Deck 22: Childbirth at Risk: Labor-Related Complications

Question 1

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

A)2 L oxygen by mask
B)Intravenous antibiotics
C)Intravenous oxytocin
D)Hysterectomy

Answer 1

Hysterectomy

Question 2

A fetal weight is estimated at 4490 grams in a gravida 1 at 38 weeks' gestation.Counseling should occur before labor regarding the:

A)Mother's undiagnosed diabetes.
B)Likelihood of a cesarean delivery.
C)Effectiveness of epidural anesthesia with a large fetus.
D)Need for early delivery.

Answer 2

Likelihood of a cesarean delivery.

Question 3

A primigravida is admitted to the birth setting in early labor.She is 3 cm dilated,−2 station,with intact membranes and FHR of 150 bpm.Her membranes rupture spontaneously,and the FHR drops to 90 bpm with variable decelerations.The initial response from the nurse would be to:

A)Perform a vaginal exam.
B)Notify the physician.
C)Place the client in a left lateral position.
D)Administer oxygen at 2 l per nasal cannula.

Answer 3

Perform a vaginal exam.

Question 4

A nurse is comparing advantages of using active management of labor (AMOL)with a less interventional approach.The nurse knows that the goal of AMOL is:

A)Preventing protracted labor and arrest of progress.
B)Preventing infection from prolonged rupture of membranes.
C)Detecting and intervening in cases of precipitous labor.
D)Relieving the anxiety and fear accompanying labor.

Question 5

During labor,the patient at 4 cm suddenly becomes dyspneic,cyanotic,and hypotensive.The nurse must prepare immediately for: (Select all that apply):

A)CPR.
B)Cesarean delivery.
C)Immediate vaginal delivery.
D)McRobert's maneuver.

Question 6

On assessment,a labor patient is noted to have frothy sputum,a heart rate of 110,and a large amount of continuos vaginal bleeding.The nurse should suspect:

A)An amniotic fluid embolus.
B)Placental abruption.
C)DIC.
D)Congestive heart failure.

Question 7

A multipara is having intense uterine contractions with little uterine relaxation between contractions.Vaginal examination reveals rapid cervical dilation and fetal descent.The nurse should:

A)Notify the physician of these findings.
B)Place the woman in knee-chest position.
C)Turn off the lights to make it easier for the woman to relax.
D)Assemble supplies to prepare for a cesarean birth.

Question 8

A woman has been in labor for 16 hours.Her cervix is dilated to 3 cm and is 80% effaced.The fetal presenting part is not engaged.The nurse would suspect:

A)Breech malpresentation.
B)Fetal demise.
C)Cephalopelvic disproportion (CPD).
D)Abruptio placentae.

Question 9

When the physician indicates a shoulder dystocia during the delivery of a macrosomic fetus,the nurse would assist by:

A)Calling a second physician to assist.
B)Preparing for an immediate cesarean delivery.
C)Assisting the woman into McRobert's maneuver.
D)Utilizing fundal pressure to push the fetus out.

Question 10

The maternal risks associated with postterm pregnancy include: (Select all that apply. )

A)Polyhydramnios.
B)Small-for-gestational age infant.
C)Large-for-gestational age infant.
D)Forceps-assisted delivery.

Question 11

During labor,the fetus was in a brow presentation,but after a prolonged labor,the fetus converted to face presentation,and was delivered vaginally with forceps assist.The nurse should explain to the parents that:

A)The infant will need to be observed for meconium aspiration.
B)Facial edema and head molding will subside in a few days.
C)The infant will have prophylactic antibiotics.
D)Breastfeeding will need to be delayed for a day or two.

Question 12

A couple requests to see their stillborn infant.The nurse should prepare the infant by: (Select all that apply. )

A)Wrapping the infant in a blanket.
B)Removing all blankets from the infant.
C)Placing a hat on the infant.
D)Removing any identification from the infant.
E)Placing a diaper on the infant.

Question 13

A pregnant client was in an automobile accident,and presents to the labor suite from the Emergency Department after she presented at the ED with a deep gash on her forearm from the crash.The client was not wearing a seat belt,and was speeding.She now seems highly agitated,is pacing continuously,and is talking very rapidly.The nurse should suspect that this client has what type of psychological disorder?

A)Schizophrenia
B)Bipolar disorder,manic phase
C)Social anxiety disorder
D)Obsessive-compulsive disorder

Question 14

A woman has been having contractions since 4 a.m.At 8 a.m. ,her cervix is dilated to 5 cm.Contractions are frequent,and mild to moderate in intensity.Cephalopelvic disproportion (CPD)has been ruled out.After giving the mother some sedation so she can rest,the nurse would anticipate preparing for:

A)Oxytocin induction of labor.
B)Amnioinfusion.
C)Increased intravenous infusion.
D)Cesarean section.

Question 15

A client is in active labor.The nurse determines that the fetus's position is occiput posterior.Which nursing diagnosis will apply to this woman's care if the occiput posterior position becomes persistent?

A)Acute pain
B)Risk for injury
C)Impaired gas exchange
D)Fluid volume deficit