ans:a
Correct
.One complication of an amniotomy is prolapse of the umbilical cord. Cord compression can be diagnosed by observing for variable decelerations or a decrease in the fetal heart rate. Maternal blood pressure, pulse, and fetal variability are a
1. Immediately following an amniotomy to observe for complications, the nurse must assess the
A. fetal heart rate.
B. maternal blood pressure.
C. maternal pulse.
D. fetal heart rate variability.
ans:c
Correct
With interruption of the membrane barrier, vaginal organisms have free access to the uterine cavity and may cause chorioamnionitis. Assessing the maternal temperature every 2 to 4 hours will be necessary to monitor for signs of infection.
A laboring woman just had an amniotomy performed to augment labor. The nurse is aware that the assessment times for which vital signs will be altered?
A. Maternal blood pressure
B. Maternal pulse
C. Maternal temperature
D. Maternal respiration
ans:c
Correct
An induction of labor would be contraindicated in a woman with placenta previa. The labor would most likely result in hemorrhaging. Options a, b, and d are all indications for induction.
When admitting a patient for induction of labor, the nurse will question the procedure if which one of the following observations is on the patient's prenatal record?
A. Spontaneous rupture of membranes 24 hours ago, with no labor
B. 42-week gestation
C.
ans:c
Correct
The uterine resting tone should have at least 30 seconds between contractions. This woman has a resting time of 20 seconds. The fetal heart rate and variability show no compromise at this time; however, hypertonic contractions can lead to de
A woman is receiving oxytocin for labor induction. The nurse notices the woman is having contractions every 2 minutes lasting for 100 seconds. The fetal heart rate is 120 to 130 bpm, with moderate variability. The nurse's next action should be to
A. conti
ans:b
Correct
Because of the drop in the fetal heart rate, the fetus should be delivered quickly. Since the woman is fatigued and no longer pushing effectively, assistance is needed. The head is at +3 station, so a low operative vaginal birth is quicker t
While caring for a woman who is 10 cm dilated, is pushing, but is fatigued and her pushing efforts are ineffective, the nurse notices that the fetal heart rate has dropped to 85 bpm. The station is +3. The nurse can anticipate
A. a cesarean section.
B. a
ans:b
Correct
Amniotomy may be used to stimulate labor that slows after it is established.
A 39-week-gestation gravida 1 is 6 cm dilated. Membranes are intact. The labor contractions have decreased in intensity, and she has not dilated in the past 2 hours. A diagnosis of hypotonic dysfunctional labor has been made. The nurse can anticipate whic
ans:b
Correct
Epidural analgesia may cause a loss of sensation, so the woman cannot feel the urge to push. The practice of laboring down, or delayed pushing�encouraging the woman to wait until she feels the reflexive urge to push�has shown a lower inciden
A woman has reached 10 cm and is attempting to push. She had an epidural and is unable to feel the urge to push. The nurse can best assist her by
A. allowing the epidural to wear off and then have her push.
B. letting her labor down, that is delaying push
ans:c
Correct
During shoulder dystocia, the shoulders of the fetus are pushed hard against the symphysis and fractures of the clavicle may occur during the birth. The infant's clavicles should be checked for crepitus, deformity, and bruising, which sugges
During birth, shoulder dystocia was diagnosed. After the birth and the newborn has been stabilized, it is important for the nurse to assess the newborn for
A. hip dysplasia.
B. lung excursion.
C. fractured clavicles.
D. clubfoot.
ans:a
Correct
The hands and knees position encourages the fetus to rotate into an anterior position. This will decrease the back pain and increase the descent of the fetal head. A prone position is contraindicated with a pregnant woman. Massaging her back
A fetus is in the posterior position. The woman is complaining of back labor and the labor is prolonged. The nurse can best assist the mother with this problem by
A. placing her in a hands and knees position.
B. placing her in a prone position.
C. massagi
ans:c
Correct
Fetal heart tones are located in the upper quadrants when the fetus is in a breech presentation. A cesarean birth is usually performed for breech presentations in primigravid women to avoid complications, such as a prolapsed cord.
A gravida 1 woman who is 39 weeks of gestation and has had no prenatal care is admitted into the labor unit in early labor. During the assessment, the nurse finds the fetal heart tones in the right upper quadrant. The nurse should anticipate
A. a precipit
ans:a
Correct
During labor, a full bladder is a common soft tissue obstruction. Bladder distention reduces available space in the pelvis and intensifies maternal discomfort. An epidural decreases the woman's sensation of the need to void, and the extra fl
A woman with an epidural has been pushing for the past 2 hours with very little progression. An appropriate nursing action at this point is to
A. assess for a full bladder.
B. assess for a full colon.
C. allow the woman to rest for two or three contractio
ans:c
Correct
Both mother and newborn are at risk for infection during the postpartum period after premature rupture of the membranes.
