Question 1

In the operating room,a client is being prepped for a cesarean delivery.The doctor is present.What is the last assessment the nurse should make just before the client is draped for surgery?&#10;A)Maternal temperature&#10;B)Maternal urine output&#10;C)Vaginal exam&#10;D)Fetal heart tones&#10;

Accepted Answer

The last assessment the nurse should make just before the client is draped for surgery is checking fetal heart tones to ensure the baby's well-being before the start of the procedure. Maternal temperature and urine output are important assessments, but they are typically done earlier in the preoperative process. A vaginal exam is not necessary at this point and could introduce bacteria, increasing the risk of infection.

Question 2

Which of the following would be a contraindication to the induction of labor?&#10;A)Placenta previa&#10;B)Isoimmunization&#10;C)Diabetes mellitus&#10;D)Premature rupture of membranes&#10;

Accepted Answer

Placenta previa is a condition in which the placenta is low-lying and covering or partially covering the cervix. Induction of labor in this situation could lead to dangerous bleeding for both the mother and fetus. Isoimmunization, diabetes mellitus, and premature rupture of membranes are not contraindications to the induction of labor in all cases.

Question 3

The client is recovering from delivery that included a midline episiotomy.Her perineum is swollen and sore.The client is asking for her ice pack to be refreshed.The best response from the nurse is:&#10;A)&#34;I'll get you one right away.&#34;&#10;B)&#34;You only need to use one ice pack.&#34;&#10;C)&#34;You need to leave it off for at least 20 minutes and then reapply.&#34;&#10;D)&#34;I'll bring you an extra so that you can change it when you are ready.&#34;&#10;

Accepted Answer

Ice packs should be used intermittently to reduce swelling and pain. Leaving the area without an ice pack for intervals (such as 20 minutes) helps prevent tissue damage from prolonged cold exposure.

Question 4

Which is an appropriate nursing diagnosis for a postpartal mother with lacerations from a forceps delivery?&#10;A)Alteration in body image related to scar formation&#10;B)High risk for infection related to lochia and decreased perineal and birth canal integrity&#10;C)Alteration in nutrition: more than body requirements related to increased appetite&#10;D)Self-care deficit related to poor opportunity for independence&#10;

Accepted Answer

A postpartal mother with lacerations from a forceps delivery is at high risk for infection related to lochia and decreased perineal and birth canal integrity. This nursing diagnosis addresses the immediate physical concern for the mother.

Question 5

Bishop's scoring system for cervical readiness includes cervical dilatation,consistency,position,and: (Select all that apply. )&#10;A)Fetal station.&#10;B)Fetal lie.&#10;C)Fetal presenting part.&#10;D)Cervical effacement.&#10;

Accepted Answer

The Bishop's scoring system includes cervical dilatation, consistency, position, effacement, and fetal station. Fetal lie and presenting part are not part of this scoring system.

Question 6

After being in labor for several hours with no progress,a client is diagnosed with CPD (cephalopelvic disproportion),and must have a cesarean section.The client is worried that she will not be able to attempt to have any future children vaginally.After sharing this information with her care provider,the nurse would anticipate that that client would receive what type of incision?

A)Transverse
B)Suprapubic
C)Classic
D)Vertical

Accepted Answer

A transverse incision, also known as a low transverse cesarean section, is often preferred for cesarean deliveries because it results in less blood loss, has a lower risk of infection, and is stronger during future pregnancies, allowing for the possibility of vaginal birth after cesarean (VBAC) in many cases.

Question 7

The client demonstrates understanding of the implications for future pregnancies secondary to her classic uterine incision when she states:&#10;A)&#34;The next time I have a baby,I can try to deliver vaginally.&#34;&#10;B)&#34;The risk of rupturing my uterus is too high for me to have any more babies.&#34;&#10;C)&#34;Every time I have a baby,I will have to have a cesarean delivery.&#34;&#10;D)&#34;I can only have one more baby.&#34;&#10;

Accepted Answer

A classic uterine incision, typically a vertical incision made in the upper part of the uterus, significantly increases the risk of uterine rupture in subsequent pregnancies. Therefore, future deliveries are recommended to be via cesarean section to avoid this risk.

