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    Exam Review

    1. The nurse is preparing to assist the nurse midwife with an amnioinfusion. The patient asks, "Why do I need this?" The best response by the nurse is:
      A)
      "We need to decrease the fluid in your uterus."
      B)
      The decreased fluid in the uterus is causing the baby to lie on the umbilical cord."
      C)
      "You need extra amniotic fluid to prevent a dry birth."
      D)
      This will replace fluid in your uterus to prevent an infection."
    2. A nurse is discussing intermittent fetal heart monitoring with a newly licensed nurse. Which of the following statements should the nurse include?
      A)
      "Count the fetal heart rate for 15 seconds to determine the baseline."
      B)
      "Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor."
      C)
      "Auscultate the fetal heart rate every 30 minutes during the second stage of labor."
      D)
      "Count the fetal heart rate after a contraction to determine baseline changes."
    3. A major responsibility of the nurse caring for a patient receiving oxytocin for labor induction is to
      A)
      Monitor the patient's urinary output.
      B)
      Monitor for tachysystole.
      C)
      Monitor the patient's coping mechanisms for labor.
      D)
      Monitor the IV site.
    4. A nurse is assisting with monitoring a client who is admitted for preterm labor and is receiving magnesium sulfate. The client's respiratory rate is 8/min. Which of the following should the nurse administer?
      A)
      Flumazenil
      B)
      Calcium gluconate
      C)
      Naloxone
      D)
      Protamine sulfate
    Page 1 of 10

    Exam Review

    1. The 5 factors that affect and define the labor and birth process are:
      A)
      Presentation, latent phase, powers, position and attitude
      B)
      Passenger, passageway, powers, position and psychological response
      C)
      Passenger, presentation, lie, attitude and station
      D)
      Passageway, presentation. powers, contractions and position
    2. A nurse is caring for a newborn who was delivered by vacuum extraction and has swelling on his head that crosses the suture line. The newborn's mother asks about the swelling on her newborn's head. Which of the following responses should the nurse make?
      A)
      "This is a cephalhematoma, which will resolve on its own in 3 to 5 days."
      B)
      "This is a caput succedaneum, which is a collection of fluid from pressure of the vacuum extractor."
      C)
      "This is erythema toxicum, which is a transient allergic reaction that causes edema in the skin."
      D)
      "This is a Mongolian spot, which is found on many newborns."
    3. A nurse is assisting with the care of a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse take first?
      A)
      Explain to the client what is happening.
      B)
      Prepare the client for an emergency cesarean birth.
      C)
      Place the client in a knee-chest or Trendelenburg position.
      D)
      Cover the cord with a sterile, moist saline dressing.
    4. A nurse is assisting with the care of a client who is in labor. Which of the following nursing actions reflects application of the gate control theory of pain?
      A)
      Encouraging the client to rest between contractions
      B)
      Turning the client onto her left side
      C)
      Massaging the client's back
      D)
      Administering prescribed analgesic medication
    Page 2 of 10

    Exam Review

    1. . nurse is assisting with the care of a client with PROM and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?
      A)
      Heart rate of 55/min
      B)
      Urine output of 50 mL in 4 hr
      C)
      Diminished deep-tendon reflexes
      D)
      Respiratory rate of 16/min
    2. What is the most common cause of early decelerations in fetal heart rate?
      A)
      Fetal head compression
      B)
      Uteroplacental insufficiency
      C)
      Cord compression
      D)
      Maternal hypertension
    3. A nurse is assisting with the care of a client who is in labor. Which of the following findings should the nurse report to the provider?
      A)
      Contraction lasting 85 seconds
      B)
      Fetal heart rate 100/min for a 10-min period
      C)
      Contraction resting period 35 seconds
      D)
      Four contractions in a 10-min period
    4. What is the primary purpose of assessing fetal heart rate patterns during labor and delivery?
      A)
      To identify the mother's risk for complications
      B)
      To monitor the baby's oxygenation and overall well-being
      C)
      To predict the baby's birth weight
      D)
      To determine the baby's gender
    Page 3 of 10

