OB exam 3 Ch 15-18,21

Question 1

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the
decelerations occurring after the peak of the contraction. The nurses first priority is to:

Answer 1

change the womens position

Question 2

The nurse caring for the laboring woman should understand that early decelerations are caused by:

Answer 2

Altered fetal cerebral blood flow.

Question 3

The nurse providing care for the laboring woman should understand that late deceleration fhr is caused by

Answer 3

Uteroplacental insufficiency.

Question 4

The nurse caring for the woman in labor should understand that maternal hypotension can result in:

Answer 4

change in positions

Question 5

What three measures should the nurse implement to provide intrauterine resuscitation? Select the response
that best indicates the priority of actions that should be taken.

Answer 5

Reposition the mother, increase intravenous (IV) fluid, and provide oxygen via face mask.

Question 6

As a perinatal nurse you realize that a fetal heart rate that is tachycardic, is bradycardic, or has late
decelerations or loss of variability is nonreassuring and is associated with:

Answer 6

Hypoxemia.

Question 7

What is an advantage of external electronic fetal monitoring?

Answer 7

The tocotransducer is especially valuable for measuring uterine activity during the first stage of
labor.

Question 8

When assessing the relative advantages and disadvantages of internal and external electronic fetal
monitoring, nurses comprehend that both:

Answer 8

Can be used during the antepartum and intrapartum periods.

Question 9

Why is continuous electronic fetal monitoring usually used when oxytocin is administered?

Answer 9

Uteroplacental exchange may be compromised.

Question 10

A nulliparous woman who has just begun the second stage of her labor would most likely:

Answer 10

Feel tired yet relieved that the worst is over.

Question 11

The nurse knows that the second stage of labor, the descent phase, has begun when:

Answer 11

The woman experiences a strong urge to bear down.

Question 12

Through vaginal examination the nurse determines that a woman is 4 cm dilated, and the external fetal
monitor shows uterine contractions every 3.5 to 4 minutes. The nurse would report this as:

Answer 12

First stage, active phase.

Question 13

The most critical nursing action in caring for the newborn immediately after birth is:

Answer 13

Keeping the newborns airway clear.

Question 14

At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is
110 bpm, and the infant is crying vigorously with the limbs flexed. The infants trunk is pink, but the hands and
feet are blue. What is the correct Apgar score for this infant?

Answer 14

9

Question 15

The nurse providing care for a woman with preterm labor who is receiving terbutaline would include which
intervention to identify side effects of the drug?

Answer 15

Assessing for chest discomfort and palpitations

Question 16

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone
intramuscularly. The purpose of this pharmacologic treatment is to:

Answer 16

Stimulate fetal surfactant production.

Question 17

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

Answer 17

Placing the woman in the knee-chest position

Question 18

As relates to the use of tocolytic therapy to suppress uterine activity, nurses should be aware that:

Answer 18

Its most important function is to afford the opportunity to administer antenatal glucocorticoids

Question 19

Nurses should be aware that the induction of labor

Answer 19

Is rated for viability by a Bishop score.

Question 20

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.

Answer 20

viral

Question 21

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

Answer 21

A gravida 4 who has had all cesarean births.

Question 22

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

Answer 22

Tocolytic drug.

Question 23

Complications and risks associated with cesarean births include (Select all that apply):

a. Placental abruption.
b. Wound dehiscence.
c. Hemorrhage.
d. Urinary tract infections.
e. Fetal injuries.

Answer 23

B,C,D,E

Question 24

Which woman is most likely to experience strong afterpains?

Answer 24

A woman who is a gravida 4, para 4-0-0-4

Question 25

A woman gave birth to a 7-pound, 3-ounce infant boy 2 hours ago. The nurse determines that the womans bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is:

Answer 25

Excessive uterine bleeding.

Question 26

A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal, and the estimated blood loss (EBL) was approximately 1500 mL. When assessing the womans vital signs, the nurse would be concerned to see:

Answer 26

Temperature 37.9 C, heart rate 120, respirations 20, blood pressure (BP) 90/50.

Question 27

Which statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth?

Answer 27

My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles.

Question 28

The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is called the:

Answer 28

Puerperium, or fourth trimester of pregnancy.