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NursingOtherMaternal Newborn and Womens Health NursingPractice Set 5
NursingOtherMaternal Newborn and Womens Health NursingPractice Set 5Nursing Care During Labor And Birth
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- Maternity and Women’s Health Care TodaySocial, Ethical, and Legal IssuesReproductive Anatomy and PhysiologyHereditary and Environmental Influences on ChildbearingConception and Prenatal DevelopmentMaternal Adaptations to PregnancyAntepartum Assessment, Care, and EducationNutrition for ChildbearingAssessing the FetusComplications of PregnancyThe Childbearing Family with Special NeedsProcesses of BirthPain Management During ChildbirthIntrapartum Fetal SurveillanceNursing Care During Labor and BirthIntrapartum ComplicationsPostpartum Adaptations and Nursing CarePostpartum Maternal ComplicationsNormal Newborn: Processes of AdaptationAssessment of the Normal NewbornCare of the Normal NewbornInfant FeedingHigh-Risk Newborn: Complications Associated with Gestational Age and DevelopmentHigh-Risk Newborn: Acquired and Congenital ConditionsFamily PlanningInfertilityWomen’s Health
Question 1
Free
Multiple Choice
The nurse is preparing to perform Leopold's maneuvers. Please select the rationale for the consistent use of these maneuvers by obstetric providers?
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To determine the status of the membranes
To determine cervical dilation and effacement
To determine the best location to assess the fetal heart rate
To determine whether the fetus is in the posterior position
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Question 2
Free
Multiple Choice
Which comfort measure should the nurse utilize in order to enable a laboring woman to relax?
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Recommend frequent position changes.
Palpate her filling bladder every 15 minutes.
Offer warm wet cloths to use on the patient's face and neck.
Keep the room lights lit so the patient and her coach can see everything.
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Question 3
Free
Multiple Choice
Which assessment finding is an indication of hemorrhage in the recently delivered postpartum patient?
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Elevated pulse rate
Elevated blood pressure
Firm fundus at the midline
Saturation of two perineal pads in 4 hours
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Question 4
Free
Multiple Choice
Which intervention is an essential part of nursing care for a laboring patient?
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Helping the woman manage the pain
Eliminating the pain associated with labor
Feeling comfortable with the predictable nature of intrapartal care
Sharing personal experiences regarding labor and birth to decrease her anxiety
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Question 5
Free
Multiple Choice
A patient at 40 weeks' gestation should be instructed to go to a hospital or birth center for evaluation when she experiences
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increased fetal movement.
irregular contractions for 1 hour.
a trickle of fluid from the vagina.
thick pink or dark red vaginal mucus.
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Question 6
Multiple Choice
Which patient at term should proceed to the hospital or birth center the immediately after labor begins?
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Gravida 2, para 1, who lives 10 minutes away
Gravida 1, para 0, who lives 40 minutes away
Gravida 2, para 1, whose first labor lasted 16 hours
Gravida 3, para 2, whose longest previous labor was 4 hours
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Question 7
Multiple Choice
A woman who is gravida 3, para 2 enters the intrapartum unit. The most important nursing assessments include
Choose correct answer/s
contraction pattern, amount of discomfort, and pregnancy history.
fetal heart rate, maternal vital signs, and the woman's nearness to birth.
last food intake, when labor began, and cultural practices the couple desires.
identification of ruptured membranes, the woman's gravida and para, and access to a support person.
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Question 8
Multiple Choice
A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the patient to be
Choose correct answer/s
discharged home with a sedative.
admitted for extended observation.
admitted and prepared for a cesarean birth.
discharged home to await the onset of true labor.
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Question 9
Multiple Choice
The nurse auscultates the fetal heart rate and determines a rate of 152 bpm. Which nursing intervention is most appropriate at this time?
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Inform the mother that the fetal heart rate is normal.
Reassess the fetal heart rate in 5 minutes because the rate is too high.
Report the fetal heart rate to the physician or nurse-midwife immediately.
Suggest to the mother that she is going to have a boy because the heart rate is fast.
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Question 10
Multiple Choice
Which clinical finding would be an indication to the nurse that the fetus may be compromised?
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Active fetal movements
Fetal heart rate in the 140s
Contractions lasting 90 seconds
Meconium-stained amniotic fluid
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Question 11
Multiple Choice
The nurse is caring for a low-risk patient in the active phase of labor. At which interval should the nurse assess the fetal heart rate?
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Every 15 minutes
Every 30 minutes
Every 45 minutes
Every 1 hour
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Question 12
Multiple Choice
Which nursing assessment indicates that a patient who is in the second stage of labor is almost ready to give birth?
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Bloody mucous discharge increases.
The vulva bulges and encircles the fetal head.
The membranes rupture during a contraction.
The fetal head is felt at 0 station during the vaginal examination.
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Question 13
Multiple Choice
During labor a vaginal examination should be performed only when necessary because of the risk of
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infection.
fetal injury.
discomfort.
perineal trauma.
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Question 14
Multiple Choice
A 25-year-old primigravida patient is in the first stage of labor. She and her husband have been holding hands and breathing together through each contraction. Suddenly, the patient pushes her husband's hand away and shouts, "Don't touch me!" This behavior is most likely
Choose correct answer/s
a sign of abnormal labor progress.
an indication that she needs analgesia.
normal and related to hyperventilation.
common during the transition phase of labor.
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Question 15
Multiple Choice
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 infant's trunk is pink and the hands and feet are blue. The Apgar score for this infant is
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7.
8.
9.
10.
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Question 16
Multiple Choice
If a woman's fundus is soft 30 minutes after birth, the nurse's first action should be to
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massage the fundus.
take the blood pressure.
notify the physician or nurse-midwife.
place the woman in Trendelenburg position.
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Question 17
Multiple Choice
The nurse thoroughly dries the infant immediately after birth primarily to
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reduce heat loss from evaporation.
stimulate crying and lung expansion.
increase blood supply to the hands and feet.
remove maternal blood from the skin surface.
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Question 18
Multiple Choice
The nurse notes that a patient who has given birth 1 hour ago is touching her infant with her fingertips and talking to him softly in high-pitched tones. Based on this observation, which action should the nurse take?
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Request a social service consult for psychosocial support.
Observe for other signs that the mother may not be accepting of the infant.
Document this evidence of normal early maternal-infant attachment behavior.
Determine whether the mother is too fatigued to interact normally with her infant.
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Question 19
Multiple Choice
Which nursing diagnosis would take priority in the care of a primipara patient with no visible support person in attendance? The patient has entered the second stage of labor after a first stage of labor lasting 4 hours.
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Fluid volume deficit (FVD) related to fluid loss during labor and birth process
Fatigue related to length of labor requiring increased energy expenditure
Acute pain related to increased intensity of contractions
Anxiety related to imminent birth process
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Question 20
Multiple Choice
Which of the following behaviors would be applicable to a nursing diagnosis of "risk for injury" in a patient who is in labor?
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Length of second-stage labor is 2 hours.
Patient has received an epidural for pain control during the labor process.
Patient is using breathing techniques during contractions to maximize pain relief.
Patient is receiving parenteral fluids during the course of labor to maintain hydration.
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