Complications Labor & Birth Test Bank Answers Ch10 - Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack by Luanne Linnard Palmer. DOCX document preview.
Chapter 10: Nursing Care of the Woman With Complications During Labor and Birth
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A 28-year-old woman is a primipara who is pregnant with triplets, is at 18 weeks’ gestation, and is receiving regular prenatal care. The nurse identifies a risk for preterm labor related to which factor?
1) | The patient’s age |
2) | 18 weeks’ gestation |
3) | Multiple gestations |
4) | Previous obstetric history |
____ 2. The presence of fetal fibronectin (tFN) is confirmed in the vaginal fluid of a multipara patient at 25 weeks’ gestation. The nurse recognizes that this patient is at risk for what complication?
1) | Polyhydramnios |
2) | Preterm labor |
3) | Umbilical cord prolapse |
4) | Oligohydramnios |
____ 3. Which of the following is a sign of magnesium sulfate toxicity?
1) | Blood pressure of 140/80 |
2) | GI upset |
3) | Respiratory rate of 12 |
4) | Hyperactive deep tendon reflexes |
___ 4. A pregnant patient reports leakage of fluid, vaginal discharge, and pelvic pressure but no contractions. What action should the nurse perform to verify the presence of amniotic fluid?
1) | Amniocentesis |
2) | Nitrazine paper test |
3) | Cervical examination |
4) | Ultrasound |
___ 5. The nurse is caring for a patient at 37 weeks’ gestation who experienced premature rupture of membranes (PROM). Which assessment finding would indicate possible chorioamnionitis?
1) | Temperature of 37°C |
2) | Presence of amniotic fluid |
3) | Elevated heart rate |
4) | Hypertension |
____ 6. Which of the following is a fetal risk associated with post-term labor?
1) | Perineal injury |
2) | Sudden infant death syndrome (SIDS) |
3) | Patent ductus arteriosus (PDA) |
4) | Meconium aspiration |
____ 7. A patient is approaching 42 weeks’ gestation and has been admitted for induction of labor. The patient tells the nurse that she does not want an induction and prefers to wait for labor to begin naturally. Which is the nurse’s best response?
1) | “Waiting for labor to begin naturally could result in the death of your baby.” |
2) | “The longer you wait, the bigger the baby gets and the harder delivery will be.” |
3) | “Complications for you and your baby increase after 42 weeks of gestation.” |
4) | “If you had controlled your weight gain during pregnancy, you might have gone into natural labor.” |
____ 8. The nurse is providing teaching to a patient with oligohydramnios. What should the nurse include in the teaching session?
1) | “You will need to begin taking indomethacin.” |
2) | “You will need to have the excess amniotic fluid drained.” |
3) | “You should drink at least 2 liters of water per day.” |
4) | “You are at risk of preterm labor because of the increased uterine size.” |
____ 9. A laboring patient woman with a history of sexual abuse is experiencing anxiety and flashbacks of previous abuse. Which of the seven Ps is impacting her labor?
1) | Psyche |
2) | Pain |
3) | Powers |
4) | Position |
____ 10. A laboring patient’s water breaks, and the umbilical cord protrudes from the vagina. The nurse immediately places the patient in the Trendelenburg position. Which of the seven Ps is most impacted?
1) | Passage |
2) | Pain |
3) | Powers |
4) | Position |
____ 11. The fetus of a laboring patient is found to be in a breech position, and the nurse prepares the patient for a cesarean section. The patient asks, “Can’t I try to deliver vaginally?” Which is the nurse’s best response?
1) | “If the fetus has CPD, it could result in serious complications for you and the baby.” |
2) | “A fetus in the breech position causes labor to progress more slowly.” |
3) | “We’ll have to talk to the delivering provider to see if that is even possible.” |
4) | “When the fetus is breech, a cesarean section is the safest choice for you and the baby.” |
____ 12. Which of the following is a factor associated with macrosomia?
1) | Female fetus |
2) | Maternal weight loss |
3) | Gestational diabetes |
4) | Caucasian ethnicity of the mother |
____ 13. A laboring woman’s membranes rupture, and the umbilical cord prolapses. The nurse notifies the provider and prepares the patient for an immediate cesarean section. The patient asks, “Why is a cesarean section necessary?” Which is the nurse’s best response?
1) | “It is our policy to always perform a cesarean section when there is a prolapsed cord.” |
2) | “The baby could die if we don’t rush to deliver it, and a cesarean section is the fastest method.” |
3) | “A cesarean section is needed to save your life and prevent the risk of hemorrhaging.” |
4) | “The baby cannot be born vaginally without crimping off blood supply through the cord.” |
____ 14. The nurse is discussing nursing interventions for a patient with umbilical cord prolapse with a student nurse. Which statement by the student nurse indicates a need for further teaching?
