Question 1

Following an amniotomy, the nursing assessment that should be reported immediately is:

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. C

Question 2

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. The nurse is aware that anxiety can affect labor by:

Accepted Answer

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

Question 3

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

Accepted Answer

laminaria
A laminaria is a narrow cone inserted in the cervix that dilates and ripens the cervix as it absorbs water.

Question 4

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

Accepted Answer

A)   report any increase in fetal activity.
B)   notify her obstetrician for 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 5

After several hours of labor, a nursing assessment reveals that a woman's cervix is 5 cm dilated but contractions are becoming shorter and less frequent. The nurse knows that this labor pattern is described as:

Accepted Answer

A)   normal.
B)   hypotonic.
C)   hypertonic.
D)   false.

Question 6

The nurse is administering terbutaline (Brethine) to a pregnant woman to prevent preterm labor. The nurse would assess for which adverse effect?

Accepted Answer

A)   Maternal tachycardia
B)   Maternal hypertension
C)   Fetal bradycardia
D)   Fetal hypokalemia

Question 7

A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously. She must be closely observed for signs of:

Accepted Answer

A)   chorioamnionitis.
B)   hemorrhage.
C)   hypotension.
D)   amniotic fluid embolism.

Question 8

To increase the quality of uterine contractions, the nurse instructs the patient to do what to stimulate her nipples? Select all that apply.

Accepted Answer

A)   Place a warm, moist washcloth over the breast.
B)   Brush the nipples with a dry washcloth.
C)   Gently pull on the nipples.
D)   Apply suction to the nipples with a breast pump.
E)   Press the palms of hands down on her breasts.

Question 9

The nurse explains that a "cervical ripening" softens the cervix with the use of:

Accepted Answer

A)   prostaglandin gel insertion.
B)   intravenous oxytocin.
C)   warm saline douches.
D)   nipple stimulation.

Question 10

The nursing care of a woman with a third-degree laceration immediately after delivery would include:

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 11

The frustrated patient in labor that has been affected by decreased uterine muscle tone complains, "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?" The nurse is aware that prior to induction, the patient should have a Bishop score of at least:

Accepted Answer

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

Question 12

A woman who is 24 weeks' pregnant is placed on an intravenous infusion of magnesium sulfate. The nurse should inform the patient that she might experience what side effect?

Accepted Answer

A)   Nausea and vomiting
B)   Headache
C)   Warm flush
D)   Urinary frequency

Question 13

A student nurse questions the instructor as to what alteration should be made for the assessment of the fundus of a new postoperative cesarean section patient. The best response is that the fundus of a patient with a cesarean section is:

Accepted Answer

A)   not assessed until the second postoperative day.
B)   assessed by "walking" fingers from side of uterus to the midline.
C)   assessed only if large clots appear in lochia.
D)   only once every shift.

Question 14

The initial vaginal examination of a woman admitted to the labor unit reveals that the cervix is dilated 9 cm. The panicked woman asks the nurse, "Please give me something." The most appropriate pain relief intervention for a woman in precipitate labor is to:

Accepted Answer

A)   get an order for an intravenous narcotic.
B)   notify the anesthesiologist for an epidural block.
C)   stay and breathe with her during contractions.
D)   tell her to bear with it because she is close to delivery.

Question 15

After an amniotomy, the nurse should be alert for what sign(s) of infection? Select all that apply.

Accepted Answer

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

Question 16

A pulsating structure is felt during a vaginal examination of a woman in labor. To prevent compression of a prolapsed cord, the nurse would position the woman:

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

A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP). To encourage fetal rotation and pain relief the nurse would position the patient:

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 18

The nurse explains to a patient that a minimum score of _____ on the Bishop scale is predictive of successful labor induction.

Accepted Answer

The answer of The nurse explains to a patient that...

Question 19

The statement that indicates a woman understands activity limitations for the management of preterm labor is:

Accepted Answer

A)   "After my shower in the morning, I do the laundry and straighten up the house, then I rest."
B)   "I pack a picnic basket and put it next to the sofa so I do not have to get up for food during the day."
C)   "I have a 2-year-old to care for, but I try to rest as much as I can."
D)   "I get really bored at home, so I go to the shopping mall for just a little while."

Question 20

The nurse would assess an infant delivered with the use of forceps for:

Accepted Answer

A)   loss of hair from contact with forceps.
B)   sacral hematoma.
C)   facial asymmetry.
D)   shoulder dislocation.

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