Deck 22: Labor and Birth at Risk

Question 1

Which statement is most likely to be associated with a breech presentation?

A) Least common malpresentation
B) Descent is rapid
C) Diagnosis by ultrasound only
D) High rate of neuromuscular disorders

Answer 1

High rate of neuromuscular disorders

Question 2

Prepidil (prostaglandin gel) has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes that this medication will be administered to:

A) Enhance uteroplacental perfusion in an aging placenta.
B) Increase amniotic fluid volume.
C) Ripen the cervix in preparation for labor induction.
D) Stimulate the amniotic membranes to rupture.

Answer 2

Ripen the cervix in preparation for labor induction.

Question 3

With regard to the care management of preterm labor, nurses should be aware that:

A) Because all women must be considered at risk for preterm labor and prediction is so hit-and-miss, teaching pregnant women the symptoms probably causes more harm through false alarms.
B) Braxton Hicks contractions often signal the onset of preterm labor.
C) Because preterm labor is likely to be the start of an extended labor, a woman with symptoms can wait several hours before contacting the primary caregiver.
D) The diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

Answer 3

The diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

Question 4

In planning for home care of a woman with preterm labor, the nurse needs to address what concern?

A) Nursing assessments will be different from those done in the hospital setting.
B) Restricted activity and medications will be necessary to prevent recurrence of preterm labor.
C) Prolonged bed rest may cause negative physiologic effects.
D) Home health care providers will be necessary.

Question 5

The nurse providing care for a woman with preterm labor on terbutaline would include which intervention to identify side effects of the drug?

A) Assessing deep tendon reflexes (DTRs)
B) Assessing for dyspnea and crackles
C) Assessing for bradycardia
D) Assessing for hypoglycemia

Question 6

Complications and risks associated with cesarean births include (choose all that apply):

A) Pulmonary edema.
B) Wound dehiscence.
C) Hemorrhage.
D) Urinary tract infections.
E) Fetal injuries.
F) None of the above

Question 7

A nurse is caring for a patient in the active phase of labor. The woman's bag of waters spontaneously ruptures. Suddenly the woman complains of dyspnea and appears restless and cyanotic. In addition, she becomes hypotensive and tachycardic. The nurse immediately suspects the presence of ___________________________________.

Question 8

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects?

A) Urine output of 160 ml in 4 hours
B) Deep tendon reflexes 2+ and no clonus
C) Respiratory rate of 16 breaths/min
D) Serum magnesium level of 10 mg/dl

Question 9

A woman is having her first child. She has been in labor for 15 hours. Two hours ago her vaginal examination revealed the cervix to be dilated to 5 cm and 100% effaced, and the presenting part was at station 0. Five minutes ago her vaginal examination indicated that there had been no change. What abnormal labor pattern is associated with this description?

A) Prolonged latent phase
B) Protracted active phase
C) Secondary arrest
D) Protracted descent

Question 10

Nurses should be aware that the induction of labor:

A) Can be achieved by external and internal version techniques.
B) Is also known as a trial of labor (TOL).
C) Is almost always done for medical reasons.
D) Is rated for viability by a Bishop score.

Question 11

A primigravida at 40 weeks of gestation is having uterine contractions every 1½ to 2 minutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor?

A) She is exhibiting hypotonic uterine dysfunction.
B) She is experiencing a normal latent stage.
C) She is exhibiting hypertonic uterine dysfunction.
D) She is experiencing pelvic dystocia.

Question 12

Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance:

A) The terms preterm birth and low birth weight can be used interchangeably.
B) Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy.
C) Low birth weight is anything below 3.7 pounds.
D) In the United States early in this century, preterm birth accounted for 18% to 20% of all births.

Question 13

In planning for an expected cesarean birth for a woman who has given birth by cesarean previously and who has a fetus in the transverse presentation, the nurse would include what information?

A) "Because this is a repeat procedure, you are at the lowest risk for complications."
B) "Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures."
C) "Because this is your second cesarean birth, you will recover faster."
D) "You will not need preoperative teaching because this is your second cesarean birth."

Question 14

With regard to the process of augmentation of labor, the nurse should be aware that it:

A) Is part of the active management of labor that is instituted when the labor process is unsatisfactory.
B) Relies on more invasive methods when oxytocin and amniotomy have failed.
C) Is a modern management term to cover up the negative connotations of forceps-assisted birth.
D) Uses vacuum cups.

Question 15

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to:

A) Stimulate fetal surfactant production.
B) Reduce maternal and fetal tachycardia associated with ritodrine administration.
C) Suppress uterine contractions.
D) Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy.

Question 16

A pregnant woman's amniotic membranes have ruptured. Prolapsed cord is suspected. What intervention would be the top priority?

A) Placing the woman in the knee-chest position
B) Covering the cord in sterile gauze soaked in saline
C) Preparing the woman for a cesarean birth
D) Starting oxygen by face mask

Question 17

In evaluating the effectiveness of oxytocin induction, the nurse would expect:

A) Contractions lasting 80 to 90 seconds, 2 to 3 minutes apart.
B) The intensity of contractions to be at least 110 to 130 mm Hg.
C) Labor to progress at least 2 cm/hr dilation.
D) At least 30 mU/min of oxytocin will be needed to achieve cervical dilation.

Question 18

The least common risk factor for a long, difficult, or abnormal labor (dystocia) is:

A) Advanced maternal age.
B) Infertility difficulties.
C) Multiparity.
D) Short stature.

Question 19

With regard to the process of inducing labor, nurses should be aware that:

A) Ripening the cervix usually results in a decreased success rate for induction.
B) Labor sometimes can be induced with balloon catheters or laminaria tents.
C) Oxytocin is less expensive than prostaglandins and more effective but creates greater health risks.
D) Amniotomy can be used to make the cervix more favorable for labor.