    Exam Review

    1. A nurse is preparing to administer amoxicillin 300 mg PO. The amount available is amoxicillin oral solution 250 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
    2. A nurse is assisting with the care of a client in active labor. The nurse observes clear fluid and a loop of pulsating umbilical cord outside the client's vagina. Which of the following actions should the nurse perform first?
      A)
      Assist in initiating IV access and administering IV fluid bolus
      B)
      Call for assistance immediately
      C)
      Apply finger pressure to the presenting part
      D)
      Administer oxygen at 10 L/min via a nonrebreather
    3. A nurse is reinforcing teaching with a client who has premature rupture of membranes at 26 weeks of gestation. Which of the following instructions should the nurse include?
      A)
      Wipe from the back to front when performing perineal hygiene
      B)
      Keep a daily record of fetal kick counts.
      C)
      Avoid bubble bath solution when taking a tub bath.
      D)
      Use a condom with sexual intercourse.
    4. A nurse is reading a Fetal monitor strip and notes accelerations. What interventions would the nurse anticipate to do next?
      A)
      Nothing-this is a normal finding
      B)
      Place patient on her left side
      C)
      Give oxygen
      D)
      Call provider
    Page 4 of 10

    Exam Review

    1. A nurse is assisting in the care of a client who is to undergo an amniotomy. Which of the following is the priority nursing action following this procedure?
      A)
      Take the client's temperature.
      B)
      Check the fetal heart rate pattern.
      C)
      Observe the color and consistency of amniotic fluid.
      D)
      Evaluate the client for signs of infection.
    2. A patient in the latent phase of labor begins to experience nausea, feelings of helplessness and has become very irritable. The nurse suspects that the patient is now in the
      A)
      Not satisfied with the nonpharmacological comfort measures
      B)
      active phase of labor
      C)
      Going to require more pain medication
      D)
      Going to have a long labor
    3. An injection of local anesthetic drug into epidural space, which blocks transmission of pain impulses to brain and is given when cervix is in active labor at least 4cm dilated is called what?
      A)
      Epidural Anesthesia
      B)
      Local anesthesia
      C)
      Pudendal block
      D)
      General anesthesia
    4. A nurse is assisting a nurse midwife in examining a client who is a primigravida at 42 weeks of gestation and states that she thinks she is in labor. Which of the following findings confirm that the client is in labor?
      A)
      Pain just above the navel
      B)
      Contractions every 5 to 10 min
      C)
      Amniotic fluid in the vaginal vault
      D)
      Cervical dilation and effacement
    Page 5 of 10

    Exam Review

    1. A disadvantage of internal fetal monitoring is:
      A)
      An artifact on the printout is very common
      B)
      Accurate information regarding FHR variability is not possible
      C)
      It cannot provide data about the uterine resting tone
      D)
      It is invasive and increases the risk for uterine infection
    2. A nurse is assisting with the care of a client who had an epidural anesthesia block during the early stages of labor. The client's blood pressure is 80/40 mm Hg and the fetal heart recording is 140/min. Which of the following actions should the nurse take first?
      A)
      Place the client in a lateral position.
      B)
      Elevate the legs.
      C)
      Notify the provider.
      D)
      Increase IV fluid rate.
    3. A nurse is assisting with performing Leopold maneuvers on a client who is in labor. Which of the following techniques should the nurse use to identify the fetal lie?
      A)
      Apply palms of both hands to one side of uterus.
      B)
      Stand facing client's feet with fingertips outlining cephalic prominence.
      C)
      Palpate the fundus of the uterus.
      D)
      Perform deep palpation of the uterus
    4. What stage of labor ends with the physiologic stabilization of the mother?
      A)
      Stage 1
      B)
      Stage 2
      C)
      Stage 3
      D)
      Stage 4
    Page 6 of 10