N8 L & D Qs Ch15-19

Wong, et al.: Maternal Child Nursing Care, 3rd Edition
Review Questions Chapter 15
1.
A primigravida asks the nurse about signs she can look for that would indicate that the onset of labor is getting closer. The nurse should describe which of the following?

A. Weight gain of 1-3 pounds
B. Quickening
C. Fatigue and lethargy
D. Bloody show
2.
The nurse should tell a primigravida that the definitive sign indicating labor has begun would be:

A. Progressive uterine contractions
B. Lightening
C. Rupture of membranes
D. Passage of the mucous plug (operculum)
3.
Upon completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. Which of the following is a correct interpretation of the data?

A. Fetal presenting part is 1 cm above the ischial spines
B. Effacement is 4 cm from completion
C. Dilation is 50% completed
D. Fetus has achieved passage through the ischial spines
Review Questions Chapter 16
1.
A laboring woman becomes anxious during the transition phase of the first stage of labor and develops a rapid and deep respiratory pattern. She complains of feeling dizzy and lightheaded. The nurse's immediate response would be to:

A. Encourage the woman to breathe more slowly
B. Help the woman to breathe into a paper bag
C. Turn the woman on her side
D. Administer a sedative

Review Questions Chapter 17
1.
When assessing a FHR tracing, the nurse notes a decrease in the baseline rate from 155 to 110. The rate of 110 persists for more than 10 minutes. The nurse could attribute this decrease in baseline to which of the following factors:

A. Maternal hyperthyroidism
B. Initiation of epidural anesthesia that resulted in maternal hypotension
C. Maternal infection accompanied by fever
D. Alteration in maternal position from semi-recumbent to lateral
2.
Upon review of a fetal monitor tracing, the nurse notes that for several contractions the FHR decelerates as a contraction begins and returns to baseline just before it ends. The nurse should:

A. Describe the finding in the nurse's notes
B. Reposition the woman onto her side
C. Call the physician for instructions
D. Administer oxygen at 8 to 10 liters/minute with a tight face mask
3.
Which of the following findings meets the criteria of a reassuring FHR pattern?

A. FHR does not change as a result of fetal activity
B. Average baseline rate ranges between 100 - 140 BPM
C. Mild late deceleration patterns occur with some contractions
D. Variability averages between 6 - 10 BPM
4.
Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position, and her vital signs are stable and fall within a normal range. Contractions are intense, last 90 seconds, and occur every 1 1/2 to 2 minutes. The nurse's immediate action would be to:

A. Change the woman's position
B. Stop the Pitocin
C. Elevate the woman's legs
D. Administer oxygen via a tight mask at 8 to 10 liters/minute

Review Questions Chapter 18
1.
Which of the following characteristics is associated with false labor contractions?

A. Painless
B. Decrease in intensity with ambulation
C. Regular pattern of frequency is established
D. Progressive in terms of intensity and duration
2.
A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class. Which of the following aspects of their birth plan would be considered unrealistic and require further discussion with the nurse?

A. "My husband and I have agreed that my sister will be my coach since he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is okay."
B. "We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor."
C. "We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born."
D. "We do not want the fetal monitor used during labor since it will interfere with movement and doing effleurage."
3.
When performing vaginal examinations on laboring women, the nurse should be guided by which of the following principles?

A. Cleanse the vulva and perineum before and after the examination as needed
B. Wear a clean glove lubricated with tap water to reduce discomfort
C. Perform the examination every hour during the active phase of the first stage of labor
D. Perform immediately if active bleeding is present
4.
The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia would be:

A. Severe postpartum headache
B. Limited perception of bladder fullness
C. Increase in respiratory rate
D. Hypotension

Review Questions Chapter 19
1.
A laboring woman's amniotic membranes have just ruptured. The immediate action of the nurse would be to:

A. Assess the FHR pattern
B. Perform a vaginal examination
C. Inspect the characteristics of the fluid
D. Assess maternal temperature
2.
A woman is evaluated to be using an effective bearing down effort if she:

A. Begins pushing as soon as she is told that her cervix is fully dilated and effaced
B. Takes two deep, cleansing breaths at the onset of a uterine contraction and at the end of the contraction
C. Uses the Valsalva maneuver by holding her breath and pushing vigorously for a count of 12
D. Continues to push for short periods between uterine contractions throughout the second stage of labor
3.
Following rupture of membranes, a prolapse of the cord was noted upon vaginal examination. Which of the following would be a recommended action to prevent cord compression?

A. Place woman in a supine position and elevate legs from the hips
B. Insert a Foley catheter to keep the bladder empty
C. Keep the protruding cord moist with warm sterile normal saline compresses
D. Attempt to reinsert the cord