Deck 21: Nursing Management of Labor and Birth at Risk

Question 1

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position?

A) Supine
B) Side-lying
C) Sitting
D) Knee-chest

Answer 1

Knee-chest

Question 2

A primigravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. The nurse would assess the woman for which condition?

A) A low-lying placenta
B) Fetopelvic disproportion
C) Contraction ring
D) Uterine bleeding

Answer 2

Fetopelvic disproportion

Question 3

The nurse would be alert for possible placental abruption during labor when assessment reveals which of the following?

A) Macrosomia
B) Gestational hypertension
C) Gestational diabetes
D) Low parity

Answer 3

Gestational hypertension

Question 4

Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal contractions that are:

A) Well coordinated
B) Poor in quality
C) Rapidly occurring
D) Erratic

Question 5

A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer?

A) Sedatives
B) Tocolytics
C) Oxytocins
D) Corticosteroids

Question 6

The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which of the following would the nurse identify as the priority intervention?

A) Position changes
B) Pain relief measures
C) Immediate cesarean birth
D) Oxytocin administration

Question 7

A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which of the following in the newborn?

A) Asphyxia
B) Clavicular fracture
C) Caput succedaneum
D) Central nervous system injury

Question 8

A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following findings would require immediate intervention?

A) Fetal heart rate of 150 beats/minute
B) Contractions every 2 minutes, lasting 45 seconds
C) Uterine resting tone of 14 mm Hg
D) Urine output of 20 mL/hour

Question 9

A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also complains of acute abdominal pain that is continuous. Which of the following would the nurse suspect?

A) Amniotic fluid embolism
B) Shoulder dystocia
C) Uterine rupture
D) Umbilical cord prolapse

Question 10

When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate?

A) One who has undergone a previous myomectomy
B) One who had a previous cesarean birth via a low transverse incision
C) One who has a history of a contracted pelvis
D) One who has a vertical incision from a previous cesarean birth

Question 11

A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure?

A) "You'll need to stay in bed while you're having this procedure."
B) "We'll give you an analgesic to help reduce the pain."
C) "After the infusion, you'll be scheduled for a cesarean birth."
D) "A suction cup is placed on your baby's head to help bring it out."

Question 12

Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction?

A) Posterior position
B) Firm
C) Closed
D) Shortened

Question 13

A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately?

A) Respiratory rate of 16 breaths per minute
B) Diminished deep tendon reflexes
C) Urine output of 45 mL/hour
D) Alert level of consciousness

Question 14

A woman who is 42 weeks pregnant comes to the clinic. Which of the following would be most important?

A) Determining an accurate gestational age
B) Asking her about the occurrence of contractions
C) Checking for spontaneous rupture of membranes
D) Measuring the height of the fundus

Question 15

After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching?

A) "Holding a pillow against my incision will help me when I cough."
B) "I'm going to have to wait a few days before I can start breast-feeding."
C) "I guess the nurses will be getting me up and out of bed rather quickly."
D) "I'll probably have a tube in my bladder for about 24 hours or so."

Question 16

The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth?

A) 11
B) 8
C) 6
D) 3

Question 17

After teaching a group of nursing students about risk factors associated with dystocia, the instructor determines that the teaching was successful when the students identify which of the following as increasing the risk? (Select all that apply.)

A) Pudendal block anesthetic use
B) Multiparity
C) Short maternal stature
D) Maternal age over 35
E) Breech fetal presentation

Question 18

A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which of the following would the nurse most likely include as the most common problem?

A) Macrosomia
B) Breech presentation
C) Persistent occiput posterior position
D) Multifetal pregnancy

Question 19

After teaching a group of nursing students about tocolytic therapy, the instructor determines that the teaching was successful when they identify which drug as being used for tocolysis? (Select all that apply.)

A) Nifedipine
B) Terbutaline
C) Dinoprostone
D) Misoprostol
E) Indomethacin

Question 20

A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings?

A) Dull low backache
B) Malodorous vaginal discharge
C) Dysuria
D) Constipation

Question 21

A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman states that if she experiences any symptoms, she will do which of the following?

A) "I'll sit down to rest for 30 minutes."
B) "I'll try to move my bowels."
C) "I'll lie down with my legs raised."
D) "I'll drink several glasses of water."

Question 22

A nurse is describing the risks associated with prolonged pregnancies as part of an inservice presentation. Which of the following would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus?

A) Aging of the placenta
B) Increased amniotic fluid volume
C) Meconium aspiration
D) Cord compression

Question 23

A group of nursing students are reviewing information about methods used for cervical ripening. The students demonstrate understanding of the information when they identify which of the following as a mechanical method?

A) Herbal agents
B) Laminaria
C) Membrane stripping
D) Amniotomy

Question 24

The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. Which findings would the nurse most likely assess? (Select all that apply.)

A) Significant difficulty breathing
B) Hypertension
C) Tachycardia
D) Pulmonary edema
E) Bleeding with bruising

Question 25

A group of nursing students are reviewing information about cesarean birth. The students demonstrate understanding of the information when they identify which of the following as an appropriate indication? (Select all that apply)

A) Active genital herpes infection
B) Placenta previa
C) Previous cesarean birth
D) Prolonged labor
E) Fetal distress

Question 26

A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which of the following?

A) Uterine hyperstimulation
B) Headache
C) Blurred vision
D) Hypotension