1) | “Two fingers of a gloved hand are placed in the vagina to lift the presenting part off the cord.” |
2) | “The patient should be placed in a left side-lying position.” |
3) | “The maternal hips should be elevated with two pillows.” |
4) | “The patient should be in a Trendelenburg position.” |
____ 15. The nurse admits a patient who reports a desire to push. A quick assessment shows crowning of the fetal head. Which is the nurse’s priority action?
1) | Running to the nursing station and calling the provider |
2) | Hurrying to the supply room for a precipitous delivery pack |
3) | Washing the hands, applying gloves, and cleansing the perineum |
4) | Remaining calm and staying with the patient while calling for help |
____ 16. A laboring patient is delivering an infant with shoulder dystocia. Which of the following is an appropriate intervention?
1) | Massage the fundus. |
2) | Place the patient in left side-lying position. |
3) | Assist the provider with the McRoberts maneuver. |
4) | Administer a tocolytic. |
____ 17. The nurse recognizes which patient is at risk for precipitous labor?
1) | A primigravida patient |
2) | A patient with a high pain threshold |
3) | A patient with gestational diabetes |
4) | A patient with a small pelvis |
____ 18. The nurse admits a woman in labor after a motor vehicle accident that also involved her 14-month-old child. Fetal monitoring shows a nonreassuring fetal heart rate pattern with variable and late decelerations. Maternal examination reveals uterine tenderness and constant abdominal pain. After notifying the provider, which is the nurse’s priority of care?
1) | Encouraging the patient to begin pushing |
2) | Obtaining a precipitous delivery pack |
3) | Initiating an IV with an 18-gauge catheter |
4) | Cleansing the perineum |
____ 19. The postpartum nurse finds a patient who delivered 15 hours ago in shock with hypotension and tachycardia. Perineal assessment reveals hemorrhage and a mass protruding from the vagina. Upon reviewing the woman’s medical record, the nurse recognizes which risk factor for this event?
1) | Precipitous delivery |
2) | Premature delivery |
3) | Multiple pregnancy |
4) | Placenta accreta |
____ 20. The nurse examines a postpartum patient and notes a mass protruding from the vagina. What is the nurse’s priority action?
1) | Measure the size of the mass and document. |
2) | Check vital signs. |
3) | Massage the fundus. |
4) | Notify the provider immediately. |
____ 21. An hour after delivery the postpartum patient begins to have a seizure and labored breathing. The nurse suspects this life-threatening complication may be caused by what?
1) | Retained placenta |
2) | Uterine inversion |
3) | Fetal debris |
4) | Precipitous labor |
____ 22. A pregnant patient reports a decrease in fetal movement. The provider conducts an assessment and notifies the patient of an absent fetal heart rate (FHR). The patient asks the provider to check again. What stage of grief is the patient displaying?
1) | Guilt |
2) | Anger |
3) | Depression |
4) | Denial |
____ 23. The nurse reviews a plan of care and sees the nursing diagnosis of Fear Related to Uncertainty of Pregnancy Outcome. Which priority nursing intervention should the nurse include when caring for this patient?
1) | Reinforcing teaching provided to the patient by the provider and registered nurse |
2) | Providing information both verbally and in writing for the patient to refer to |
3) | Monitoring the patient and fetus for any nonreassuring signs and symptoms |
4) | Encouraging the participation of the support person in providing care |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 24. Which of the following types of breech positions is correctly matched with its description? (Select all that apply.)
1) | Complete breech: the hips are flexed and the knees are flexed. |
2) | Frank breech: the hips are flexed and the knees are extended. |
3) | Footling breech: one or both hips are extended and the foot presents. |
4) | Incomplete breech: one or both hips are extended and the foot presents. |
5) | Complete breech: the hips are extended and the knees are extended. |
____ 25. The nurse is caring for a patient who delivered at 22 weeks’ gestation and experienced a fetal demise when the newborn could not be resuscitated in the delivery room. Which actions will the postpartum nurse include in the immediate plan of care for this family? (Select all that apply.)
1) | Clean and dress the baby. |
2) | Allow the family to hold the baby. |
3) | Obtain footprints and pictures of the baby. |
4) | Encourage the parents to cry over their loss. |
5) | Connect the family to a support group. |
Chapter 10: Nursing Care of the Woman With Complications During Labor and Birth
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Connected Book
Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack
By Luanne Linnard Palmer