Question 1

Under which circumstances would the nurse remove prostaglandin from the client's cervix?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

B, C, D

Question 2

Induction of labor is planned for a 31-year-old client at 39 weeks due to insulin-dependent diabetes. Which nursing action is most important?

Accepted Answer

Misoprostol (Cytotec) is used for cervical ripening and labor induction. When used, it's important to allow an appropriate interval before starting oxytocin (Pitocin) to minimize the risk of uterine hyperstimulation. The choice to begin Pitocin 4 hours after administering 50 mcg of misoprostol is aligned with safe practice guidelines, making it the most important and appropriate action among the options provided.

Question 3

The client is having fetal heart rate decelerations. An amnioinfusion has been ordered to alleviate the decelerations. The nurse understands that the type of decelerations that will be alleviated by amnioinfusion is which of the following?

Accepted Answer

Amnioinfusion is primarily used to alleviate variable decelerations, which are caused by umbilical cord compression. The infusion of fluid into the amniotic cavity helps to cushion and reduce the pressure on the umbilical cord, thereby reducing variable decelerations.

Question 4

The client tells the nurse that she has come to the hospital so that her baby's position can be changed. The nurse would begin to organize the supplies needed to perform which procedure?

Accepted Answer

A version is a procedure used to change the baby's position in the uterus, which aligns with the client's statement about wanting her baby's position to be changed.

Question 5

The nurse is caring for a client who is about to receive an amnioinfusion. For which complication(s) should the nurse monitor the client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

The answer of The nurse is caring for a client...

Question 6

The nurse is completing discharge teaching for a client who delivered 2 days ago. Which statement by the client indicates that further information is required?

Accepted Answer

The statement "The tear I have through my rectum is unrelated to my episiotomy." indicates a misunderstanding. An episiotomy can lead to or be associated with a tear that extends to the rectum, known as a third or fourth-degree tear, indicating the need for further information and clarification.

Question 7

The client is recovering from a delivery that included a midline episiotomy. Her perineum is swollen and sore. Ten minutes after an ice pack is applied, the client asks for another. What is the best response from the nurse?

Accepted Answer

Applying cold packs for swelling after a delivery with a midline episiotomy is a common practice. However, it's important to alternate the application of the ice pack with periods without it to prevent tissue damage from prolonged cold exposure. A common guideline is to apply the ice pack for 10-20 minutes and then leave it off for at least 20 minutes before reapplying. This approach helps reduce swelling and pain while minimizing the risk of cold injury to the skin and underlying tissues.

Question 8

The nurse knows that the Bishop scoring system for cervical readiness includes which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

The Bishop scoring system evaluates cervical readiness for labor and includes factors such as fetal station (A), cervical effacement (D), and cervical softness (E). It does not assess fetal lie (B) or the fetal presenting part (C), which are related to the position and orientation of the fetus but not directly to cervical readiness for labor.

Question 9

Amniotomy as a method of labor induction has which of the following advantages?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

Amniotomy, or artificial rupture of membranes, is a method of labor induction that has several advantages. It does not increase the risk of hypertonus or rupture of the uterus (B), allows for the evaluation of the color and composition of amniotic fluid (D), and the contractions it elicits are similar to those of spontaneous labor (E). It does not decrease the danger of a prolapsed cord or decrease pain; in fact, it may increase the risk of cord prolapse and can increase the intensity of contractions, potentially increasing pain.

Question 10

A laboring client's obstetrician has suggested amniotomy as a method for creating stronger contractions and facilitating birth. The client asks, "What are the advantages of doing this?" What should the nurse cite in response?

Accepted Answer

Amniotomy, or artificial rupture of membranes, can make contractions more similar to those experienced in spontaneous labor, potentially facilitating the progression of labor. It does not decrease the chances of a prolapsed cord, reduce labor pain, or eliminate the need for an episiotomy.

Question 11

The nurse is training a nurse new to the labor and delivery unit. They are caring for a laboring client who will have a forceps delivery. Which action or assessment finding requires intervention?

Accepted Answer

Instructing the client to push between contractions is incorrect and requires intervention. During labor, the client should be instructed to push during contractions, not between them, to effectively aid in the delivery process.

Question 12

The client requires vacuum extraction assistance. To provide easier access to the fetal head, the physician cuts a mediolateral episiotomy. After delivery, the client asks the nurse to describe the episiotomy. How does the nurse respond?

Accepted Answer

A mediolateral episiotomy is cut diagonally away from the vagina to prevent the risk of tearing towards the rectum and to provide more space for delivery.

Question 13

A laboring client's obstetrician has suggested amniotomy as a method for inducing labor. Which assessment(s) must be made just before the amniotomy is performed?

Accepted Answer

Before performing an amniotomy, it is crucial to assess fetal presentation, position, station, and heart rate to ensure the safety of the procedure and to monitor for any potential complications that could arise from the intervention.

Question 14

Major perineal trauma (extension to or through the anal sphincter) is more likely to occur if what type of episiotomy is performed?

Accepted Answer

Major perineal trauma, including extension to or through the anal sphincter, is more likely to occur with a midline episiotomy compared to a mediolateral episiotomy. Midline episiotomies are straight incisions made directly towards the anus, increasing the risk of extension into the anal sphincter.

Question 15

The client is undergoing an emergency cesarean birth for fetal bradycardia. The client's partner has not been allowed into the operating room. What can the nurse do to alleviate the partner's emotional distress?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

The answer of The client is undergoing an emergency cesarean...

Question 16

The nurse knows that a contraindication to the induction of labor is which of the following?

Accepted Answer

Placenta previa is a condition where the placenta covers the cervix, making vaginal delivery dangerous due to the risk of severe bleeding. Inducing labor in such cases is contraindicated.

Question 17

The client presents for cervical ripening in anticipation of labor induction tomorrow. What should the nurse include in her plan of care for this client?

Accepted Answer

Electronic fetal monitoring is used to monitor the baby's heart rate and the frequency and duration of the mother's contractions, which is important during cervical ripening and labor induction to ensure the baby's well-being.

Question 18

A woman has been admitted for an external version. She has completed an ultrasound exam and is attached to the fetal monitor. Prior to the procedure, why will terbutaline be administered?

Accepted Answer

Terbutaline is administered to relax the uterus, which can help facilitate the external version procedure by making it easier to turn the fetus.

Question 19

The nurse is scheduling a client for an external cephalic version (E C V). Which finding in the client's chart requires immediate intervention?

Accepted Answer

A previous cesarean birth is a contraindication for external cephalic version (ECV) due to the risk of uterine rupture along the scar line.

Question 20

After inserting prostaglandin gel for cervical ripening, what should the nurse do?

Accepted Answer

Placing the client in a supine position with a right hip wedge helps maintain uterine perfusion and prevents supine hypotension syndrome by avoiding compression of the inferior vena cava.

Quiz 25: Birth-Related Procedures

Under which circumstances would the nurse remove prostaglandin from the client's cervix? Note: Credit will be given only if all correct choices and no incorrect choices are selected.