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?&#10;A) The patient's age&#10;B) 18 weeks' gestation&#10;C) Multiple gestations&#10;D) Previous obstetric history&#10;

Accepted Answer

Multiple gestations, such as carrying triplets, increase the risk for preterm labor. The other factors listed may also impact pregnancy outcomes, but they are not specifically related to preterm labor risk.

Question 2

The nurse examines a patient with postpartum hemorrhaging.Which assessment finding indicates placenta accreta rather than retained placenta?&#10;A) Severe lower abdominal pain&#10;B) Heavy vaginal bleeding&#10;C) Elevated heart rate and hypotension&#10;D) Pale mucous membranes and nailbeds&#10;

Accepted Answer

Placenta accreta is characterized by the abnormal attachment of the placenta to the uterine wall, which can cause severe lower abdominal pain due to the invasive nature of the condition.

Question 3

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?&#10;A) Running to the nursing station and calling the provider&#10;B) Hurrying to the supply room for a precipitous delivery pack&#10;C) Washing the hands,applying gloves,and cleansing the perineum&#10;D) Remaining calm and staying with the patient while calling for help&#10;

Accepted Answer

Remaining calm and staying with the patient while calling for help is the priority action. It ensures the patient is not left alone during a critical moment, allows for immediate assistance, and helps in maintaining a calm environment conducive to a safe delivery.

Question 4

The nurse is caring for a woman with suspected macrosomia.Which assessment finding best indicates the ability to deliver vaginally?&#10;A) Cervical dilation at 10 cm&#10;B) Fetus at +3 station&#10;C) 100% effacement&#10;D) Fetus at +1 station&#10;

Accepted Answer

A fetus at +3 station indicates that the fetal head is well engaged in the pelvis and has descended significantly, suggesting a higher likelihood of successful vaginal delivery.

Question 5

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?&#10;A) Passage&#10;B) Pain&#10;C) Powers&#10;D) Position&#10;

Accepted Answer

The answer of A laboring patient's water breaks,and the umbilical...

Question 6

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?

A) "It is our policy to always perform a Cesarean section when there is a prolapsed cord."
B) "The baby could die if we don't rush to deliver it,and a Cesarean section is the fastest method."
C) "A Cesarean section is needed to save your life and prevent the risk of hemorrhaging."
D) "The baby cannot be born vaginally without crimping off blood supply through the cord."

Accepted Answer

A prolapsed cord means the umbilical cord has slipped into the cervix and is being compressed by the fetus, which can cut off the baby's oxygen supply. A Cesarean section is necessary in this situation because the delivery needs to be expedited to prevent fetal distress or death. Delivering vaginally with a prolapsed cord can lead to cord compression and result in serious complications for the baby.

Question 7

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?

A) Reinforcing teaching provided to the patient by the provider and registered nurse
B) Providing information both verbally and in writing for the patient to refer to
C) Monitoring the patient and fetus for any nonreassuring signs and symptoms
D) Encouraging the participation of the support person in providing care

Accepted Answer

The answer of The nurse reviews a plan of care...

Question 8

The experienced nurse recognizes that a graduate nurse needs guidance in caring for a woman at 38 weeks' gestation with premature rupture of membranes when the graduate nurse is seen preparing to do what?

A) Fetal monitoring
B) Vital signs
C) Provide support and education
D) Conduct a cervical examination

Accepted Answer

Conducting a cervical examination in a woman with premature rupture of membranes can increase the risk of infection and should only be done by a healthcare provider who is trained to do so. The graduate nurse needs guidance and supervision to ensure safe and appropriate care for the patient. Fetal monitoring, vital signs, and providing support and education are all appropriate tasks for the graduate nurse to perform under the guidance of an experienced nurse or provider.

Question 9

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?

A) Encouraging the patient to begin pushing
B) Obtaining a precipitous delivery pack
C) Initiating an IV with an 18-gauge catheter
D) Cleansing the perineum

Accepted Answer

The priority intervention in this scenario is to initiate an IV access with an 18-gauge catheter. The nonreassuring fetal heart rate pattern and uterine tenderness suggest that the fetus may be experiencing hypoxia, and the provider may need to administer medications or fluids to improve fetal oxygenation. Therefore, an IV access is critical to allow for the delivery of such interventions. Encouraging the patient to begin pushing, obtaining a precipitous delivery pack, and cleansing the perineum are all important interventions but they are not the priority in this scenario.

