Question 1

A pregnant woman's membranes ruptured prematurely at 34 weeks.She will be discharged to her home for the next few weeks.What would the nurse planning discharge instruction teach the woman to do?

Accepted Answer

For the woman with premature rupture of membranes (PROM)who is not having labor induced right away,teaching combines information about infection and preterm labor.The woman should monitor her temperature and report a temperature greater than 37.8° C (100° F).

Question 2

A pulsating structure is felt during a vaginal examination of a woman in labor.How would the nurse position the woman to prevent compression of a prolapsed cord?

Accepted Answer

The Trendelenburg (head down)position displaces the fetus upward to stop compression of the prolapsed cord.

Question 3

What nursing assessment should be reported immediately after an amniotomy?

Accepted Answer

Amniotic fluid should be clear.Green fluid indicates the fetus has passed meconium,which is associated with fetal compromise.

Question 4

A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to 5 cm with membranes intact.What action by the physician will the nurse anticipate?

Accepted Answer

Medical treatment for hypotonic labor dysfunction includes an amniotomy as the first remedy if the membranes are intact.

Question 5

A new mother is distressed and tearful about the elevated dome over her infant's posterior fontanelle.The nurse responds,"This condition will resolve itself in a few days." What is the cause?

Accepted Answer

The "chignon" is due to the effect of the vacuum extractor and will disappear in a few days.

Question 6

When a woman is admitted to the labor and delivery unit,she tells the nurse that she is anxious about delivery,the welfare of her infant,and how quickly she will recover.How can anxiety affect labor?

Accepted Answer

Excessive anxiety reduces uterine blood flow,making uterine contractions less effective,and creates muscle tension that counteracts the expulsion powers of contractions.

Question 7

A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously.What complication should the nurse closely assess for with this patient?

Accepted Answer

Infection of the amniotic sac,called chorioamnionitis,may cause prematurely ruptured membranes,or it may be a consequence of rupture because the barrier to the uterine cavity is broken.

Question 8

Which statement indicates a woman understands activity limitations for the management of preterm labor?

Accepted Answer

Lengthy activity restrictions are often needed to prevent preterm birth.The nurse can help the woman identify ways to organize necessary activities and maximize rest.

Question 9

After several hours of labor,a nursing assessment reveals that a woman's cervix is 5 cm dilated but contractions are becoming shorter and less frequent.What is this labor pattern considered?

Accepted Answer

The woman with labor dysfunction related to decreased uterine muscle tone begins labor normally,but contractions diminish after the active phase.

Question 10

A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP).What position will the nurse promote to encourage fetal rotation and pain relief?

Accepted Answer

A position that favors fetal rotation and descent and that is helpful for the woman with back labor is to sit or kneel leaning forward on a support.

Question 11

A woman who is 24 weeks pregnant is placed on an intravenous infusion of magnesium sulfate.What side effect should the nurse inform the patient that she might experience?

Accepted Answer

Magnesium sulfate is the drug of choice for initiating therapy to stop labor.The patient will notice a warm flush with the initiation of the drug.

Question 12

The nurse is administering terbutaline (Brethine)to a pregnant woman to prevent preterm labor.The nurse would assess for which adverse effect?

Accepted Answer

Maternal tachycardia is the common negative side effect of terbutaline,which should be corrected with a dose of propranolol.

Question 13

A student nurse questions the instructor regarding what alteration should be made for the assessment of the fundus of a new postoperative cesarean section patient.What is the best response?

Accepted Answer

Assessment of the fundus following a cesarean section is done as usual,but using especially gentle fundal massage.

Question 14

During a strenuous labor,the woman asks for some pain remedy for the sudden pain between her scapulae that seems to occur with every breath she takes.What is the best nursing action?

Accepted Answer

Sudden pain between the scapulae during a strenuous labor is an indicator of uterine rupture.This should be reported immediately.

Question 15

A woman 2 weeks past her expected delivery date is receiving an oxytocin infusion to induce labor and begins to have contractions every 90 seconds.What is the nurse's initial action?

Accepted Answer

Oxytocin is discontinued if signs of fetal compromise or excessive uterine contractions occur.

Question 16

What nursing care should be provided to a woman with a third-degree laceration immediately after delivery?

Accepted Answer

Ice is applied to the perineum to reduce bruising and edema.

Question 17

The initial vaginal examination of a woman admitted to the labor unit reveals that the cervix is dilated 9 cm.The panicked woman begs the nurse,"Please give me something." What is the most appropriate pain relief intervention for a woman in precipitate labor?

Accepted Answer

The nurse would stay with the woman experiencing precipitate labor and breathe with her during contractions to help the woman focus and cope with each contraction.

Question 18

A frustrated patient in labor has been affected by decreased uterine muscle tone and reports,"My doctor won't induce my labor because of some silly score.He said I was a 4.What kind of magic number do I need?" What is the lowest Bishop score the patient should have prior to induction?

Accepted Answer

The Bishop score evaluates the suitability of the patient for a vaginal delivery.A minimum score of 6 is recommended by the American Congress of Obstetricians and Gynecologists (ACOG).

Question 19

An infant is delivered with the use of forceps.What should the nurse assess for in the newborn?

Accepted Answer

Pressure from forceps may injure the infant's facial nerve,which is evidenced by facial asymmetry.

Question 20

Several hours after delivery the nurse finds a woman crying.The woman says repeatedly,"My baby is beautiful,but I was planning on a vaginal delivery.Instead I needed an emergency C-section." What is the most appropriate nursing diagnosis?

Accepted Answer

Women who have cesarean births usually need greater support than those who have vaginal births.They may feel grief,guilt,or anger because the expected course of birth did not occur.

Quiz 8: Nursing Care of Women with Complications During Labor and Birth