Question 1

The perinatal nurse explains to a nursing student that perinatal loss occurs when a woman's baby is lost during what time period?

Accepted Answer

A)  Any time during the first year of life 
B)  From conception through birth 
C)  From conception through the first 28 days after birth 
D)  During labor or delivery

Question 2

A woman is about to undergo an external version.What action by the nurse takes priority?

Accepted Answer

A)  Determine Rh status; give Rh immune globulin if needed. 
B)  Explain the procedure to the woman and obtain consent. 
C)  Offer emotional support to both the woman and her partner. 
D)  Prepare to administer oxytocin (Pitocin) as per protocol.

Question 3

A nurse has instructed a woman on the procedure for nipple rolling.What action by the patient demonstrates good understanding of the teaching?

Accepted Answer

A)  Pinches and pulls the nipples on alternating sides 
B)  Rolls both nipples together for 10 minutes 
C)  Rolls one nipple at a time during a contraction 
D)  Rolls one nipple at a time through her clothing

Question 4

The nurse is caring for a woman who is undergoing an induction with oxytocin (Pitocin).The nurse explains to a nursing student that contraindications to labor induction include which of the following?

Accepted Answer

A)  Active genital herpes infection 
B)  Breech presentation 
C)  History of a myomectomy 
D)  Severe hypertension 
E)  Vasa previa or complete placenta previa

Question 5

The perinatal nurse explains to a nursing student that the most appropriate patient for an amnioinfusion is a woman who has a fetal heart rate tracing that exhibits which pattern?

Accepted Answer

A)  Absent variability 
B)  Early decelerations 
C)  Late decelerations 
D)  Variable decelerations

Question 6

A woman has been diagnosed with hypertonic labor.She has an order for hydromorphone (Dilaudid).The student is preparing the medication and asks the labor nurse the rationale for using it.What response by the nurse is best?

Accepted Answer

A)  "It is to induce prescribed rest and relax the uterus." 
B)  "It's for the pain associated with those strong contractions." 
C)  "The patient must be allergic to other pain meds." 
D)  "This is the best medication for labor and birth."

Question 7

A nurse is caring for a patient with abruptio placentae.What assessment findings would indicate that the woman is hemodynamically stable?

Accepted Answer

A)  Fetal heart rate: 108 beats/minute 
B)  Hematocrit: 33% 
C)  Oxygen saturation: 90% 
D)  Urine output: 20 mL/hour

Question 8

A nurse is caring for a pregnant woman with diabetes mellitus.What assessment finding demonstrates that the patient has successfully met an important goal during pregnancy?

Accepted Answer

A)  Blood glucose consistently  4,500 g at birth 
D)  Pregnancy weight gain of no more than 20 lb

Question 9

The nurse is explaining dysfunctional labor patterns to a group of nursing students.Which of the following should the nurse include in the list of risk factors for hypotonic labor?

Accepted Answer

A)  Anxiety and fear 
B)  Fetal malpresentation 
C)  Maternal obesity 
D)  Multiple gestation 
E)  Pain medication

Question 10

A woman reports feeling uterine contractions that are strong,but on subsequent cervical checks,the nurse does not note any changes.What action by the nurse is most appropriate?

Accepted Answer

A)  Assess the woman for causes of anxiety. 
B)  Attempt an external version of the fetus. 
C)  Instruct the woman on nipple stimulation. 
D)  Prepare to administer oxytoxin (Pitocin).

Question 11

A nurse is caring for a woman who will be induced,but her cervix is not yet favorable for this intervention.The provider leaves an order for dinoprostone vaginal insert (Cervidil),which the nurse administers at 9:00 a.m.At what time does the nurse anticipate induction with oxytocin (Pitocin)?

Accepted Answer

A)  In 30 to 60 minutes after the last dose of dinoprostone 
B)  In 30 to 60 minutes after the dinoprostone insert is removed 
C)  In 5 to 7 hours or when contractions begin 
D)  In 6 to 12 hours after the dinoprostone insert is removed

Question 12

The nurse manager of the perinatal services unit wants to improve outcomes associated with perinatal loss.What action by the manager would best help meet this goal?

Accepted Answer

A)  Develop a unit specifically for this population. 
B)  Establish a multidisciplinary perinatal loss team. 
C)  Identify key nurses to care for these patients. 
D)  Provide debriefing services for the nursing staff.

Question 13

The perinatal nurse knows that one of the most severe complications for a patient with a diagnosis of abruptio placentae is which of the following?

Accepted Answer

A)  Couvelaire uterus 
B)  Hydrops fetalis 
C)  Hypertension 
D)  Increased blood volume

Question 14

A laboring woman complains of sudden,sharp,severe pain during a contraction,and when the contraction ceases,the pain is gone.What assessment by the nurse takes priority?

Accepted Answer

A)  Abdominal palpation 
B)  Fetal heart tracing 
C)  Maternal vital signs 
D)  Intrauterine pressure

Question 15

The perinatal nurse is providing care to a 17-year-old G2 TPAL 0010 patient at 32 weeks' gestation.An ultrasound examination confirms that she is experiencing an abruptio placentae.The patient's vital signs are as follows: BP: 110/66 mm Hg,P: 92 beats/minute,R: 18 breaths/minute,fetal heart rate: 156 beats/minute.What assessment should the nurse include in this patient's plan of care as a priority?

Accepted Answer

A)  Hourly vital signs 
B)  Intake and output every 8 hours 
C)  Blood draw for complete blood count (CB
C) , prothrombin time (PT), and electrolytes 
D)  Checks for perineal bleeding every 15 minutes

Question 16

The perinatal nurse is providing care to a multiparous woman in labor.Upon arrival to the birthing suite,the cervix is 5 cm dilated and the patient is experiencing contractions every 1 to 2 minutes that she describes as "strong." The patient states that she labored for 1 hour at home and is feeling some rectal pressure.The patient is most likely experiencing what condition?

Accepted Answer

A)  Hypertonic contractions 
B)  Hypotonic contractions 
C)  Precipitous labor 
D)  Uterine hyperstimulation

Question 17

The nurse explains to a class of nursing students that which of the following are the main predictors of medically indicated and elective cesarean birth?

Accepted Answer

A)  Use of assisted reproductive technology 
B)  Induced labor before 39 weeks of gestation 
C)  Maternal age greater than 35 
D)  Multiple-gestation pregnancy 
E)  Native American ethnicity

Question 18

A nurse is caring for a woman who gave birth to a term infant an hour ago.The chart notes that the baby was born after demonstrating a positive turtle sign.What assessment finding by the nurse warrants immediate action?

Accepted Answer

A)  Lochia rubra is noted an hour after birth. 
B)  Maternal blood pressure is 90/42 mm Hg. 
C)  Maternal heart rate is 68 beats/minute. 
D)  Patient saturates one perineal pad in 2 hours.

Question 19

The nurse is teaching a childbirth preparation class for women who will have planned cesarean births for medical need.What potential complications of this operation does the nurse describe?

Accepted Answer

A)  Chronic pain 
B)  Sexual dysfunction 
C)  Subsequent placental problems 
D)  Urinary tract injury 
E)  Wound dehiscence

Question 20

A woman arrives at the birthing unit for a scheduled cesarean birth.What action by the nurse is most important?

Accepted Answer

A)  Cleanse and shave the woman's abdomen. 
B)  Ensure that signed informed consent is on the chart. 
C)  Facilitate a blood draw for type and cross match. 
D)  Initiate a large-bore IV and insert a catheter.

Exam 14: Caring for the Woman Experiencing Complications During Labor and Birth