Question 1

The client has delivered a 4200 g fetus. The physician performed a midline episiotomy, which extended into a third-degree laceration. The client asks the nurse where she tore. Which response is best?

Accepted Answer

A third-degree laceration involves the anal sphincter. This type of laceration extends through the skin and muscle of the perineum and continues to tear through the anal sphincter muscle.

Question 2

What is required for any woman receiving oxytocin (Pitocin)?

Accepted Answer

Continuous electronic fetal monitoring is required for any woman receiving oxytocin (Pitocin) to closely monitor the fetal heart rate and uterine contractions, ensuring the safety of both the mother and the fetus during labor induction or augmentation.

Question 3

The nurse is caring for a client in active labor. The membranes spontaneously rupture, with a large amount of clear amniotic fluid. Which nursing action is most important to undertake at this time?

Accepted Answer

A sterile vaginal exam is important to assess for umbilical cord prolapse, which is a potential emergency situation following the rupture of membranes.

Question 4

A woman is admitted to the birth setting in early labor. She is 3 c m dilated, -2 station, with intact membranes and F H R of 150 beats/min. Her membranes rupture spontaneously, and the F H R drops to 90 beats/min with variable decelerations. What would the initial response from the nurse be?

Accepted Answer

The answer of A woman is admitted to the birth...

Question 5

A laboring patient is attempting a vaginal birth. An episiotomy has already been performed and the healthcare provider is prepared to extend the episiotomy if necessary. What is this fetus's most likely presentation?

Accepted Answer

The answer of A laboring patient is attempting a vaginal...

Question 6

A 26-year-old client is having her initial prenatal appointment. The client reports to the nurse that she suffered a pelvic fracture in a car accident 3 years ago. The client asks whether her pelvic fracture might affect her ability to have a vaginal delivery. What response by the nurse is best?

Accepted Answer

"It depends on how your pelvis healed." is the best response because the ability to have a vaginal delivery after a pelvic fracture depends on the extent of the injury, how well it healed, and if there were any changes to the shape or integrity of the pelvis that could affect childbirth.

Question 7

What is one of the most common initial signs of nonreassuring fetal status?

Accepted Answer

Meconium-stained amniotic fluid is one of the most common initial signs of nonreassuring fetal status, indicating that the fetus may be under stress or experiencing hypoxia.

Question 8

During an intrapartum vaginal examination the following is palpated. In which type of presentation is this fetus?

Accepted Answer

The answer of During an intrapartum vaginal examination the following...

Question 9

The client delivered 30 minutes ago. Her blood pressure and pulse are stable. Vaginal bleeding is scant. The nurse should prepare for which procedure?

Accepted Answer

Given the information, the most likely procedure the nurse should prepare for is the manual removal of the placenta. This is indicated if the placenta has not been delivered within a certain time frame after childbirth, which can lead to scant vaginal bleeding if it is partially retained or adherent.

Question 10

After delivery, it is determined that there is a placenta accreta. Which intervention should the nurse anticipate?

Accepted Answer

Placenta accreta involves the placenta attaching too deeply into the uterine wall, which can lead to severe bleeding. A hysterectomy is often required to manage the condition and prevent life-threatening hemorrhage.

Question 11

During labor, the client at 4 c m suddenly becomes short of breath, cyanotic, and hypoxic. The nurse must prepare or arrange immediately for which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

The answer of During labor, the client at 4 c...

Question 12

A fetal weight is estimated at 4490 grams in a client at 38 weeks' gestation. Counseling should occur before labor regarding which of the following?

Accepted Answer

The likelihood of a cesarean delivery increases with fetal macrosomia (a baby weighing more than 4000 to 4500 grams), as it can lead to complications such as shoulder dystocia during a vaginal delivery.

Question 13

The client gave birth to a 7 pound, 14 ounce female 30 minutes ago. The placenta has not yet delivered. Manual removal of the placenta is planned. What should the nurse prepare to do?

Accepted Answer

The nurse should prepare to start an IV of lactated Ringer's to ensure the client is well-hydrated and to provide a route for potential medications during the manual removal of the placenta.

Question 14

Lacerations of the cervi × or vagina may be present when bright red vaginal bleeding persists in the presence of a well-contracted uterus. The incidence of lacerations is higher among which of the following childbearing women?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

Lacerations are more common in women who have had an episiotomy, forceps-assisted or vacuum-assisted birth, and in nulliparous women due to increased tissue resistance and potential for trauma during delivery.

Question 15

A fetus has a brow cephalic presentation. Which head shape should the nurse expect when the infant is delivered?

Accepted Answer

The answer of A fetus has a brow cephalic presentation....

Question 16

A woman has been in labor for 16 hours. Her cervi × is dilated to 3 c m and is 80% effaced. The fetal presenting part is not engaged. The nurse would suspect which of the following?

Accepted Answer

Cephalopelvic disproportion (CPD) is suspected when labor does not progress as expected, which can be due to the baby's head being too large for the mother's pelvis. The prolonged labor, lack of engagement of the fetal presenting part, and the dilation and effacement of the cervix without progression are indicative of CPD.

Question 17

On assessment, a laboring client is noted to have cardiovascular and respiratory collapse and is unresponsive. What should the nurse suspect?

Accepted Answer

An amniotic fluid embolus can lead to cardiovascular and respiratory collapse and is a rare but serious condition that occurs when amniotic fluid, fetal cells, hair, or other debris enters the mother's bloodstream, potentially causing an allergic-like reaction. This can lead to sudden, severe symptoms, including cardiovascular collapse and respiratory distress, aligning with the scenario described.

Question 18

A patient's placenta it is identified as having a double fold of chorion and amnion that formed a ring around the umbilical cord on the fetal side of the placenta. What should the nurse expect when examining this placenta?

Accepted Answer

The answer of A patient's placenta it is identified as...

Question 19

During an intrapartum vaginal examination the following is assessed. In which position should the patient be placed at this time?

Accepted Answer