Question 1

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

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. C

Question 2

What sign(s)of infection should the nurse assess for after an amniotomy?

Accepted Answer

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

Question 3

A woman 2 weeks past her expected delivery date is receiving an oxytocin infusion to induce labor and begins to have contractions every 90 seconds.What is the nurse's initial action?

Accepted Answer

A)   Stop the oxytocin infusion.
B)   Continue the infusion and report the findings to the physician.
C)   Turn her on her left side and reassess the contractions.
D)   Administer oxygen by mask. A

Question 4

How might the nurse instruct the patient to stimulate her nipples in an attempt to increase the quality of uterine contractions? (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 her hands down on her breasts.

Question 5

A new mother is distressed and tearful about the elevated dome over her infant's posterior fontanelle.The nurse responds,"This condition will resolve itself in a few days." What is the cause?

Accepted Answer

A)   Prolonged pressure against the partially dilated cervix
B)   Small leak of fluid through the posterior fontanelle
C)   Pressure of the forceps during delivery
D)   The effect of the vacuum extractor

Question 6

Several hours after delivery,the nurse finds a woman crying.The woman says repeatedly,"My baby is beautiful,but I was planning on a vaginal delivery.Instead I needed an emergency C-section." What is the most appropriate nursing diagnosis?

Accepted Answer

A)   Anxiety related to the development of postpartum complications
B)   Ineffective individual coping related to unfamiliarity with procedures
C)   Risk for ineffective parenting related to emergency cesarean section
D)   Grieving related to loss of expected birth experience

Question 7

A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously.What complication should the nurse closely assess for with this patient?

Accepted Answer

A)   Chorioamnionitis
B)   Hemorrhage
C)   Hypotension
D)   Amniotic fluid embolism

Question 8

A student nurse questions the instructor regarding what alteration should be made for the assessment of the fundus of a new postoperative cesarean section patient.What is the best response?

Accepted Answer

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

Question 9

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

Accepted Answer

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

Question 10

A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to 5 cm with membranes intact.What action by the physician will the nurse anticipate?

Accepted Answer

A)   Perform an amniotomy.
B)   Initiate tocolytic drugs.
C)   Order a sedative for the patient.
D)   Plan to do an emergency cesarean section.

Question 11

The nurse is caring for a patient diagnosed with hypotonic labor dysfunction.What will the nurse expect when caring for this patient?

Accepted Answer

A)   Elevated uterine resting tone
B)   Painful and poorly coordinated contractions
C)   Implementation of fluid restriction
D)   Use of frequent position changes

Question 12

What nursing care should be provided to a woman with a third-degree laceration immediately after delivery?

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 13

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

Accepted Answer

A)   Report any increase in fetal activity.
B)   Notify her obstetrician if she has a temperature above 37.8° C (100° F) .
C)   Massage her breasts to promote uterine relaxation.
D)   Rest in a side-lying Trendelenburg's position with hips elevated.

Question 14

Which interventions could a nurse apply to help stimulate contractions? (Select all that apply. )

Accepted Answer

A)   Encouraging the patient to sit upright
B)   Assisting the patient to ambulate
C)   Stimulating the nipples
D)   Offering emotional support
E)   Allowing the patient to vent frustration

Question 15

What nursing assessment should be reported immediately after an amniotomy?

Accepted Answer

A)   Fetal heart rate is regular at 154 beats/minute.
B)   Amniotic fluid is clear with flecks of vernix.
C)   Amniotic fluid is watery and pale green.
D)   Maternal temperature is 37.8° C.

Question 16

What complications of overstimulation of uterine contractions may occur? (Select all that apply. )

Accepted Answer

A)   Water intoxication
B)   Impaired placental exchange of oxygen and nutrients
C)   Increased blood pressure
D)   Convulsions
E)   Uterine rupture

Question 17

A woman is 37 weeks pregnant and questioning the nurse about possible induction of labor at term.What conditions would contraindicate labor induction? (Select all that apply. )

Accepted Answer

A)   Maternal gynecoid pelvis
B)   Placenta previa
C)   Horizontal cesarean incision
D)   Prolapsed cord
E)   Gestational diabetes

Question 18

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.What is this labor pattern considered?

Accepted Answer

A)   Normal
B)   Hypotonic
C)   Hypertonic
D)   False

Question 19

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.How can anxiety affect labor?

Accepted Answer

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

Question 20

A frustrated patient in labor has been affected by decreased uterine muscle tone and reports,"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?" What is the lowest Bishop score the patient should have prior to induction?

Accepted Answer

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

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