Verified Test Bank 2e Ch.11 Birth-Related Procedures - Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack by Luanne Linnard Palmer. DOCX document preview.
Chapter 11: Birth-Related Procedures
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which patient does the nurse recognize as not an appropriate candidate for amniotomy?
1) | The woman who is at 41 weeks’ gestation |
2) | The woman with a fetus in the breech presentation |
3) | The woman with a history of hypertension |
4) | The woman with a history of precipitous delivery |
____ 2. A nurse is assessing a patient who has undergone an amniotomy. Which assessment finding is most important for the nurse to report immediately?
1) | Promotion of labor |
2) | Clear, odorless amniotic fluid |
3) | Abnormal fetal heart rate (FHR) pattern |
4) | Wet underpads from vaginal leakage of clear fluid |
____ 3. A nurse is preparing a patient for an external cephalic version. The nurse notices that the patient is Rh-negative and has received limited prenatal care. The nurse expects to see which medication ordered by the health-care provider?
1) | Oxytocin |
2) | Magnesium sulfate |
3) | RhoGAM |
4) | IV Antibiotics |
____ 4. After a successful external cephalic version, the patient says, “Oh good! Now I won’t have to worry about having a cesarean section!” Which teaching should the nurse provide this patient in response to this comment?
1) | The fetus can drift back into an abnormal presentation. |
2) | There is no reason to worry about having a cesarean section. |
3) | Potential complications may follow the procedure. |
4) | Need to drink plenty of fluids for the next 24 hours. |
____ 5. A patient is 39 weeks pregnant and is admitted for induction of labor. Her Bishop’s score is 2. Which teaching does the nurse prepare for this patient?
1) | Explain the process of inducing labor. |
2) | Describe the fetal monitoring equipment. |
3) | Explain the importance of monitoring fetal activity. |
4) | Explain the need for chemical or mechanical cervical ripening. |
____ 6. A nurse is discussing the methods of cervical ripening and induction of labor with the patient.
Which method does the nurse inform as the safest and least likely to result in complications?
1) | Insertion of a transcervical Foley catheter |
2) | Application of prostaglandin gel |
3) | Administration of Prepidil Endocervical Gel |
4) | Infusion of oxytocin (Pitocin) |
____ 7. Which outcome is most appropriate for a nursing diagnosis of Risk for Injury in a patient whose labor is induced?
1) | Demonstrates and verbalizes reduced anxiety |
2) | Verbalizes understanding of the process of labor induction |
3) | Verbalizes readiness to become a mother |
4) | Maintains a good labor pattern with a reassuring FHR pattern |
____ 8. What will the nurse instruct the patient to do when the provider begins to apply traction to the vacuum extractor?
1) | Hold her breath and count to 10. |
2) | Push with the contraction. |
3) | Turn to her left side. |
4) | Pant to avoid pushing. |
____ 9. Which patient does the nurse identify as likely to require a cesarean delivery?
1) | Post-term |
2) | Vertex presentation |
3) | Multiple gestations |
4) | Treated genital herpes 4 years prior to pregnancy |
____ 10. Which patient does the nurse assess as most likely to be able to deliver vaginally rather than requiring a cesarean delivery?
1) | Active genital herpes |
2) | Fetal macrosomia |
3) | Multiple gestations |
4) | History of previous cesarean section |
____ 11. A nurse has made a call to the operating room to notify of an impending cesarean delivery. What is the priority intervention for the nurse to obtain?
1) | Administer preoperative medications given. |
2) | Obtain a signed consent form. |
3) | Obtain a diet history for the past 8 hours. |
4) | Insert an indwelling catheter. |
____ 12. Which medication is contraindicated immediately prior to performance of a cesarean section?
1) | Cefazolin 1 g IV |
2) | Famotidine 20 mg IV |
3) | Fentanyl 100 mcg IV |
4) | Citric acid-sodium citrate solution 30 mL PO |
____ 13. A nurse is preparing discharge instructions for a patient post-cesarean section. Which should the nurse include in the teaching?
1) | Plan to be in the hospital for 3 to 5 days. |
2) | Arrange for help at home. |
3) | Arrange for a ride home then resume driving the following day. |
4) | Resume normal activities. |
____ 14. A patient is at her routine visit 2 weeks prior to her scheduled cesarean delivery. Which teaching should the nurse provide in order to prepare the patient for hospital admission?
