ch 21 nursing management of labor and birth at risk

Question 1

after spontaneous rupture of membranes, the nurse notices a prolapsed cord. the nurse immediately pleas the woman in which position?

Answer 1

knee-chest

Question 2

a primagravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. the nurse would assess the woman for which condition?

Answer 2

fetopelvic disproportion

Question 3

which assessment finding will alert the nurse to be on the lookout for possible placental abruption during labor?

Answer 3

gestational hypertension

Question 4

a woman in labor is experiencing hypotonic uterine dysfunction. assessment reveals no fetopelvic disproportion. which group of medications would the nurse expect to administer?

Answer 4

uterine stimulants

Question 5

a woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. the nurse would be alert for which possible effect in the newborn?

Answer 5

cephalohematoma

Question 6

a pregnant client is undergoing labor induction and is receiving oxytocin infusion. which finding would require immediate intervention?

Answer 6

urine output of 20 ml/hour

Question 7

a woman with a history of crack cocaine use disorder is admitted to the labor and birth area. while caring for the client, the nurse notes a sudden onset of fetal bradycardia. inspection of the abdomen reveals an irregular wall contour. the client also reports acute abdominal pain that is continuous. which condition should the nurse expect?

Answer 7

uterine rupture

Question 8

a woman receives magnesium sulfate as treatment for preterm labor. the nurse assesses and maintains the infusion at the prescribed rate based on which finding?

Answer 8

decreased fetal heart rate variability

Question 9

the nurse is reviewing the physical examination findings for a client who is to undergo labor induction. which finding would indicate to the nurse that a woman’s cervix is ripe in preparation for labor induction?

Answer 9

shortened

Question 10

a woman with preterm labor is receiving magnesium sulfate. which finding would require the nurse to intervene immediately?

Answer 10

1+ deep tendon reflexes

Question 11

after teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching?

Answer 11

i’m going to have to wait a few days before i can start breastfeeding

Question 12

when describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage?

Answer 12

cervical dilation

Question 13

the nurse is providing care to several pregnant women who may be schedule for labor induction. the nurse identifies the woman with which bishop score as having he best chance for a successful induction and vaginal birth?

Answer 13

11

Question 14

a nurse is reviewing the medical record of a pregnant client. the nurse suspected that the client may be at risk for dystocia based on what factors? select all that apply.

Answer 14

-short maternal stature
-body mass index of 30.2
-breech fetal presentation

Question 15

a nurse is preparing an in service education program for a group of nurses about dystocia involving problems with passenger. which problem would the nurse likely include as the most common?

Answer 15

persistent occiput posterior position

Question 16

a nurse is conducting a review course on tocolytic therapy for perinatal nurses. after teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being use for tocolytic? select all that apply:

Answer 16

-nifedipine
-magnesium sulfate
-indomethacin

Question 17

a nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. the nurse determines that the teaching was successful when the woman makes which statement?

Answer 17

ill drink several glasses of water

Question 18

a nurse is describing the risks associated with post term pregnancies as part of an in service presentation. the nurse determines that more teaching is needed when the group identifies which factor as an underlying reading for problems in the fetus?

Answer 18

increased amniotic fluid volume

Question 19

a nurse is explaining to a group of nurses new to the labor and birth unit about methods used for cervical ripening. the group demonstrates understanding of the information when they identify which method as a mechanical one?

Answer 19

laminaria

Question 20

the nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. when reporting suspicion, which findings would the nurse include? select all that apply

Answer 20

-significant difficulty breathing
-tachycardia
-pulmonary edema
-bleeding with bruising

Question 21

a nurse is conducting an in service program for a group of labor and birth unit nurses about cesarean birth. the group demonstrates understanding of the information when they identify which conditions as appropriate indications? select all that apply

Answer 21

-active genital herpes infection
-placenta previa
-previous cesarean birth
-fetal distress

Question 22

a pregnant woman is receiving misoprostol to ripen her cervix and induce labor. the nurse assesses the woman closely for which effect?

Answer 22

uterine hyper stimulation

Question 23

a nurse is teaching a woman about measures to prevent preterm labor in future pregnancies because the woman just experienced preterm labor with her most recent pregnancy. the nurse determines that the teaching was successful based on which statement by the woman?

Answer 23

ill make sure to limit the amount of long distance traveling i do

Question 24

a woman at 31 weeks gestation calls the clinic and tells the nurse that she is having contractions sporadically. which instructions would be the most appropriate for the nurse to give the woman? select all that apply

Answer 24

-drink two or three glasses of water
-try emptying your bladder
-stop what you are doing and rest

Question 25

a pregnant client has received dinoprostone. following administration of this medication, the nurse assesses the client and determines that the client is experiencing an adverse effect of the medication based on which client report? select all that apply

Answer 25

-headache -nausea -diarrhea

Question 26

a nurse is reading a journal article about cesarean births and the indications from them. place the indications for cesarean brith below in proper sequence from the most frequent to least frequent. all options must be used

Answer 26

1. labor dystocia 2. abnormal fetal heart rate tracing 3. fetal malpresentation 4. multiple gestation 5. suspected macrosomia

Question 27

a nurse is taking history on a woman who is at 20 weeks gestation. the woman reports that she feels some heaviness in their thighs since yesterday. the nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? select all that apply

Answer 27

-dull low backache -viscous vaginal discharge -dysuria

Question 28

a pregnant client at 24 weeks gestation comes to the clinic for an evaluation. the client called the clinic earlier in the day stating that she had not felt the fetus move since yesterday evening. further assessment reveals absent fetal heart tones. intrauterine fetal demise is suspected. the nurse would expect to prepare the client for which testing to confirm the suspicion?

Answer 28

ultrasound

Question 29

a 32 year old black woman in her second trimester has come to the clinic for an evaluation. while interviewing the client, she reports a history of fibroids and urinary tract infection. the client states, “i know smoking is bad and i have tried to stop, but it is impossible. i have cut down quite a bit though, and i do not drink alcohol.” complete blood count results reveal a low red blood cell count, low hemoglobin, and low hematocrit. when planning this client’s care, which factors would the nurse identify and increasing the clients risk for preterm labor? select all that apply

Answer 29

-african heritage -history of fibroids -cigarette smoking -history of urinary tract infections -complete blood count results

Question 30

a pregnant client at 30 weeks gestation calls the clinic because she thinks that she may be in labor. to determine if the client is experiencing labor, which questions would be appropriate to ask? select all that apply

Answer 30

-are you feeling any pressure or heaviness in your pelvis? -are you having contractions that come and go, on and off? -have you noticed any liquid coming from your vagina? -have you been having nausea or vomiting