Exam Review

A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure would be to use:
A)
Conscious relaxation or guided imagery.
B)
Counterpressure against the sacrum.
C)
Effleurage.
D)
Pant-blow (breaths and puffs) breathing techniques.
The patient received a narcotic analgesic during the transition stage of labor. Which of the following will the nurse assess for in the newborn?
A)
Acrocyanosis.
B)
Respiratory depression.
C)
Bradycardia.
D)
Tachypnea.
The patient has shared a copy of her birth plan with the nurse. When is the best time for the nurse to review the birth plan and discuss the patient's options for pharmacologic pain relief in labor?
A)
The third stage of labor.
B)
During a uterine contraction.
C)
Before a uterine contraction.
D)
The second stage of labor.
E)
Upon admission during the latent phase of labor.
The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been effective when the client reports that she has been sleeping:
A)
On her abdomen.
B)
In a side-lying position.
C)
On her back with a pillow under her knees.
D)
With her head elevated on two pillows.

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Exam Review

A woman has requested an epidural for her pain. She is 5 cm dilated and 100
A)
She is septic.
B)
She has thrombocytopenia.
C)
She is too far dilated.
D)
She is anemic.
A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively; she states that she did not attend childbirth classes. The most important nursing action is to:
A)
Administer the prescribed narcotic analgesic.
B)
Assure her that her labor will be over soon.
C)
Assist her with simple breathing and relaxation instructions.
D)
Notify the woman's health care provider.
A major advantage of nonpharmacologic pain management is that:
A)
A slower labor decreases the risk of complications.
B)
Elimination of pain is possible.
C)
The woman remains fully alert at all times.
D)
There are no side effects or risks to the fetus.
The nurse is taking an advice call from a woman at 40 weeks' gestation. The nurse instructs the patient to go to the hospital to be evaluated when the patient states which of the following?
A)
"I passed the mucous plug.”.
B)
"I have a trickle of fluid leaking from my vagina.”.
C)
"I have had irregular contractions for the last hour.”.
D)
"The baby has been moving.”. —

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Exam Review

Immediately following administration of epidural anesthesia to the patient, the nurse must monitor the mother for which of the following?
A)
Increase in her central venous pressure.
B)
Fetal heart rate accelerations.
C)
Paresthesia in her feet and legs.
D)
Decrease in her blood pressure.
A primigravida is pushing with contractions. The nurse notes that the woman's perineum is beginning to bulge and that there is an increase in bloody show. Which of the following actions by the nurse is appropriate at this time?
A)
Report the findings to the woman's health care provider.
B)
Place the client on her side with oxygen via face mask.
C)
Immediately assess the woman's pulse and blood pressure.
D)
Monitor the fetal heart rate every 60 minutes.
E)
Prepare for imminent delivery of the newborn.
When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include when possible:
A)
Telling the woman to start pushing as soon as her cervix is fully dilated.
B)
Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction.
C)
Starting an epidural so that pain is reduced and the woman can relax.
D)
Encouraging the woman to try various upright positions, including squatting and pushing with the head of the bed up. —
A 20-week pregnant client is being seen in the prenatal clinic. Her fundus is palpated 3 cm below the umbilicus. This finding is:
A)
Higher than normal for gestational age.
B)
A sign of impending complications.
C)
Appropriate for gestational age.
D)
Lower than normal for gestational age.

