Deck 12: Birth-Related Procedures

Question 1

When caring for a woman undergoing a trial of labor after Cesarean (TOLAC),the nurse most carefully observes for signs of what?

A) Macrosomia
B) Failure to progress
C) Anxiety
D) Uterine rupture

Answer 1

Uterine rupture

Question 2

What will the nurse instruct the patient to do when the provider begins to apply traction to the vacuum extractor?

A) Hold her breath and count to 10
B) Push with the contraction
C) Turn to her left side
D) Pant to avoid pushing

Answer 2

Push with the contraction

Question 3

Which assessment data will the nurse obtain from a patient who is being prepared for a Cesarean section?

A) Cervical dilation and effacement
B) Obtain a signed consent form
C) Diet history for the past 8 hours
D) Insert an indwelling catheter

Answer 3

Diet history for the past 8 hours

Question 4

The nurse assesses which patient as having the best chance of a successful vaginal birth after a Cesarean section?

A) The woman whose first and third children were born vaginally
B) The woman with well-controlled gestational diabetes
C) The woman whose last child is 12 months old and was born by Cesarean section
D) The woman requiring induction of labor 4 years after a Cesarean section

Question 5

After a successful external cephalic version,the patient says,"Oh good! Now I won't have to worry about having a Cesarean section!" Which teaching should the nurse provide this patient in response to this comment?

A) The fetus can drift back into an abnormal presentation.
B) There is no reason to worry about having a Cesarean section.
C) Potential complications following the procedure
D) Need to drink plenty of fluids for the next 24 hours

Question 6

During the induction process,a patient frequently asks,"What are you doing now?" or "What is that for?" Which nursing diagnosis is most appropriate for this patient?

A) Knowledge Deficit related to induction of labor
B) Fear/Anxiety
C) Risk for Injury
D) Altered Mental Status

Question 7

Which patient does the nurse assess as most likely to be able to delivery vaginally rather than requiring a Cesarean delivery?

A) Active genital herpes
B) Fetal macrosomia
C) Multiple gestations
D) History of previous Cesarean section

Question 8

Which patient does the nurse identify as likely to require a Cesarean delivery?

A) Postterm
B) O-negative blood type
C) Active genital herpes
D) 35 weeks' gestation

Question 9

Which medication is contraindicated immediately prior to performance of a Cesarean section?

A) Cefazolin 1 g IV
B) Famotidine 20 mg IV
C) Fentanyl 100 mcg IV
D) Citric acid-sodium citrate solution 30 mL PO

Question 10

Which assessment finding is most important for the nurse to report immediately after the performance of an amniotomy?

A) Temperature of 37.6°C
B) Clear,odorless amniotic fluid
C) Abnormal fetal heart rate (FHR)pattern
D) Leakage of clear fluid from the vagina

Question 11

Which method of cervical ripening and induction of labor does the nurse consider safest and least likely to result in complications?

A) Insertion of a transcervical Foley catheter
B) Application of prostaglandin gel
C) Administration of Prepidil Endocervical Gel
D) Infusion of oxytocin (Pitocin)

Question 12

A patient is 39 weeks pregnant and is admitted for induction of labor.Her Bishop score is 2.Which teaching does the nurse prepare for this patient?

A) Explain the process of inducing labor
B) Describe the fetal monitoring equipment
C) Explain the importance of monitoring fetal activity
D) Explain the need for chemical or mechanical cervical ripening

Question 13

Which patient does the nurse recognize as a candidate for an amnioinfusion?

A) The woman who is postterm
B) The woman with multiple gestations
C) The woman with oligohydramnios
D) The woman carrying a fetus with a neural tube defect

Question 14

A patient's cervix is 2 cm dilated and 40% effaced,the fetal head is in the 0 station,and the consistency of the cervix is medium and is in the midposition.On the basis of the calculated Bishop score,how does the nurse interpret these findings?

A) The patient's cervix is ripe and ready for induction.
B) The patient's cervix is ripening,but readiness for induction is questionable.
C) Induction could be attempted,but cervical ripening is questionable.
D) The patient's cervix is not ripe,and induction should not be initiated at this time.

Question 15

Which teaching should the patient scheduled for a Cesarean birth receive during a routine visit with the provider 2 weeks prior to hospital admission?

A) Pack for 3 to 5 days in the hospital.
B) Obtain preoperative laboratory work.
C) Sign a consent for the operative procedure.
D) Maintain good hydration.

Question 16

Which outcome is most appropriate for a nursing diagnosis of Risk for Injury in a patient whose labor is induced?

A) Demonstrates and verbalizes reduced anxiety
B) Verbalizes understanding of the process of labor induction
C) Verbalizes readiness to become a mother
D) Maintains a good labor pattern with a reassuring FHR pattern

Question 17

Which patient does the nurse recognize as not an appropriate candidate for amniotomy?

A) The woman who is at 41 weeks' gestation
B) The woman with a fetus in the breech presentation
C) The woman with a history of hypertension
D) The woman with a history of precipitous delivery

Question 18

When a patient is prepared for discharge post-Cesarean section,which teaching does the nurse provide?

A) Plan to be in the hospital for 3 to 5 days.
B) Arrange for help at home.
C) Keep hair on the lower abdomen and pubis clipped.
D) Avoid unnecessary activity for 2 weeks.