Question 1

The nurse is speaking with a pregnant patient who is asking what processes start labor. Which responses by the nurse are appropriate? Select all that apply.

Accepted Answer

A) Pressure on the cervix can indeed stimulate the release of oxytocin, which is involved in the initiation of labor contractions. B) Oxytocin plays a crucial role in stimulating uterine contractions, which are essential for labor. D) The aging and deterioration of the placenta can signal the body to initiate labor as it indicates that the pregnancy is nearing its term. E) The release of cortisol from the fetus is thought to play a role in the timing of labor by influencing the levels of other hormones that regulate the readiness of the uterus and cervix for labor. Contrary to option C, labor is actually associated with an increase in estrogen levels, which works alongside progesterone to prepare the uterus for contractions.

Question 2

The nurse is helping the patient assume a position for placement of an epidural. Which of the following positions are appropriate for placing an epidural? Select all that apply.

Accepted Answer

A,B

Question 3

The nursing is caring for a patient in active labor with significant back pain. The patient has requested nonpharmacologic methods of pain relief. The nurse thinks that sterile water injections may help with her pain management. Which of the following explanations should the nurse explain to the patient?

Accepted Answer

The nurse should explain that they will inject 0.5 mL of sterile water subcutaneously, and it will last for an hour to 90 minutes. This is the correct explanation for sterile water injections for pain relief during labor.

Question 4

The nurse encourages the patient to bring loved ones to be with her during labor because the nurse knows that their presence does which of the following? Select all that apply.

Accepted Answer

The presence of loved ones during labor can have several positive effects on the birthing process. It can shorten the length of labor (A) and reduce the likelihood that a patient will require an epidural (B) by providing emotional support and comfort, which can help manage pain and stress. Additionally, having loved ones present can increase patients' happiness and satisfaction with the outcome of their birth (E) by creating a supportive and positive environment. There is no evidence to suggest that the presence of loved ones reduces the risk of infection after birth (C) or lowers the chance that the patient will breastfeed (D).

Question 5

The nursing is caring for a 31-year-old female patient who is pregnant at 37 weeks and 5 days gestation. The patient is having contractions every 3 minutes and was found to have a platypelloid pelvis upon examination. The fetus has an estimated fetal weight of 7 lbs and is in the LOA position. This patient is laboring on the birth ball, and her mother-in-law is helping her labor. The nurse is concerned about the five Ps and their effect on the patient's labor. Which P is the nurse most likely concerned about based on the patient's history?

Accepted Answer

The nurse is most likely concerned about "Passage" due to the patient's platypelloid pelvis, which can affect the shape and size of the pelvic outlet, potentially complicating the passage of the fetus during labor.

Question 6

A 40-year-old G5P1031 is attending a childbirth education class. During the class, the woman says, "The worst part of contractions with my last labor was when they were at the peak of intensity." The nurse educator correctly explains that the woman is identifying which part of a contraction?

Accepted Answer

The shortest part of a contraction is when it is at its peak intensity, which is when the woman feels the most discomfort.

Question 7

The nurse is reading the patient's chart, which indicates the patient has a "gynecoid pelvis." What finding is expected in this patient?

Accepted Answer

A gynecoid pelvis is the most common pelvis shape in females and is typically wider at the pelvic outlet, which makes it favorable for childbirth. The pubic arch in a gynecoid pelvis may be slightly wider, and the diameter between the coccyx and ischium may be slightly longer compared to other pelvis shapes, but not to the point that it would impede childbirth. The inlet of a gynecoid pelvis may also be slightly wider.

Question 8

The nurse educator is in a childbirth education class discussing nonpharmacological ways nurses can assist to enhance labor and spontaneous vaginal delivery. Which of the following facts regarding nonpharmacologic approaches will the nurse use to help illustrate its benefits?

Accepted Answer

The answer of The nurse educator is in a childbirth...

Question 9

The nurse is caring for a 24-year-old woman who is G1P0 at 40 weeks, 1 day gestation and in active labor. She has just received an epidural and now complains of "an itchy feeling all over." Her vitals are as follows: HR 120, RR 12, BP 130/74, T 98.8, and O₂ sat 98%. Which action should the nurse take first?

Accepted Answer

Pruritus is a common side effect of epidural anesthesia due to opioids. The nurse should call the healthcare provider to order an antipruritic medication to relieve the patient's discomfort.

