Question 1

What does the nurse explain is used to soften the cervix with a "cervical ripening" agent?

Accepted Answer

A)   Prostaglandin gel insertion
B)   Intravenous oxytocin
C)   Warm saline douches
D)   Nipple stimulation A

Question 2

What sign(s)of infection should the nurse assess for after an amniotomy?

Accepted Answer

A)   Oral temperature of 37° C (99.8° F) 
B)   Increase of fetal heart rate (FHR)  from 160 to 174 beats/minute
C)   Flecks of vernix in the amniotic fluid
D)   Low back pain
E)   Edematous labia B

Question 3

The nurse is caring for a patient who is threatening preterm labor and has been given glucocorticoids.What is the purpose of glucocorticoid administration?

Accepted Answer

A)   Prevent infection.
B)   Increase fetal lung maturity.
C)   Increase blood flow from placenta.
D)   Relax the cervix. B

Question 4

_____________________________ is a lower-than-normal amount of amniotic fluid.

Accepted Answer

The answer of _____________________________ is a lower-than-normal amount of amniotic...

Question 5

What nursing assessment should be reported immediately after an amniotomy?

Accepted Answer

A)   Fetal heart rate is regular at 154 beats/min.
B)   Amniotic fluid is clear with flecks of vernix.
C)   Amniotic fluid is watery and pale green.
D)   Maternal temperature is 37.8° C.

Question 6

Several hours after delivery the nurse finds a woman crying.The woman says repeatedly,"My baby is beautiful,but I was planning on a vaginal delivery.Instead I needed an emergency C-section." What is the most appropriate nursing diagnosis?

Accepted Answer

A)   Anxiety related to the development of postpartum complications
B)   Ineffective individual coping related to unfamiliarity with procedures
C)   Risk for ineffective parenting related to emergency cesarean section
D)   Grieving related to loss of expected birth experience

Question 7

A frustrated patient in labor has been affected by decreased uterine muscle tone and reports,"My doctor won't induce my labor because of some silly score.He said I was a 4.What kind of magic number do I need?" What is the lowest Bishop score the patient should have prior to induction?

Accepted Answer

A)   6
B)   8
C)   10
D)   12

Question 8

A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to 5 cm with membranes intact.What action by the physician will the nurse anticipate?

Accepted Answer

A)   Perform an amniotomy.
B)   Initiate tocolytic drugs.
C)   Order a sedative for the patient.
D)   Plan to do an emergency cesarean section.

Question 9

A(n)_______________ is a narrow cone inserted into the cervix to "ripen" the cervix to increase uterine contractions.

Accepted Answer

The answer of A(n)_______________ is a narrow cone inserted into...

Question 10

The nurse arrives at the start of a shift on the labor unit to find a census of four patients in active labor.Which laboring patient should the nurse attend to first?

Accepted Answer

A)   18-year-old primigravida with a fetal breech presentation
B)   25-year-old multigravida with history of previous cesarean section
C)   35-year-old multigravida with history of precipitate birth
D)   16-year-old primigravida with a twin pregnancy

Question 11

A pregnant woman's membranes ruptured prematurely at 34 weeks.She will be discharged to her home for the next few weeks.What would the nurse planning discharge instruction teach the woman to do?

Accepted Answer

A)   Report any increase in fetal activity.
B)   Notify her obstetrician if she has a temperature above 37.8° C (100° F) .
C)   Massage her breasts to promote uterine relaxation.
D)   Rest in a side-lying Trendelenburg position with hips elevated.

Question 12

A new mother is distressed and tearful about the elevated dome over her infant's posterior fontanelle.The nurse responds,"This condition will resolve itself in a few days." What is the cause?

Accepted Answer

A)   Prolonged pressure against the partially dilated cervix
B)   Small leak of fluid through the posterior fontanelle
C)   Pressure of the forceps during delivery
D)   The effect of the vacuum extractor

Question 13

A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP).What position will the nurse promote to encourage fetal rotation and pain relief?

Accepted Answer

A)   Prone with legs supported and give her a back massage
B)   Supine with legs bent at the knee
C)   Standing with support
D)   Sitting up and leaning forward on the over-bed table

Question 14

A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously.What complication should the nurse closely assess for with this patient?

Accepted Answer

A)   Chorioamnionitis
B)   Hemorrhage
C)   Hypotension
D)   Amniotic fluid embolism

Question 15

When a woman is admitted to the labor and delivery unit,she tells the nurse that she is anxious about delivery,the welfare of her infant,and how quickly she will recover.How can anxiety affect labor?

Accepted Answer

A)   By decreasing a woman's pain sensitivity
B)   By reducing blood flow to the uterus
C)   By increasing the ability to tolerate pain
D)   By enhancing maternal pushing through greater muscle tension

Question 16

A pulsating structure is felt during a vaginal examination of a woman in labor.How would the nurse position the woman to prevent compression of a prolapsed cord?

Accepted Answer

A)   On her right side with knees flexed
B)   On her left side with a pillow placed between her legs
C)   On her back with her head lower than the rest of her body
D)   Supine with her legs elevated and bent at the knee

Question 17

What nursing care should be provided to a woman with a third-degree laceration immediately after delivery?

Accepted Answer

A)   Warm compresses to the perineum
B)   Cold pack to the perineum
C)   Warm sitz bath
D)   Elevation of hips to prevent edema

Question 18

A woman is preparing for administration of a cervical ripening agent.What nursing actions will the nurse anticipate implementing?

Accepted Answer

A)   Insert IV.
B)   Record a baseline fetal heart rate.
C)   Explain procedure to patient.
D)   Instruct patient to ambulate immediately afterward.
E)   Ensure a tocolytic is available.

Question 19

The nurse is caring for a patient diagnosed with hypotonic labor dysfunction.What will the nurse expect when caring for this patient?

Accepted Answer

A)   Elevated uterine resting tone
B)   Painful and poorly coordinated contractions
C)   Implementation of fluid restriction
D)   Use of frequent position changes

Question 20

A woman 2 weeks past her expected delivery date is receiving an oxytocin infusion to induce labor and begins to have contractions every 90 seconds.What is the nurse's initial action?

Accepted Answer

A)   Stop the oxytocin infusion.
B)   Continue the infusion and report the findings to the physician.
C)   Turn her on her left side and reassess the contractions.
D)   Administer oxygen by mask.

Exam 8: Nursing Care of Women with Complications During Labor and Birth