NursGuru

    Exam Review

    1. Because cervical effacement and dilation are not progressing in a patient in labor, the doctor orders I.V. administration of oxytocin (Pitocin). Why should the nurse monitor the patient's fluid intake and output closely during oxytocin administration?
      A)
      Oxytocin causes water intoxication.
      B)
      Oxytocin causes excessive thirst.
      C)
      Oxytocin is toxic to the kidneys.
      D)
      Oxytocin has a diuretic effect.
    2. The nurse instructs the laboring client to begin pushing with her contractions
      A)
      at the beginning of the second stage
      B)
      at the end of the active phase
      C)
      during the latter part of the second stage
      D)
      during transition
    3. A vaginal examination on a laboring client reveals that the biparietal diameter of the fetal head is at +2 station. This indicates that the fetal head is
      A)
      achieving attitude
      B)
      reaching ballottement
      C)
      below the ischial spines
      D)
      floating above "0" station
    4. What is the nursing action that has the highest priority for a client experiencing hypertonic contractions during the use of oxytocin to stimulate labor?
      A)
      Open up the IV.
      B)
      Start oxygen per face mask.
      C)
      Stop the oxytocin infusion.
      D)
      Turn the client on her left side.

    Exam Review

    1. Internal version (manual rotation) is attempted only in:
      A)
      adolescents with a breech presentation
      B)
      response to fetal distress
      C)
      multiple gestation, for the birth of the second twin
      D)
      obstetric intensive care unit for delivery of baby in fetal distress
    2. A client is a gravida 1 para 0, 42 weeks gestation in early labor. Her tracing indicates normal variability and variable decelerations. As her nurse you are aware that the decelerations are probably caused by
      A)
      compression of the umbilical cord
      B)
      head compression
      C)
      maternal hypotension
      D)
      uteroplacental insufficiency
    3. A nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions is most appropriate?
      A)
      Document the findings and tell the mother that the monitor indicates fetal well-being
      B)
      Take the mother's vital signs and tell the mother that bed rest is required to conserve oxygen
      C)
      Notify the physician or nurse midwife of the findings
      D)
      Reposition the mother and check the monitor for changes in the fetal tracing
    4. Which of the following are disadvantages of a midline episiotomy
      A)
      more bleeding
      B)
      delayed delivery
      C)
      extends to anus
      D)
      more pain

    Exam Review

    1. The placenta failed to separate and deliver. On examination the doctor finds that the placenta has grown through the uterine wall and has attached to the bladder. What kind of abnormal attachments is this called?
      A)
      Accreta
      B)
      Plancreta
      C)
      percreta
      D)
      increta
    2. The nurse explains to a client that the purpose of a cerclage is to
      A)
      stop premature labor contractions
      B)
      control active vaginal bleeding
      C)
      prevent dilation of the cervix
      D)
      prevent spontaneous rupture of membranes
    3. A client presents to labor and delivery for evaluation. Upon placing her on the monitor you find the fetal heart rate to be consistently 170 to 180 bpm. What should the nurse do first?
      A)
      Apply a fetal scalp electrode.
      B)
      Apply oxygen at 10 liters per minute by face mask.
      C)
      Prepare for cesarean delivery.
      D)
      Take the mother's temperature.
    4. Fetal attitude describes which characteristic of the fetus?
      A)
      The relationship of the long axis of the fetus to the long axis of the mother
      B)
      The relationship of fetal body parts to one another
      C)
      The relationship of the presenting fetal part to the maternal pelvis
      D)
      The part of the fetus that enters the pelvis first

    Exam Review

    1. The nurse knows that the occurrence of shoulder dystocia during labor is most likely related to
      A)
      Macrosomia
      B)
      preterm birth
      C)
      polyhydramnios
      D)
      maternal age
    2. A pregnant client asks why her urine is checked every visit for glucose and protein. The nurse explains that the purpose of the test is to monitor for the development of
      A)
      diabetes and hypertension
      B)
      diabetes and PIH
      C)
      pyelonephritis and diabetes
      D)
      urinary tract infection and PIH
    3. Which symptom indicates increasing severity of pregnancy-induced hypertension and signs of HELLP syndrome?
      A)
      Edema in hands and feet of +2
      B)
      Fatigue and headache unrelieved by analgesic
      C)
      Low platelets and elevated liver enzymes
      D)
      Weight gain and shortness of breath
    4. A client is on magnesium sulfate for pre-eclampsia, what assessments should be done hourly. Select all that apply.
      A)
      deep tendon reflexes
      B)
      edema
      C)
      respirations
      D)
      level of consciousness
      E)
      heart rate
      F)
      urine output

    Exam Review

    1. The following hourly assessments are obtained by the nurse on a patient with preeclampsia receiving Magnesium Sulfate: T 97.3, P88, R10, blood pressure 148/110. What other priority physical assessment by the nurse should be implemented hourly to assess for early signs potential toxicity?
      A)
      Lung sounds
      B)
      Oxygen saturation
      C)
      Deep Tendon Reflexes
      D)
      Magnesium sulfate level
    2. The painful phenomenon known as "back labor" occurs in a client whose fetus is in what position?
      A)
      LOP
      B)
      breech
      C)
      brow
      D)
      ROA
    3. If shoulder dystocia occurs during a delivery, the nurse should immediately
      A)
      put the client in a knee-chest position
      B)
      turn the client to the left side and administer oxygen
      C)
      perform McRoberts maneuver
      D)
      prepare for a cesarean section delivery
    4. During a vaginal exam, the nurse palpates a loop of prolapsed umbilical cord beside the fetal head. The nurse has the client's husband assist the client onto her hands and knees while the nurse supports the fetal head. The rationale for this action is to
      A)
      help the fetal head descend faster
      B)
      prevent head compression during contractions
      C)
      facilitate rapid dilation of the cervix
      D)
      relieve compression of the cord through gravity and manipulation

    Exam Review

    1. Which assessment is the best indication that a client is in true labor?
      A)
      Bloody show present
      B)
      Nitrazine test positive
      C)
      Vertex presentation at -1 station
      D)
      Cervical changes noted from last exam 2 hours ago
    2. A laboring client has been dilated 9-10 cm for 2 hours. The fetal head has remained at zero station for 45 minutes despite adequate pushing efforts by the client. A sterile vaginal exam reveals a position of occiput posterior. Which of the following actions by the nurse would be most appropriate?
      A)
      Assist the client to knee chest position
      B)
      Assist the client to a supine position.
      C)
      Prepare the client for a forceps rotation.
      D)
      Prepare the client for a cesarean delivery.
    3. A laboring woman's amniotic membranes have just ruptured. The immediate action of the nurse would be to:
      A)
      assess the fetal heart rate (FHR) pattern.
      B)
      perform a vaginal examination.
      C)
      inspect the characteristics of the fluid.
      D)
      assess maternal temperature
    4. A laboring client is having contractions every 3 minutes lasting 60 seconds and is dilated 10 centimeters. The nurse determines the client is in what phase of labor?
      A)
      Latent
      B)
      Active
      C)
      Second
      D)
      Transition