1) | Pack for 3 to 5 days in the hospital. |
2) | Arrange for help at home. |
3) | Sign a consent for the epidural. |
4) | Maintain good hydration. |
____ 15. The nurse assesses which patient has the best chance of a successful vaginal birth after a cesarean section?
1) | The woman whose first and third children were born vaginally |
2) | The woman with well-controlled gestational diabetes |
3) | The woman whose last child is 12 months old and was born by cesarean section |
4) | The woman requiring induction of labor 4 years after a cesarean section |
____ 16. A nurse is caring for a woman undergoing a trial of labor after cesarean (TOLAC). What signs is the nurse carefully observing for?
1) | Gestational diabetes |
2) | Spontaneous labor |
3) | Anxiety |
4) | Uterine rupture |
____ 17. A nurse is caring for a client undergoing an amnioinfusion due to oligohydramnios. Which symptom indicates that the solution is too cold?
1) | Fetal tachycardia |
2) | Maternal chilling |
3) | Anxiety |
4) | Bladder infection |
____ 18. A patient asks the nurse why the provider has suggested an external cephalic version. What is the nurse's best response?
1) | “The provider attempts the progression of labor.” |
2) | “The provider attempts to reposition the fetus.” |
3) | “The provider attempts to rupture the amniotic membranes.” |
4) | “The provider attempts to move the fetus through the birth canal.” |
____ 19. A patient asks the nurse the meaning of a Bishop’s score. What is the nurse’s best response?
1) | “The score given to the baby when it is born” |
2) | “The score used to evaluate cervical ripening” |
3) | “The score given to determine fetal position” |
4) | “The score used to determine fetal heart rate” |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 20. An immediate cesarean section will need to be performed if the nurse assesses which signs or symptoms in a woman attempting vaginal birth after a prior cesarean section? (Select all that apply.)
1) | A popping sensation reported by the patient |
2) | Acute, continuous abdominal pain |
3) | Repetitive or prolonged fetal heart rate decelerations |
4) | Slow labor progression |
5) | Vaginal bleeding |
____ 21. Prior to discharging a patient following cephalic version, which teaching does the nurse provide? (Select all that apply.)
1) | Teach the patient how to monitor fetal activity and when to call the provider. |
2) | Teach the patient how to monitor the fetal heart rate and when to call the provider. |
3) | Teach the patient the signs of the rupture of membranes and when to return to the hospital. |
4) | Teach the patient the signs and symptoms of labor and when to return to the hospital. |
5) | Teach the patient the importance of receiving RhoGAM prior to delivery. |
____22. A patient has discussed the option of a vaginal birth after a cesarean (VBAC) with her health provider. The nurse understands that the woman has a chance of a successful VBAC delivery based on which of the following history? (Select all that apply.)
1) | Prior VBAC |
2) | Cephalic presentation of the fetus |
3) | Had a prior vaginal delivery |
4) | Multiple gestations |
5) | Gestational age greater than 41 weeks |
___23. A nurse is caring for a patient undergoing a vaginal birth after a cesarean (VBAC). The nurse notifies the health-care provider after observing which signs of uterine rupture? (Select all that apply.)
1) | Vaginal bleeding |
2) | Acute abdominal pain |
3) | Palpation of fetal parts outside of the uterus |
4) | Prolonged FHR deceleration |
5) | Uterine contractions |
___24. A nurse is discussing the risks of a cesarean delivery. Which of the following risks should the nurse include? (Select all that apply.)
1) | Hemorrhage |
2) | Venous thrombosis |
3) | Nausea |
4) | Anxiety |
5) | Shock |
___25. A nurse is discussing a vacuum extractor as an instrument used for assisted vaginal delivery. The nurse informs the patient of which of the following indications may be required for an assisted vaginal delivery? (Select all that apply.)
1) | Maternal exhaustion |
2) | Fetal distress |
3) | Cervix is not fully dilated |
4) | Unruptured amniotic membrane |
5) | Prolonged second stage of labor |
Chapter 11: Birth-Related Procedures
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Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack
By Luanne Linnard Palmer