 8

A primigravida at 40 weeks of gestation is having uterine contractions every 1½ 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 labor?

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.

Question 9

A nurse is caring for a patient in the active phase of labor. The woman's bag of waters spontaneously ruptures. Suddenly the woman complains of dyspnea and appears restless and cyanotic. In addition, she becomes hypotensive and tachycardic. The nurse immediately suspects the presence of ___________________________________.

Accepted Answer

An amniotic fluid embolism
Anaphylactoid

Question 10

In planning for home care of a woman with preterm labor, the nurse needs to address what 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 labor. 
C)  Prolonged bed rest may cause negative physiologic effects. 
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 labor. 
C)  Prolonged bed rest may cause negative physiologic effects. 
D)  Home health care providers will be necessary.

Question 11

With regard to the care management of preterm labor, nurses should be aware that:

Accepted Answer

A)  Because all women must be considered at risk for preterm labor 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 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)  The 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 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 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)  The diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

Question 12

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects?

Accepted Answer

A)  Urine output of 160 ml in 4 hours 
B)  Deep tendon reflexes 2+ and no clonus 
C)  Respiratory rate of 16 breaths/min 
D)  Serum magnesium level of 10 mg/dl 
A)  Urine output of 160 ml in 4 hours 
B)  Deep tendon reflexes 2+ and no clonus 
C)  Respiratory rate of 16 breaths/min 
D)  Serum magnesium level of 10 mg/dl

Question 13

A woman is having her first child. She has been in labor for 15 hours. Two hours ago her vaginal examination revealed the cervix to be dilated to 5 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 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 14

In planning for an expected cesarean birth for a woman who has given birth by cesarean 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, you are at the lowest risk for complications." 
B)  "Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures." 
C)  "Because this is your second cesarean birth, you will recover faster." 
D)  "You will not need preoperative teaching because this is your second cesarean birth." 
A)  "Because this is a repeat procedure, you are at the lowest risk for complications." 
B)  "Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures." 
C)  "Because this is your second cesarean birth, you will recover faster." 
D)  "You will not need preoperative teaching because this is your second cesarean birth."

Question 15

Complications and risks associated with cesarean births include (choose all that apply):

Accepted Answer

A)  Pulmonary edema. 
B)  Wound dehiscence. 
C)  Hemorrhage. 
D)  Urinary tract infections. 
E)  Fetal injuries.
F) None of the above 
A)  Pulmonary edema. 
B)  Wound dehiscence. 
C)  Hemorrhage. 
D)  Urinary tract infections. 
E)  Fetal injuries.
F) None of the above

Question 16

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to:

Accepted Answer

A)  Stimulate fetal surfactant production. 
B)  Reduce maternal and fetal tachycardia associated with ritodrine administration. 
C)  Suppress uterine contractions. 
D)  Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy. 
A)  Stimulate fetal surfactant production. 
B)  Reduce maternal and fetal tachycardia associated with ritodrine administration. 
C)  Suppress uterine contractions. 
D)  Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy.

Question 17

The nurse providing care for a woman with preterm labor on terbutaline would include which intervention to identify side effects of the drug?

Accepted Answer

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

Question 18

Which statement is most likely to be associated with a breech presentation?

Accepted Answer

A)  Least common malpresentation 
B)  Descent is rapid 
C)  Diagnosis by ultrasound only 
D)  High rate of neuromuscular disorders 
A)  Least common malpresentation 
B)  Descent is rapid 
C)  Diagnosis by ultrasound only 
D)  High rate of neuromuscular disorders

Question 19

The least common risk factor for a long, difficult, or abnormal labor (dystocia) is:

Accepted Answer

A)  Advanced maternal age. 
B)  Infertility difficulties. 
C)  Multiparity. 
D)  Short stature. 
A)  Advanced maternal age. 
B)  Infertility difficulties. 
C)  Multiparity. 
D)  Short stature.

Exam 22: Labor and Birth at Risk

Nurses should be aware that the induction of labor:

With regard to the process of inducing labor, nurses should be aware that:

Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance:

With regard to the process of augmentation of labor, the nurse should be aware that it:

A pregnant woman's amniotic membranes have ruptured. Prolapsed cord is suspected. What intervention would be the top priority?

Prepidil (prostaglandin gel) has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes that this medication will be administered to:

In evaluating the effectiveness of oxytocin induction, the nurse would expect:

A primigravida at 40 weeks of gestation is having uterine contractions every 1½ 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 labor?

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

With regard to the care management of preterm labor, nurses should be aware that:

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects?

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

Complications and risks associated with cesarean births include (choose all that apply):

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to:

The nurse providing care for a woman with preterm labor on terbutaline would include which intervention to identify side effects of the drug?

Which statement is most likely to be associated with a breech presentation?

The least common risk factor for a long, difficult, or abnormal labor (dystocia) is:

21st Century Maternity Nursing: Culturally Competent, Family and Community Focused

Assessment and Health Promotion

Common Concerns

Contraception, Abortion, and Infertility

Genetics, Conception, and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care of the Family During Pregnancy

Maternal and Fetal Nutrition

Labor and Birth Processes

Management of Discomfort

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Maternal Physiologic Changes

Nursing Care of the Family During the Fourth Trimester

Transition to Parenthood

Physiologic and Behavioral Adaptations of the Newborn

Assessment and Care of the Newborn and Family

Newborn Nutrition and Feeding

Assessment of High Risk Pregnancy

Pregnancy at Risk: Preexisting Conditions

Pregnancy at Risk: Gestational Conditions

Postpartum Complications

The Newborn at Risk

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