Question 1

Which of the following should the nurse be aware of with regard to induction of labour?

Accepted Answer

A)   It can be achieved by external and internal version techniques.
B)   It is also known as a trial of labour (TOL) .
C)   It is always done for medical reasons.
D)   It is rated for viability by a Bishop score. D

Question 2

Prepidil (prostaglandin gel)has been ordered for a pregnant woman at 43 weeks of gestation.The nurse knows that this medication will be administered for which of the following reasons?

Accepted Answer

A)   It will enhance uteroplacental perfusion in an aging placenta.
B)   It will increase amniotic fluid volume.
C)   It will ripen the cervix in preparation for labour induction.
D)   It will stimulate the amniotic membranes to rupture. C

Question 3

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

Question 4

What should the nurse be aware of with regard to the process of augmentation of labour?

Accepted Answer

A)   It is active management of labour instituted when the labour process is not satisfactory.
B)   It relies on more invasive methods when oxytocin and amniotomy have failed.
C)   It is a modern management term to cover up the negative connotations of forceps-assisted birth.
D)   It uses vacuum cups to actively assist with the birth of the baby.

Question 5

In planning for home care of a woman with preterm labour,the nurse needs to address which concern?

Accepted Answer

A)   Nursing assessments will be different from those done in the hospital setting.
B)   Restricted activity and medications will be necessary to prevent recurrence of preterm labour.
C)   Prolonged bed rest may cause tension because of confinement.
D)   Home health care providers will be necessary.

Question 6

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

Accepted Answer

A)   Place the woman in the knee-chest position.
B)   Cover the cord in sterile gauze soaked in saline.
C)   Prepare the woman for a Caesarean birth.
D)   Start oxygen by face mask.

Question 7

What should the nurse be aware of with regard to Caesarean birth when providing care to a woman in labour?

Accepted Answer

A)   Caesarean births are declining in frequency in the twenty-first century in Canada.
B)   A Caesarean birth is more likely to be done for convenience than for medical risk.
C)   A Caesarean is performed primarily for the benefit of the fetus.
D)   A Caesarean birth can be either elected or refused by women as their absolute legal right.

Question 8

A woman in preterm labour at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly.What is the purpose of this pharmacological treatment?

Accepted Answer

A)   It stimulates fetal surfactant production.
B)   It reduces maternal and fetal tachycardia associated with ritodrine administration.
C)   It suppresses uterine contractions.
D)   It maintains adequate maternal respiratory effort and ventilation during magnesium sulphate therapy.

Question 9

What should the nurse be aware of in the use of tocolytic therapy to suppress uterine activity?

Accepted Answer

A)   The drugs can be given efficaciously up to the designated beginning of term at 37 weeks.
B)   There are no important maternal (as opposed to fetal)  contraindications.
C)   Its most important function is to afford the opportunity to administer antenatal glucocorticoids.
D)   If the patient develops pulmonary edema while on tocolytics, intravenous (IV)  fluids should be given.

Question 10

Which of the following may occur after 37 weeks of gestation when a fetus is in a transverse lie?

Accepted Answer

A)   Preterm birth
B)   Internal version
C)   Fetal distress
D)   External cephalic version

Question 11

While caring for a patient whose labour is being augmented with oxytocin,the nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of which of the following?

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 patient needing to void
D)   Rupture of the patient's amniotic membranes

Question 12

What should the nurse be aware of for the care management of preterm labour?

Accepted Answer

A)   Because all women must be considered at risk for preterm labour 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 labour.
C)   Because preterm labour is likely to be the start of an extended labour, a woman with symptoms can wait several hours before contacting the primary caregiver.
D)   The diagnosis of preterm labour is based on gestational age, uterine activity, and progressive cervical change.

Question 13

What should the nurse be aware of with regard to the process of inducing labour?

Accepted Answer

A)   Ripening the cervix usually results in a decreased success rate for induction.
B)   Labour sometimes can be induced with balloon catheters or laminaria tents.
C)   Oxytocin is less expensive than prostaglandins and more effective but has greater health risks.
D)   Amniotomy can be used to make the cervix more favourable for labour.

Question 14

Which of the following infections is not thought to be a major factor in many preterm labours?

Accepted Answer

A)   Viral
B)   Periodontal
C)   Measles
D)   Common cold

Question 15

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

Accepted Answer

A)   "After the baby is born."
B)   "When we can stabilize your preterm labour and arrange home health visits."
C)   "Whenever the doctor says that it is okay."
D)   "It depends on the results of the fern test."

Question 16

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

Accepted Answer

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

Question 17

What assessment is least likely to be associated with a breech presentation?

Accepted Answer

A)   Meconium-stained amniotic fluid
B)   Fetal heart tones heard at or above the maternal umbilicus
C)   Preterm labour and birth
D)   Postterm gestation

Question 18

A woman is having her first child.She has been in labour for 15 hours.Two hours ago,her vaginal examination revealed the cervix to be dilated to 5 cm and 100% effaced,and the presenting part was at station 0.Five minutes ago,her vaginal examination indicated that there had been no change.What abnormal labour pattern is associated with this description?

Accepted Answer

A)   Primary prolonged latent phase
B)   Protracted active phase
C)   Secondary arrest of active phase
D)   Protracted descent

Question 19

In evaluating the effectiveness of nitroglycerin for the treatment of preterm labour,what finding would alert the nurse to possible adverse effects?

Accepted Answer

A)   Urine output of 160 mL in 4 hours
B)   Deep tendon reflexes 2+ and no clonus
C)   Blood pressure of 80/46
D)   Serum magnesium level of 10 mg/dL

Question 20

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions.What clinical cue would alert the nurse that the woman is experiencing uterine hyperstimulation?

Accepted Answer

A)   Uterine contractions lasting 2 minutes in frequency
B)   Uterine contractions lasting >60 seconds and occurring >3 minutes in frequency
C)   Uterine tone 15 mm Hg
D)   Uterine tone 10 mm Hg

Exam 19: Labour and Birth at Risk