Question 10

The nurse is reviewing the chart of a 35-year-old G4P2012 woman. The patient is at 38 weeks, 4 days and is in active labor with SROM clear fluid 2 hours ago. What action should the nurse take?

Accepted Answer

Changing the patient's position every 30 minutes can help with labor progression and fetal positioning, which is important in active labor.

Question 11

The nurse educator is teaching about regional and local anesthesia in a childbirth education class. The nurse should teach that regional anesthesia is used for which of the following? Select all that apply.

Accepted Answer

The answer of The nurse educator is teaching about regional...

Question 12

The obstetric nurse is assessing the laboring patient for pain. Which of the following should the nurse identify in a pain assessment? Select all that apply.

Accepted Answer

The intensity, frequency, and duration of contractions can give insight into the level of pain the patient is experiencing. Pain in the neck or back can also indicate discomfort. Additionally, signs of anxiety, such as increased heart rate or hyperventilation, can also indicate pain. FHR with intermittent auscultation is not relevant to a pain assessment.

Question 13

A patient is interested in a pain relief option that she can control during labor. The nurse explains to the patient what pain relief options are available that would meet her needs, and they mutually decide on nitrous oxide. Which of the following does the nurse describe to the patient about the use of nitrous oxide in labor? Select all that apply.

Accepted Answer

Nitrous oxide takes effect quickly, usually within 50 seconds, and helps the patient feel calm. It does not affect the progress of labor, so it does not prolong labor.

Question 14

The nurse is counseling a 15-year-old pregnant patient at her first prenatal appointment. Which patient teaching by the nurse is appropriate?

Accepted Answer

Choice D is the best option because it is an appropriate patient teaching for a 15-year-old pregnant patient. It acknowledges that her response to pregnancy, labor, and delivery may differ from that of an adult due to her incomplete cognitive development. It also highlights the importance of individualized care for teenage pregnancy. Choices A, B, and C are incorrect and not appropriate patient teachings. Choice A makes a generalization about adolescents' coping mechanisms without considering individual differences. Choice B is inaccurate and may cause unnecessary fear or anxiety. Choice C is also inaccurate and unsupported by evidence.

Question 15

The patient is having an unmedicated childbirth and has begun to bear down. She vocalizes, "The baby is coming!" Which action should the nurse take?

Accepted Answer

Having the patient assume a comfortable and upright position can facilitate childbirth by using gravity to assist in the descent of the baby, and it allows the patient to find a position that is most comfortable for them during an unmedicated childbirth.

Question 16

The nurse is caring for a 34-year-old woman who is G2P1001 at 39 weeks and 1 day. The patient is an observant Muslim and is in active labor. Which outcome would be the most effective form of applying culturally sensitive communication?

Accepted Answer

The answer of The nurse is caring for a 34-year-old...

Question 17

The nurse is teaching the patient about the trends and risks of epidural anesthesia. Which of the following should the nurse relay about the risks of epidural anesthesia? Select all that apply.

Accepted Answer

The answer of The nurse is teaching the patient about...

Question 18

The patient is a 26-year-old G1P0 at 38 weeks, 2 days of gestation. She is at her provider's office for a visit and complains to the nurse of wrist pain, fatigue, increased discharge, and "feeling heavy." Which complaint could be a sign of impending labor?

Accepted Answer

Increased discharge can be a sign of impending labor as the cervix begins to soften and thin out (efface) and the mucus plug may be released. Wrist pain and fatigue may be related to pregnancy-induced carpal tunnel syndrome and general fatigue associated with the late stage of pregnancy. Feeling heavy is a common complaint in late pregnancy due to the weight of the growing baby and uterus. However, it is not necessarily a sign of impending labor.

Question 19

The nursing preceptor asks the nursing student how to best determine the intensity of contractions before placing the patient on an electronic fetal monitoring strip. How would the nurse assess this?

Accepted Answer

Palpating the maternal abdomen during a contraction is the most accurate manual method to assess the intensity of uterine contractions. This technique allows the nurse to feel the hardness of the uterus, which correlates with the strength of the contraction.

Question 20

The nurse educator is teaching the nursing student the basic principles of using analgesia by using a patient, Christa, as an example. Which of the following demonstrates the basic principles of analgesia during Christa's labor and delivery? Select all that apply.

Accepted Answer

The answer of The nurse educator is teaching the nursing...

Quiz 8: Intrapartum Assessment and Interventions