Question 8

A laboring client's obstetrician has suggested amniotomy as a method for inducing labor.Which assessment(s)must be made just before the amniotomy is performed?&#10;A)Maternal temperature,BP,and pulse&#10;B)Estimation of fetal birth weight&#10;C)Fetal presentation,position,and station&#10;D)Biparietal diameter&#10;

Accepted Answer

Fetal presentation, position, and station must be assessed before an amniotomy to ensure the fetus is in a favorable position for delivery and to reduce the risk of cord prolapse.

Question 9

The need for forceps has been determined.The client's cervix is dilated to 10 cm,and the fetus is at +2 station.What category of forceps application would the nurse anticipate being used?&#10;A)Input&#10;B)Low&#10;C)Mid&#10;D)Outlet&#10;

Accepted Answer

Low forceps are used when the fetal head is at +2 station but not on the pelvic floor, which matches the scenario described.

Question 10

The client tells the nurse that she has come to the hospital so that her baby's position can be changed.The nurse would begin to organize the supplies needed to do which procedure?&#10;A)A version&#10;B)An amniotomy&#10;C)Leopold's maneuver&#10;D)A ballottement&#10;

Accepted Answer

A version is a medical procedure to manually turn a baby from a breech position to a head-down (vertex) position. It is the only option among the given choices that involves changing the position of the baby within the uterus. An amniotomy is the artificial rupture of the amniotic sac to induce or augment labor. Leopold's maneuver is a method used to determine the position of the fetus by palpating the abdomen. Ballottement is a technique used in physical examination to assess the smoothness and elasticity of organs such as the uterus.

Question 11

Under which circumstances would the nurse remove prostaglandins from the client's cervix? Select all that apply.&#10;A)Contractions every 5 minutes&#10;B)Nausea and vomiting&#10;C)Late decelerations&#10;D)Contractions every 90 seconds&#10;

Accepted Answer

The answer of Under which circumstances would the nurse remove...

Question 12

A client is consulting a certified nurse-midwife because she is hoping for a vaginal birth after cesarean (VBAC)for this pregnancy.Which statement indicates that the client requires more information about VBAC?

A)"I can try a vaginal birth because my uterine incision is a low segment transverse incision."
B)"The vertical scar on my skin doesn't mean that the scar on my uterus goes in the same direction."
C)"There is about a 90% chance of giving birth vaginally after a cesarean."
D)"Because my hospital has a surgery staff on call 24 hours a day,I can try a VBAC there."

Accepted Answer

The answer of A client is consulting a certified nurse-midwife...

Question 13

After inserting prostaglandin gel for cervical ripening,the nurse should:&#10;A)Apply an internal fetal monitor.&#10;B)Insert an indwelling catheter.&#10;C)Withhold oral intake and start intravenous fluids.&#10;D)Place the client in a supine position with a right hip wedge.&#10;

Accepted Answer

The answer of After inserting prostaglandin gel for cervical ripening,the...

Question 14

A woman has been admitted for an external version.She has completed an ultrasound exam and is attached to the fetal monitor.Prior to attempting the procedure,terbutaline will be administered to:&#10;A)Provide analgesia.&#10;B)Relax the uterus.&#10;C)Induce labor.&#10;D)Prevent hemorrhage.&#10;

Accepted Answer

The answer of A woman has been admitted for an...

Question 15

The obstetrician opts to use a vacuum extraction device for a delivery.The nurse understands that:&#10;A)There is little risk with vacuum devices.&#10;B)There should be further fetal descent with the first two pulls.&#10;C)Traction is applied between contractions.&#10;D)The woman often feels increased discomfort during the procedure.&#10;

Accepted Answer

The answer of The obstetrician opts to use a vacuum...

Deck 23: Birth-Related Procedures