Question 1

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation.The nurse recognizes that this medication is 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 C

Question 2

Which statement related to cephalopelvic disproportion (CPD)is the least accurate?

Accepted Answer

A) CPD can be related to either fetal size or fetal position. 
B) The fetus cannot be born vaginally. 
C) CPD can be accurately predicted. 
D) The cause may be of maternal or fetal origin. 
A) CPD can be related to either fetal size or fetal position. 
B) The fetus cannot be born vaginally. 
C) CPD can be accurately predicted. 
D) The cause may be of maternal or fetal origin. C

Question 3

____________________ is defined as long,difficult,or abnormal labor.It is caused by various conditions associated with the five factors affecting labor.

Accepted Answer

Dystocia
It is estimated that dystocia occurs in approximately 8% to 11% of all births.Dystocia is the second most common indication for cesarean birth (after previous cesarean birth)and is responsible for approximately 60% of all cesarean deliveries in the United States.

Question 4

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions.What clinical cues alert the nurse that the woman is experiencing uterine hyperstimulation? Choose all that apply.

Accepted Answer

A) Uterine contractions lasting 2 minutes in frequency 
B) Uterine contractions lasting >90 seconds and occurring 20 mm Hg 
E) Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR)and pattern 
A) Uterine contractions lasting 2 minutes in frequency 
B) Uterine contractions lasting >90 seconds and occurring 20 mm Hg 
E) Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR)and pattern

Question 5

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

Question 6

Obese women are at risk for several complications during pregnancy and birth.These include all except:

Accepted Answer

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

Question 7

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 8

A nurse is caring for a client 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.Additionally,she becomes hypotensive and tachycardic.The nurse immediately suspects the presence of ___________________________________.

Accepted Answer

An amniotic fluid embolism
Anaphylactoid

Question 9

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

Question 10

The exact cause of preterm labor is unknown and believed to be multifactorial.Infection is thought to be a major factor in many preterm labors.Select the type of infection that has not been linked to preterm births:

Accepted Answer

A) Viral 
B) Periodontal 
C) Cervical 
D) Urinary tract 
A) Viral 
B) Periodontal 
C) Cervical 
D) Urinary tract

Question 11

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

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.

Question 12

With regard to the process of augmentation of labor,a 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 13

Nurses need to know that when any woman is admitted to the hospital and is __________ to __________ weeks pregnant,she should receive antenatal glucocorticoids unless she has chorioamnionitis.Because these drugs require a 24-hour period to become effective,timely administration is essential.

Accepted Answer

24;34
All women between 24 and

Question 14

In evaluating the effectiveness of an oxytocin induction,the nurse expects:

Accepted Answer

A) Contractions lasting 40 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 milliunits/min of oxytocin are needed to achieve cervical dilation 
A) Contractions lasting 40 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 milliunits/min of oxytocin are needed to achieve cervical dilation

Question 15

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 16

The nurse is teaching a client with PPROM about self-care activities.Which activities should the nurse include in her teaching? Choose all that apply.

Accepted Answer

A) Report a temperature higher than 40° C. 
B) It is safe to use a tampon to absorb the leaking amniotic fluid. 
C) Do not engage in sexual activity. 
D) It is safe to take frequent tub baths. 
E) It is acceptable to douche to cleanse the vagina of foul-smelling fluids. 
A) Report a temperature higher than 40° C. 
B) It is safe to use a tampon to absorb the leaking amniotic fluid. 
C) Do not engage in sexual activity. 
D) It is safe to take frequent tub baths. 
E) It is acceptable to douche to cleanse the vagina of foul-smelling fluids.

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) Deep tendon reflexes 2+ and no clonus 
C) Respiratory rate (RR)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 (RR)of 16 breaths/min 
D) Serum magnesium level of 10 mg/dl

Question 18

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 19

A client is to have an amniotomy to induce labor.The nurse recognizes that the priority intervention after the amniotomy is to:

Accepted Answer

A) Apply clean linens under the woman 
B) Take the client's vital signs 
C) Perform a vaginal examination 
D) Assess the fetal heart rate (FHR) 
A) Apply clean linens under the woman 
B) Take the client's vital signs 
C) Perform a vaginal examination 
D) Assess the fetal heart rate (FHR)

Question 20

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

Accepted Answer

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

Exam 33: Labor and Birth Complications

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation.The nurse recognizes that this medication is administered to:

Which statement related to cephalopelvic disproportion (CPD)is the least accurate?

____________________ is defined as long,difficult,or abnormal labor.It is caused by various conditions associated with the five factors affecting labor.

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions.What clinical cues alert the nurse that the woman is experiencing uterine hyperstimulation? Choose all that apply.

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

Obese women are at risk for several complications during pregnancy and birth.These include all except:

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

Nurses should be aware that the induction of labor:

The exact cause of preterm labor is unknown and believed to be multifactorial.Infection is thought to be a major factor in many preterm labors.Select the type of infection that has not been linked to preterm births:

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

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

Nurses need to know that when any woman is admitted to the hospital and is __________ to __________ weeks pregnant,she should receive antenatal glucocorticoids unless she has chorioamnionitis.Because these drugs require a 24-hour period to become effective,timely administration is essential.

In evaluating the effectiveness of an oxytocin induction,the nurse expects:

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 is teaching a client with PPROM about self-care activities.Which activities should the nurse include in her teaching? Choose all that apply.

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

A client is to have an amniotomy to induce labor.The nurse recognizes that the priority intervention after the amniotomy is to:

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

21st Century Maternity and Womens Health Nursing

Community Care: the Family and Culture

Clinical Genetics

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

Maternal and Fetal Nutrition

Nursing Care of the Family During Pregnancy

Labor and Birth Processes

Pain Management

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Postpartum Physiology

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 for Risk Factors in Pregnancy

Hypertensive Disorders in Pregnancy

Antepartum Hemorrhagic Disorders

Endocrine and Metabolic Disorders in Pregnancy

Medical-Surgical Problems in Pregnancy

Obstetric Critical Care

Mental Health Disorders and Substance Abuse in Pregnancy

Postpartum Complications

Acquired Problems of the Newborn

Hemolytic Disorders and Congenital Anomalies

Nursing Care of the High Risk Newborn

Perinatal Loss and Grief

Filters

Nurses need to know that when any woman is admitted to the hospital and is to weeks pregnant,she should receive antenatal glucocorticoids unless she has chorioamnionitis.Because these drugs require a 24-hour period to become effective,timely administration is essential.