Question 1

When planning care for a laboring woman whose membranes have ruptured,the nurse recognizes that the woman's risk for _________________________ has increased.

Accepted Answer

A) Intrauterine infection 
B) Hemorrhage 
C) Precipitous labor 
D) Supine hypotension

Question 2

If a woman complains of back labor pain,the nurse could best suggest that she:

Accepted Answer

A) Lie on her back for a while with her knees bent. 
B) Do less walking around. 
C) Take some deep, cleansing breaths. 
D) Lean over a birth ball with her knees on the floor.

Question 3

The nurse expects to administer an oxytocic (e.g.,Pitocin,Methergine)to a woman after expulsion of her placenta to:

Accepted Answer

A) Relieve pain. 
B) Stimulate uterine contraction. 
C) Prevent infection. 
D) Facilitate rest and relaxation.

Question 4

A means of controlling the birth of the fetal head with a vertex presentation is:

Accepted Answer

A) The Ritgen maneuver. 
B) Fundal pressure. 
C) The lithotomy position. 
D) The De Lee apparatus.

Question 5

Leopold maneuvers would be an inappropriate method of assessment to determine:

Accepted Answer

A) Gender of the fetus. 
B) Number of fetuses. 
C) Fetal lie and attitude. 
D) Degree of the presenting part's descent into the pelvis.

Question 6

The labor process is an exciting and anxious time for the patient and her partner and family. In a relatively short period of time, they experience one of the most profound changes in their lives. Nursing care management focuses on assessment and support throughout labor and birth, with the goal of ensuring the best possible outcome for mother and newborn. Please match each nursing diagnosis with the appropriate intervention needed to achieve the expected outcome.

-Orient the patient and family to the labor and birth unit.

Accepted Answer

A) Anxiety related to labor and the birthing process 
B) Acute pain related to contractions 
C) Risk for impaired urinary elimination 
D) Risk for impaired individual coping 
E) Fatigue related to energy expenditure during labor and birth

Question 7

Women who have participated in childbirth education classes often bring a "birth bag" or "Lamaze bag" with them to the hospital.These items often assist in reducing stress and providing comfort measures.The nurse caring for women in labor should be aware of common items that a client may bring,including (Select all that apply):

Accepted Answer

A) Rolling pin. 
B) Tennis balls. 
C) Pillow. 
D) Stuffed animal or photo. 
E) Candles.

Question 8

The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 6

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 9

Because the risk for childbirth complications may be revealed,nurses should know that the point of maximal intensity (PMI)of the fetal heart tone (FHT)is:

Accepted Answer

A) Usually directly over the fetal abdomen. 
B) In a vertex position heard above the mother's umbilicus. 
C) Heard lower and closer to the midline of the mother's abdomen as the fetus descends and rotates internally. 
D) In a breech position heard below the mother's umbilicus.

Question 10

It is paramount for the obstetric nurse to understand the regulatory procedures and criteria for admitting a woman to the hospital labor unit.Which guideline is an important legal requirement of maternity care?

Accepted Answer

A) The patient is not considered to be in true labor (according to the Emergency Medical Treatment and Active Labor Act [EMTALA]) until a qualified health care provider says she is. 
B) The woman can have only her male partner or predesignated "doula" with her at assessment. 
C) The patient's weight gain is calculated to determine whether she is at greater risk for cephalopelvic disproportion (CP
D)  and cesarean birth. 
D) The nurse may exchange information about the patient with family members.

Question 11

When assessing a multiparous woman who has just given birth to an 8-pound boy,the nurse notes that the woman's fundus is firm and has become globular in shape.A gush of dark red blood comes from her vagina.The nurse concludes that:

Accepted Answer

A) The placenta has separated. 
B) A cervical tear occurred during the birth. 
C) The woman is beginning to hemorrhage. 
D) Clots have formed in the upper uterine segment.

Question 12

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage.The nurse's best response is:

Accepted Answer

A) "Don't worry about it. You'll do fine." 
B) "It's normal to be anxious about labor. Let's discuss what makes you afraid." 
C) "Labor is scary to think about, but the actual experience isn't." 
D) "You can have an epidural. You won't feel anything."

Question 13

The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 5

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 14

The primary difference between the labor of a nullipara and that of a multipara is the:

Accepted Answer

A) Amount of cervical dilation. 
B) Total duration of labor. 
C) Level of pain experienced. 
D) Sequence of labor mechanisms.

Question 15

The nurse teaches a pregnant woman about the characteristics of true labor contractions.The nurse evaluates the woman's understanding of the instructions when she states,"True labor contractions will:

Accepted Answer

A) Subside when I walk around." 
B) Cause discomfort over the top of my uterus." 
C) Continue and get stronger even if I relax and take a shower." 
D) Remain irregular but become stronger."

Question 16

The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 1

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 17

When a nulliparous woman telephones the hospital to report that she is in labor,the nurse initially should:

Accepted Answer

A) Tell the woman to stay home until her membranes rupture. 
B) Emphasize that food and fluid intake should stop. 
C) Arrange for the woman to come to the hospital for labor evaluation. 
D) Ask the woman to describe why she believes she is in labor.

Exam 16: Nursing Care of the Family During Labor and Birth

When planning care for a laboring woman whose membranes have ruptured,the nurse recognizes that the woman's risk for _________________________ has increased.

If a woman complains of back labor pain,the nurse could best suggest that she:

The nurse expects to administer an oxytocic (e.g.,Pitocin,Methergine) to a woman after expulsion of her placenta to:

A means of controlling the birth of the fetal head with a vertex presentation is:

Leopold maneuvers would be an inappropriate method of assessment to determine:

Because the risk for childbirth complications may be revealed,nurses should know that the point of maximal intensity (PMI) of the fetal heart tone (FHT) is:

It is paramount for the obstetric nurse to understand the regulatory procedures and criteria for admitting a woman to the hospital labor unit.Which guideline is an important legal requirement of maternity care?

When assessing a multiparous woman who has just given birth to an 8-pound boy,the nurse notes that the woman's fundus is firm and has become globular in shape.A gush of dark red blood comes from her vagina.The nurse concludes that:

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage.The nurse's best response is:

The primary difference between the labor of a nullipara and that of a multipara is the:

The nurse teaches a pregnant woman about the characteristics of true labor contractions.The nurse evaluates the woman's understanding of the instructions when she states,"True labor contractions will:

When a nulliparous woman telephones the hospital to report that she is in labor,the nurse initially should: