Intrapartum Complications

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Maternity and Women’s Health Care Today
Social, Ethical, and Legal Issues
Reproductive Anatomy and Physiology
Hereditary and Environmental Influences on Childbearing
Conception and Prenatal Development
Maternal Adaptations to Pregnancy
Antepartum Assessment, Care, and Education
Nutrition for Childbearing
Assessing the Fetus
Complications of Pregnancy
The Childbearing Family with Special Needs
Processes of Birth
Pain Management During Childbirth
Intrapartum Fetal Surveillance
Nursing Care During Labor and Birth
Intrapartum Complications
Postpartum Adaptations and Nursing Care
Postpartum Maternal Complications
Normal Newborn: Processes of Adaptation
Assessment of the Normal Newborn
Care of the Normal Newborn
Infant Feeding
High-Risk Newborn: Complications Associated with Gestational Age and Development
High-Risk Newborn: Acquired and Congenital Conditions
Family Planning
Infertility
Women’s Health

All Questions

Question 1

Free

Multiple Choice

Which pelvic shape is most conducive to vaginal labor and birth?

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Android

Gynecoid

Platypelloid

Anthropoid

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Question 2

Free

Multiple Choice

Which action by the nurse prevents infection in the labor and birth area?

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Using clean techniques for all procedures

Keeping underpads and linens as dry as possible

Cleaning secretions from the vaginal area by using a back to front motion

Performing vaginal examinations every hour while the patient is in active labor

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Question 3

Free

Multiple Choice

A pregnant patient with premature rupture of membranes is at higher risk for postpartum infection. Which assessment data indicates a potential infection?

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Fetal heart rate, 150 beats/minute

Maternal temperature, 37.2°C (99°F)

Cloudy amniotic fluid, with strong odor

Lowered maternal pulse and decreased respiratory rates

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Question 4

Free

Multiple Choice

A patient with polyhydramnios is admitted to a labor-birth-recovery-postpartum (LDRP) suite. Her membranes rupture and the fluid is clear and odorless; however, the fetal heart monitor indicates bradycardia and variable decelerations. Which action should be taken next?

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Perform Leopold maneuvers.

Perform a vaginal examination.

Apply warm saline soaks to the vagina.

Place the patient in a high Fowler position.

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Question 5

Free

Multiple Choice

Which technique is least effective for the patient with persistent occiput posterior position?

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Squatting

Lying supine and relaxing

Sitting or kneeling, leaning forward with support

Rocking the pelvis back and forth while on hands and knees

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Question 6

Multiple Choice

Birth for the nulliparous patient with a fetus in a breech presentation is usually

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cesarean birth.

vaginal birth.

vacuumed extraction.

forceps-assisted birth.

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Question 7

Multiple Choice

Which patient situation presents the greatest risk for the occurrence of hypotonic dysfunction during labor?

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A primigravida who is 17 years old

A 22-year-old multiparous patient with ruptured membranes

A primigravida who has requested no analgesia during her labor

A multiparous patient at 39 weeks of gestation who is expecting twins

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Question 8

Multiple Choice

Which factor is most likely to result in fetal hypoxia during a dysfunctional labor?

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Incomplete uterine relaxation

Maternal fatigue and exhaustion

Maternal sedation with narcotics

Administration of tocolytic drugs

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Question 9

Multiple Choice

After a birth complicated by a shoulder dystocia, the infant's Apgar scores were 7 at 1 minute and 9 at 5 minutes. The infant is now crying vigorously. The nurse in the birthing room should

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palpate the infant's clavicles.

encourage the parents to hold the infant.

perform a complete newborn assessment.

give supplemental oxygen with a small face mask.

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Question 10

Multiple Choice

A laboring patient in the latent phase is experiencing uncoordinated irregular contractions of low intensity. How should the nurse respond to complaints of constant cramping pain?

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"You are only 2 cm dilated, so you should rest and save your energy for when the contractions get stronger."

"Let me take off the monitor belts and help you get into a more comfortable position."

"You must breathe more slowly and deeply so there is greater oxygen supply for your uterus. That will decrease the pain."

"I have notified the doctor that you are having a lot of discomfort. Let me rub your back and see if that helps."

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Question 11

Multiple Choice

Which nursing action should be initiated first when there is evidence of prolapsed cord?

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Notify the health care provider.

Apply a scalp electrode.

Prepare the mother for an emergency cesarean birth.

Reposition the mother with her hips higher than her head.

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Question 12

Multiple Choice

A patient who has had two previous cesarean births is in active labor when she suddenly complains of pain between her scapulae. Which should be the nurse's priority action?

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Notify the health care provider promptly.

Observe for abnormally high uterine resting tone.

Decrease the rate of nonadditive intravenous fluid.

Reposition the patient with her hips slightly elevated.

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Question 13

Multiple Choice

Which factor should alert the nurse to the potential for a prolapsed umbilical cord?

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Oligohydramnios

Pregnancy at 38 weeks of gestation

Presenting part at a station of -3

Meconium-stained amniotic fluid

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Question 14

Multiple Choice

The fetus in a breech presentation is often born by cesarean birth because

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the buttocks are much larger than the head.

compression of the umbilical cord is more likely.

internal rotation cannot occur if the fetus is breech.

postpartum hemorrhage is more likely if the patient delivers vaginally.

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Question 15

Multiple Choice

A patient who is 32 weeks pregnant telephones the nurse at her obstetrician's office and complains of constant backache. She asks what pain reliever is safe for her to take. The best nursing response is

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"You should come into the office and let the doctor check you."

"Acetaminophen is acceptable during pregnancy. You should not take aspirin, however."

"Back pain is common at this time during pregnancy because you tend to stand with a sway back."

"Avoid medication because you are pregnant. Try soaking in a warm bath or using a heating pad on low before taking any medication."

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Question 16

Multiple Choice

Which is the priority nursing assessment for the patient undergoing tocolytic therapy with terbutaline (Brethine)?

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Intake and output

Maternal blood glucose level

Internal temperature and odor of amniotic fluid

Fetal heart rate, maternal pulse, and blood pressure

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Question 17

Multiple Choice

Which clinical finding during assessment indicates uterine rupture?

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Fetal tachycardia occurs.

The patient becomes dyspneic.

Labor progresses unusually quickly.

Contractions abruptly stop during labor.

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Question 18

Multiple Choice

Which intervention should be incorporated in the plan of care for a labor patient who is experiencing hypertonic labor? Vaginal exam is unchanged from prior exam-3 cm, 80% effaced, and 0 station presenting part vertex.

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Augmentation of labor with oxytocin (Pitocin)

AROM

Performing a vaginal exam to denote progress

Preparing the patient for epidural administration as ordered by the physician

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Question 19

Multiple Choice

During the course of the birth process, the physician suspects that a shoulder dystocia is occurring and asks the nurse for assistance. Which priority action should be taken in response to this request?

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Put pressure on the fundus.

Ask the physician if he or she would like you to prepare for a surgical method of birth.

Tell the patient not to push until you prepare the vacuum extraction device for physician.

Reposition the patient to facilitate birth.

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Question 20

Multiple Choice

A pregnant patient who has had a prior obstetric history of preterm labors is pregnant with her third child. The physician has ordered a fetal fibronectin test. Which instructions should be given to the patient regarding this clinical test?

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Patient must be NPO prior to testing.

Blood work will be drawn every week to help confirm the start of preterm labor.

Patient should refrain from sexual activity prior to testing.

A urine specimen will be collected for testing.

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