Question 10

A patient is approaching 42 weeks' gestation and has been admitted for induction of labor.The patient tells the nurse she does not want an induction and prefers to wait for labor to begin naturally.Which is the nurse's best response?

A) "Waiting for labor to begin naturally could result in the death of your baby."
B) "The longer you wait,the bigger the baby gets and the harder delivery will be."
C) "Complications for you and your baby increase after 42 weeks of gestation."
D) "If you had controlled your weight gain during pregnancy,you might have gone into natural labor."

Accepted Answer

Option C is the best response as it provides the patient with factual information regarding the risks associated with continuing the pregnancy beyond 42 weeks of gestation. It does not use scare tactics or blame the patient for their situation. It is important for healthcare providers to inform patients of the potential risks and benefits of induction of labor, while still respecting the patient's autonomy to make their own decision.

Question 11

The nurse questions an order to administer a tocolytic drug for which patient?&#10;A) The patient under age 18&#10;B) The patient with a history of multiple gestations&#10;C) The patient who is 2 cm dilated&#10;D) The patient with acute vaginal bleeding&#10;

Accepted Answer

The answer of The nurse questions an order to administer...

Question 12

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.)

A) Clean and dress the baby
B) Allow the family to hold the baby
C) Obtain footprints and pictures of the baby
D) Encourage the parents to cry over their loss
E) Connect the family to a support group

Accepted Answer

The answer of The nurse is caring for a patient...

Question 13

The nurse admits a patient at 32 weeks' gestation with a history of cervical cerclage to rule out preterm labor.Which finding is inconsistent with the patient's history?&#10;A) Rupture of membranes&#10;B) Signs of infection&#10;C) Cervical dilation to 3 cm&#10;D) Mild vaginal bleeding&#10;

Accepted Answer

The answer of The nurse admits a patient at 32...

Question 14

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?

A) Precipitous delivery
B) Premature delivery
C) Multiple pregnancy
D) Placenta accreta

Accepted Answer

The answer of The postpartum nurse finds a patient who...

Question 15

The nurse identifies which client as being at highest risk for placental abruption?&#10;A) The client with hypertension&#10;B) The client who reports drinking one beer 2 months ago&#10;C) The client who uses marijuana&#10;D) The client delivering triplets&#10;

Accepted Answer

The answer of The nurse identifies which client as being...

Question 16

A woman's labor is not progressing,and the fetus is found to be in the breech position.Which of the seven Ps of labor is involved with this woman's failure to progress?&#10;A) Presentation&#10;B) Passenger&#10;C) Passage&#10;D) Powers&#10;

Accepted Answer

The answer of A woman's labor is not progressing,and the...

Question 17

The nurse is caring for a woman who has been admitted with a diagnosis of polyhydramnios and recognizes which as the most likely cause?&#10;A) Fetal kidney failure&#10;B) Gastrointestinal blockage&#10;C) Rupture of the membranes&#10;D) Fetal demise&#10;

Accepted Answer

The answer of The nurse is caring for a woman...

Question 18

The nurse recognizes which patient is at risk for delivering an infant with shoulder dystocia?&#10;A) The patient in premature labor&#10;B) The patient with fetal macrosomia&#10;C) The patient whose labor has been induced&#10;D) The patient with hypertension&#10;

Accepted Answer

The answer of The nurse recognizes which patient is at...

Question 19

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?

A) "If the fetus has CPD,it could result in serious complications for you and the baby."
B) "A fetus in the breech position causes labor to progress more slowly."
C) "We'll have to talk to the delivering provider to see if that is even possible."
D) "When the fetus is breech,a Cesarean section is the safest choice for you and the baby."

Accepted Answer

The answer of The fetus of a laboring patient is...

Question 20

A laboring patient becomes severely hypoxic and hypotensive,has altered mental status,and begins to have seizures.Which is the priority nursing intervention?&#10;A) Administering oxygen&#10;B) Initiating the rapid response team&#10;C) Providing emotional support for patient and family&#10;D) Administering IV fluids&#10;

Accepted Answer

The answer of A laboring patient becomes severely hypoxic and...

Deck 11: Nursing Care of the Woman With Complications During Labor and Birth