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?

Accepted Answer

D

Question 2

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?

Accepted Answer

Infusing a bolus of 500-1000 mL of an isotonic solution before the procedure can help prevent maternal hypotension by expanding the intravascular volume and maintaining blood pressure. Administering intravenous phenylephrine and monitoring blood pressure closely are also important steps, but they are not the nurse's initial action. Turning the patient onto her left side and giving a rapid bolus of IV fluids may help treat maternal hypotension if it occurs, but they are not preventative measures.

Question 3

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

Accepted Answer

The nurse should inform the patient to avoid live vaccines for at least 3 months after receiving RhoGAM to prevent interference with the immune response.

Question 4

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?

Accepted Answer

Bisacodyl tablets should be stored in a cool, dry place. They should not be crushed or taken with carbonated beverages. Taking with milk is not indicated for GI upset.

Question 5

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?

Accepted Answer

Teaching breathing exercises can help the woman to focus and relax, decreasing her perception of pain without relying on medications that can have side effects for her or her baby.

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?

Accepted Answer

If the continuous infusion of epidural anesthesia is not effective, the patient should inform the provider. Rescue doses of anesthesia may be needed to manage pain. In this case, adjustments to the infusion rate may also be made. Option A is incorrect because increasing the amount of anesthesia may increase the risk of other side effects, not just postdural headache. Option C is incorrect because epidural anesthesia can be combined with other forms of anesthesia. Option D is incorrect because not all patients may find the consistent level provided by the continuous infusion to 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?

Accepted Answer

Promethazine (Phenergan) is a commonly used antiemetic medication that can help alleviate nausea and vomiting. It can be given intravenously and is often used in labor and delivery settings for women who experience nausea or vomiting from pain medications or the labor process itself. Hydroxyzine HCl (Vistaril) is also an antiemetic medication but is not typically used in labor and delivery settings. Pentobarbital sodium (Nembutal) and pentobarbital are sedative medications and not appropriate choices for treating nausea and vomiting.

Question 8

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 recommend which of the following?

Accepted Answer

The MMR vaccine is a live attenuated vaccine and is contraindicated in pregnancy. Therefore, the woman should wait until after the baby is born to receive the vaccine. However, it is safe for her children to receive the vaccine now. Delaying their immunizations can put them at risk for contracting and spreading these diseases. It is important to protect them and the community from these preventable illnesses.

Question 9

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 is being used for which purpose?

Accepted Answer

Oxytocin is a medication used to prevent uterine atony, which is a condition where the uterus fails to contract after delivery of the placenta. This can lead to postpartum hemorrhage, which is a life-threatening complication. Oxytocin helps to stimulate the uterus to contract and prevent excessive bleeding. It is not used for closing the cervix, enhancing milk letdown, or suppressing lactation.

Question 10

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 may need:

Accepted Answer

Rh-negative mothers who give birth to Rh-positive infants are at risk for hemolytic disease of the newborn in future pregnancies. To prevent sensitization, a larger-than-normal dose of human D immune globulin (RhoGAM) is required within 72 hours of delivery. The usual dose is 300 µg, but the dose required for postpartal prophylaxis is 1,200 µg.

Question 11

Constipation is common during the postpartum period. Which of the following OTC products can be used to help manage constipation postpartum?

Accepted Answer

Docusate sodium and sennosides are commonly used to manage constipation. Hydrocodone and promethazine are not indicated for constipation and dinoprostone is used for cervical ripening and induction of labor.

Question 12

The nurse examines a 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:

Accepted Answer

The lack of progression in cervical dilation after being stable for an hour may indicate uterine dysfunction and a need for augmentation of contractions with oxytocin. Cesarean section, forceps delivery, and vacuum extraction are not indicated in this scenario.

Question 13

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response. Which of the following medications can contribute to delayed breastfeeding with a poor sucking response for up to 4 days if used during labor?

Accepted Answer

Pentobarbital (Nembutal) is a barbiturate that can cause sedation in the newborn, leading to a poor sucking response and delayed breastfeeding.

Quiz 50: Labor, Delivery, and Postpartum

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?

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?

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

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?

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?

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?

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 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 recommend which of the following?

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 is being used for which purpose?

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 may need:

Constipation is common during the postpartum period. Which of the following OTC products can be used to help manage constipation postpartum?

The nurse examines a 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:

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response. Which of the following medications can contribute to delayed breastfeeding with a poor sucking response for up to 4 days if used during labor?

Quiz 50: Labor, Delivery, and Postpartum

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?

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?

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

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?

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?

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?

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 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 recommend which of the following?

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 is being used for which purpose?

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 may need:

Constipation is common during the postpartum period. Which of the following OTC products can be used to help manage constipation postpartum?

The nurse examines a 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:

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response. Which of the following medications can contribute to delayed breastfeeding with a poor sucking response for up to 4 days if used during labor?

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