Deck 50: Labor, Delivery, and Postpartum

Question 1

The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative,rubella titer less than 1:8/1:10,Rh-negative with Rh-positive infant.Which injections will the nurse expect to be ordered?

A) Hepatitis B immune globulin and MMR today
B) MMR and Rho(D) immune globulin (RhoGAM) today
C) Rho(D) immune globulin (RhoGAM) and hepatitis B immune globulin today
D) Rho(D) immune globulin (RhoGAM) today and MMR in 3 months

Answer 1

Rho(D) immune globulin (RhoGAM) today and MMR in 3 months

Question 2

The nurse administers meperidine (Demerol)to a woman who is in early labor.Immediately after the drug is given,the woman's labor progresses quickly,and she delivers her infant.The nurse will monitor the infant closely for which condition?

A) Opioid withdrawal syndrome
B) Orthostatic hypotension
C) Respiratory depression
D) Tachycardia and poor perfusion

Answer 2

Respiratory depression

Question 3

A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases.She has 3-year-old and 5-year-old children who have not been immunized.The nurse will counsel the patient to perform which action?

A) Delay obtaining the vaccines for her children and herself until after her baby is born.
B) Have her children vaccinated now and obtain the vaccine for herself after the baby is born.
C) Obtain the MMR vaccine for her children and herself when she is in her third trimester of pregnancy.
D) Obtain the MMR vaccine for her children and herself within the next few weeks.

Answer 3

Have her children vaccinated now and obtain the vaccine for herself after the baby is born.

Question 4

When teaching a postpartal patient about the use of mineral oil as a laxative,the nurse will explain that mineral oil

A) does not have serious side effects.
B) is safe to take with other laxatives.
C) may be taken with food.
D) should be mixed with juice or soda.

Question 5

The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation.What information will the nurse include when teaching this patient about this medication?

A) "Crush the tablet if it is difficult to swallow."
B) "Store this medication in a cool, dry place."
C) "Take the tablet with a carbonated beverage."
D) "Take with milk if gastrointestinal upset occurs."

Question 6

The nurse is preparing a woman who is in labor for a lumbar epidural and explains that she will receive a continuous infusion of epidural anesthesia.She asks what will happen if that isn't effective.What response by the nurse is correct?

A) "Increasing the amount of anesthesia will increase the risk of postdural headache."
B) "You should tell the provider, and you may receive rescue doses of anesthesia if needed."
C) "You will receive opioid analgesics if the epidural anesthesia is ineffective."
D) "The consistent level provided by the continuous anesthesia will be sufficient."

Question 7

The nurse is caring for a woman who is in labor.The woman is anxious and reports increasing nausea after receiving an opioid analgesic medication.The nurse will contact the provider and request an order for which intravenous medication?

A) Hydroxyzine HCl (Vistaril)
B) Pentobarbital sodium (Nembutal)
C) Promethazine (Phenergan)
D) Secobarbital sodium (Seconal)

Question 8

The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section.The mother's blood type is Rh-negative,and the infant's blood type is Rh-positive.The provider has ordered human D immune globulin (RhoGAM).The nurse understands that this patient will need

A) less than the usual RhoGAM dose.
B) more than the usual RhoGAM dose.
C) no RhoGAM.
D) the usual RhoGAM dose.

Question 9

The nurse is assisting with placement of epidural anesthesia for a woman who is in labor.To help prevent maternal hypotension,which is the nurse's initial action?

A) Administer 40-80 mcg of intravenous phenylephrine.
B) Infuse a bolus of 500-1000 mL of IV crystalloid solution.
C) Monitor the patient's blood pressure closely during epidural placement.
D) Turn the patient onto her left side and give a rapid bolus of crystalloid solution.

Question 10

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response.The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?

A) Butorphanol tartrate (Stadol)
B) Fentanyl (Sublimaze)
C) Nalbuphine (Nubain)
D) Secobarbital (Seconal)

Question 11

The nurse is caring for a woman who is in early labor.The woman wants to avoid pain medications as long as possible.What will the nurse tell her?

A) "I can give you a sedative-hypnotic now to help you relax."
B) "I can teach you some simple breathing exercises to help lessen discomfort."
C) "If you take fentanyl (Sublimaze) now, it will be more effective than if you wait."
D) "You may take ibuprofen, which won't cause drowsiness."

Question 12

The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately.Her intravenous line has just infiltrated.The nurse will perform which action?

A) Administer fentanyl intramuscularly.
B) Contact the provider for an order for IM meperidine (Demerol).
C) Give the woman promethazine (Phenergan)
D) Request an order for hydroxyzine (Vistaril).

Question 13

The nurse has just administered Rh₀(D)immune globulin (RhoGAM)to a postpartal woman.What information will the nurse include when teaching this patient?

A) "Avoid live vaccines for 3 months."
B) "There are no adverse reactions to this injection."
C) "The immune globulin does not cross into breast milk."
D) "You will not need to have the injection with future deliveries."

Question 14

The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant.She asks why she cannot use drugs to suppress lactation.Which response by the nurse is correct?

A) "Hormonal drugs are not as effective as complementary therapies."
B) "Hormonal drugs cause increased constipation."
C) "Hormonal drugs increase the risk of blood clots."
D) "Hormonal drugs promote uterine atony."

Question 15

The nurse is caring for a patient after the third stage of labor,and the provider orders 20 units of oxytocin to be given intramuscularly.The nurse will explain to the patient that this drug for which purpose?

A) To allow the cervix to close
B) To enhance milk letdown
C) To prevent uterine atony
D) To suppress lactation

Question 16

The nurse examines a primipara woman who has received an epidural block.The woman's cervix has been dilated at 5 cm for an hour after having shown steady progression earlier.The nurse will notify the provider and anticipate a need for

A) caesarean section.
B) forceps delivery.
C) intravenous oxytocin.
D) vacuum extraction.