Question 1

Before the physician performs an external version,the nurse should expect an order for a:

Accepted Answer

A)  Tocolytic drug.
B)  Contraction stress test (CST) .
C)  Local anesthetic.
D)  Foley catheter. A

Question 2

With regard to the process of augmentation of labor,the 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

Question 3

Which patient status is an acceptable indication for serial oxytocin induction of labor?

Accepted Answer

A)  Past 42 weeks' gestation
B)  Multiple fetuses
C)  Polyhydramnios
D)  History of long labors A

Question 4

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.

Question 5

In planning for an expected cesarean birth for a woman who has given birth by cesarean previously and who has a fetus in the transverse presentation,which information would the nurse include?

Accepted Answer

A)  "Because this is a repeat procedure, you are at the lowest risk for complications."
B)  "Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures."
C)  "Because this is your second cesarean birth, you will recover faster."
D)  "You will not need preoperative teaching because this is your second cesarean birth."

Question 6

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

Question 7

For a woman at 42 weeks of gestation,which finding would require further assessment by the nurse?

Accepted Answer

A)  Fetal heart rate of 116 beats/min
B)  Cervix dilated 2 cm and 50% effaced
C)  Score of 8 on the biophysical profile
D)  One fetal movement noted in 1 hour of assessment by the mother

Question 8

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor.Her labor is being controlled with tocolytic medications.She asks when she would be able to go home.Which response by the nurse is most accurate?

Accepted Answer

A)  "After the baby is born."
B)  "When we can stabilize your preterm labor and arrange home health visits."
C)  "Whenever the doctor says that it is okay."
D)  "It depends on what kind of insurance coverage you have."

Question 9

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor,what finding would alert 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 of 16 breaths/min
D)  Serum magnesium level of 10 mg/dL

Question 10

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor.What finding indicates that preterm labor is occurring?

Accepted Answer

A)  Estriol is not found in maternal saliva.
B)  Irregular, mild uterine contractions are occurring every 12 to 15 minutes.
C)  Fetal fibronectin is present in vaginal secretions.
D)  The cervix is effacing and dilated to 2 cm.

Question 11

With regard to dysfunctional labor,nurses should be aware that:

Accepted Answer

A)  Women who are underweight are more at risk.
B)  Women experiencing precipitous labor are about the only "dysfunctionals" not to be exhausted.
C)  Hypertonic uterine dysfunction is more common than hypotonic dysfunction.
D)  Abnormal labor patterns are most common in older women.

Question 12

The nurse practicing in a labor setting knows that the woman most at risk for uterine rupture is:

Accepted Answer

A)  A gravida 3 who has had two low-segment transverse cesarean births.
B)  A gravida 2 who had a low-segment vertical incision for delivery of a 10-pound infant.
C)  A gravida 5 who had two vaginal births and two cesarean births.
D)  A gravida 4 who has had all cesarean births.

Question 13

Prepidil (prostaglandin gel)has been ordered for a pregnant woman at 43 weeks of gestation.The nurse recognizes that this medication will be 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.

Question 14

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

Accepted Answer

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

Question 15

The nurse is caring for a client whose labor is being augmented with oxytocin.He or she recognizes that the oxytocin should be discontinued immediately if there is evidence of:

Accepted Answer

A)  Uterine contractions occurring every 8 to 10 minutes.
B)  A fetal heart rate (FHR)  of 180 with absence of variability.
C)  The client's needing to void.
D)  Rupture of the client's amniotic membranes.

Question 16

A pregnant woman's amniotic membranes rupture.Prolapsed umbilical cord is suspected.What intervention would be the top priority?

Accepted Answer

A)  Placing the woman in the knee-chest position
B)  Covering the cord in sterile gauze soaked in saline
C)  Preparing the woman for a cesarean birth
D)  Starting oxygen by face mask

Question 17

The nurse providing care to a woman in labor should understand that cesarean birth:

Accepted Answer

A)  Is declining in frequency in the twenty-first century in the United States.
B)  Is more likely to be performed for poor women in public hospitals who do not receive the nurse counseling as do wealthier clients.
C)  Is performed primarily for the benefit of the fetus.
D)  Can be either elected or refused by women as their absolute legal right.

Question 18

Induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus.The charge nurse on the labor and delivery unit is often asked to schedule patients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction.These include (Select all that apply):

Accepted Answer

A)  Rupture of membranes at or near term.
B)  Convenience of the woman or her physician.
C)  Chorioamnionitis (inflammation of the amniotic sac) .
D)  Post-term pregnancy.
E)  Fetal death.

Question 19

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.

Question 20

The priority nursing care associated with an oxytocin (Pitocin)infusion is:

Accepted Answer

A)  Measuring urinary output.
B)  Increasing infusion rate every 30 minutes.
C)  Monitoring uterine response.
D)  Evaluating cervical dilation.

Exam 17: Labor and Birth Complications