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Exam Review

Which complaint made by a client at 35 weeks of gestation requires additional assessment?
A)
Shortness of breath when climbing stairs.
B)
Ankle edema in the afternoon.
C)
Backache with prolonged standing.
D)
Abdominal pain.
Which client at term should go to the hospital or birth center the soonest after labor begins?
A)
Gravida 3, para 2 whose longest previous labor was 4 hours.
B)
Gravida 1, para 0 who lives 40 minutes away.
C)
Gravida 2, para 1 whose first labor lasted 16 hours.
D)
Gravida 2, para 1 who lives 10 minutes away.
The nurse is teaching a 25 year old pregnant woman about nutrition and weight gain. Which of the following statements demonstrates the woman understands the teaching?
A)
"A weight gain of 5 pounds per month is a healthy weight gain for the baby and for me.”.
B)
"The normal weight gain for pregnancy is 25-35 pounds (11.5-16 kg) for a woman with a normal BMI.”.
C)
"I should maintain a weight gain of one pound per month so that by gestation week 40, I would have gained 40 pounds (18 kg), which is the minimum healthy weight gain I need for my baby.”.
D)
"Even though I'm obese, I should not be concerned because obesity is not associated with pregnancy loss.”. —
A Gravida 1, Para 0 patient, 40 weeks pregnant, is laboring in bed, flat on her back, in the supine position. She becomes pale, her skin becomes clammy, and she states she feels dizzy. What is the first action by the nurse?
A)
Apply oxygen 10 liters by simple face mask.
B)
Notify her medical provider.
C)
Administer 250 ml Lactated Ringer's IV fluid bolus.
D)
Turn the patient to her side.

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Exam Review

A client is admitted to the birthing suite in early active labor. Which nursing action takes priority during the admission process?
A)
Determining when the last meal was eaten.
B)
Ascertaining whether the membranes have ruptured.
C)
Obtaining an obstetric history.
D)
Auscultating the fetal heart.
The client has just received an epidural and is concerned about having a bowel movement while pushing and delivering her baby. Which of the following statements by the nurse is appropriate?
A)
"Don't worry, we can get you to the bathroom and you can have a bowel movement before delivery.”.
B)
"This happens with most deliveries. You shouldn't worry about having a bowel movement.”.
C)
"When you visited the bathroom before your epidural was placed, that was your opportunity to have a bowel movement.”.
D)
"You are at risk for falling if you try to get out of bed. I will assist you in keeping clean while you are pushing.”. —
The client has just received an epidural and is concerned about having a bowel movement while pushing and delivering her baby. Which of the following statements by the nurse is appropriate?
A)
"Don't worry, we can get you to the bathroom and you can have a bowel movement before delivery.”.
B)
"This happens with most deliveries. You shouldn't worry about having a bowel movement.”.
C)
"When you visited the bathroom before your epidural was placed, that was your opportunity to have a bowel movement.”.
D)
"You are at risk for falling if you try to get out of bed. I will assist you in keeping clean while you are pushing.”. .
A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She asks the nurse: "One of my friends told me I need to take folic acid. Why do I have to do that?" The nurse's best response is:
A)
Folic acid prevents neural tube defects like spina bifida.
B)
Folic acid is used to treat certain types of anemia.
C)
Folic acid is in enriched breads and cereals, so you do not need any extra in pregnancy.
D)
Folic acid is not needed in pregnancy, so you do not need to take it. . .

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Exam Review

A client in labor and delivery has just received a dose of ephedrine. Which of the following signs should the nurse expect to see?
A)
An increase in temperature.
B)
A decrease in blood pressure.
C)
An increase in the blood pressure.
D)
A decrease in respiratory rate.
The nurse who performs vaginal examinations to assess a woman's progress in labor should:
A)
Wear two clean gloves for each examination.
B)
Perform the examination with the woman in the supine position.
C)
Discuss the findings with the woman and her partner.
D)
Perform an examination at least once every hour during the active phase of labor.
With regard to their role in the personal hygiene of the expectant mother, maternity nurses should be aware that:
A)
Tub bathing is permitted even in late pregnancy unless membranes have ruptured.
B)
The perineum should be wiped from back to front.
C)
Expectant mothers should use specially treated soap to cleanse the nipples.
D)
Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath.
A pregnant patient at 28 weeks has become anemic. The nurse would anticipate giving the following guidelines regarding iron supplementation, except:
A)
Take the iron pill with vitamin C or orange juice.
B)
Darkening of the stools is a normal side effect of iron supplementation.
C)
To help reduce nausea, drink a glass of milk when taking your iron pill.
D)
You may take iron in between meals or at night.

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