A woman had premature rupture of the membranes at 37 weeks of gestation. She went into labor within 10 hours and delivered a 7 lb, 12 oz boy after a 12-hour labor. In planning care for the newborn, it is important to monitor him for
A. respiratory distres
ans:d
Correct
Calcium loss from bones can begin as early as 3 days after the onset of bed rest. Weight loss, constipation, and a decrease in plasma volume and cardiac output are associated with bed rest.
Research has found that bed rest as an intervention for preventing preterm labor can result in
A. maternal weight gain.
B. diarrhea.
C. increased maternal plasma volume and cardiac output.
D. bone demineralization, with calcium loss.
ans:a
Correct
A constant low backache is a common symptom of preterm labor. She needs to be evaluated as soon as possible. Drinking fluids has not been proven to stop preterm labor but decreases uterine irritability.
A woman who is 27 weeks pregnant calls the clinic and complains of constant low backache. The nurse should
A. have the woman come in to be evaluated.
B. have the woman call back in 1 day if the backache does not improve.
C. have the woman call back if the
ans:a
Correct
Fetal fibronectin is normally found in the vaginal secretions until about 20 weeks' gestation and again at term. If it is found between those dates, it suggests early labor. A negative report indicates that the woman is at low risk for labor
A nurse is reviewing the charts of antepartal patients. A 28-week-gestation woman's fetal fibronectin report has returned, with negative results. The nurse should
A. document this report.
B. notify the health care provider.
C. document the need to do pati
ans:c
Correct
The most common side effect of terbutaline is maternal and fetal tachycardia.
A woman who has been admitted for preterm labor is started on terbutaline (Brethine) to decrease uterine irritability. Within 24 hours, the contractions have stopped and the woman is resting comfortably. During vital sign assessment the nurse records a bl
ans:a
Correct
Magnesium sulfate can lead to fluid overload, which can cause pulmonary edema. Assessing lung sounds every hour will alert the nurse to changes. Bowel sounds should be checked every 4 to 8 hours. Magnesium sulfate should not affect the lower
A woman is receiving magnesium sulfate intravenously to control preterm labor. She is at the maximum dose and the contractions have slowed to eight/hr. The nurse is assessing the woman's vital signs every hour. In addition to blood pressure, pulse, and re
ans:c
Correct
Nifedipine is a vasodilator, so the woman may be prone to postural hypotension. She needs to be assisted when sitting or standing and taught about the effects of postural hypotension.
A woman admitted with preterm labor is started on nifedipine (Procardia) to reduce uterine muscle contractions. The nurse should include in this woman's care plan a nursing diagnosis of
A. risk for deficient fluid volume.
B. risk for infection.
C. risk fo
ans:b
Correct
By dates, her EDD was March 9. To determine proper management of her pregnancy, it will be necessary to determine whether the fetus is thriving in the uterus. Ultrasounds at this stage are not accurate for fetal age.
A woman came in for a prenatal check up on March 15. She tells the nurse that her last normal menstrual period was June 2. The nurse is aware that she will be scheduled for
A. immediate birth.
B. testing to determine fetal well-being.
C. follow-up appoint
ans:b
Correct
A fetus that is in a high station is at high risk for a prolapsed cord when the membranes rupture.
Which one of the following laboring women is at highest risk for a prolapsed cord? All the women have intact membranes and are cephalic presentations.
A. Gravida 3, station +2, cervix 7 cm, and 100% effaced
B. Gravida 1, station ?2-2, cervix 3 cm, and 50%
ans:c
Correct
During a dehiscence of an old uterine scar, little or no bleeding may occur. No signs or symptoms may exist, and the rupture may be found incidentally during a subsequent cesarean birth or other abdominal surgery.
Which type of uterine rupture may go undiagnosed during labor and the postpartum period?
A. Complete rupture
B. Incomplete rupture
C. Dehiscence
D. All the ruptures are detectable by electronic uterine monitoring.
ans:a
Correct
These are symptoms of an anaphylactoid syndrome or an embolism. The nurse should remain with the woman, but needs assistance to notify the health care provider and start oxygen. The woman may be in need of cardiopulmonary resuscitation and s
A woman delivered a baby boy 30 minutes ago. The labor and birth were uneventful. The nurse is assessing the woman's vital signs when the woman suddenly complains of chest pain and difficulty breathing. The vital signs show a decreased blood pressure and
ans: turtle sign
If the head retracts against the perineum after the birth, it is commonly referred to as the __________________.
ans: precipitous labor
The term that describes a labor lasting 3 hours or less is ____________.