Exam Review
- 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.
- The nurse instructs the laboring client to begin pushing with her contractionsA)at the beginning of the second stageB)at the end of the active phaseC)during the latter part of the second stageD)during transition
- 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 isA)achieving attitudeB)reaching ballottementC)below the ischial spinesD)floating above "0" station
- 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
- Internal version (manual rotation) is attempted only in:A)adolescents with a breech presentationB)response to fetal distressC)multiple gestation, for the birth of the second twinD)obstetric intensive care unit for delivery of baby in fetal distress
- 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 byA)compression of the umbilical cordB)head compressionC)maternal hypotensionD)uteroplacental insufficiency
- 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-beingB)Take the mother's vital signs and tell the mother that bed rest is required to conserve oxygenC)Notify the physician or nurse midwife of the findingsD)Reposition the mother and check the monitor for changes in the fetal tracing
- Which of the following are disadvantages of a midline episiotomyA)more bleedingB)delayed deliveryC)extends to anusD)more pain
Exam Review
- 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)AccretaB)PlancretaC)percretaD)increta
- The nurse explains to a client that the purpose of a cerclage is toA)stop premature labor contractionsB)control active vaginal bleedingC)prevent dilation of the cervixD)prevent spontaneous rupture of membranes
- 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.
- Fetal attitude describes which characteristic of the fetus?A)The relationship of the long axis of the fetus to the long axis of the motherB)The relationship of fetal body parts to one anotherC)The relationship of the presenting fetal part to the maternal pelvisD)The part of the fetus that enters the pelvis first
Exam Review
- The nurse knows that the occurrence of shoulder dystocia during labor is most likely related toA)MacrosomiaB)preterm birthC)polyhydramniosD)maternal age
- 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 ofA)diabetes and hypertensionB)diabetes and PIHC)pyelonephritis and diabetesD)urinary tract infection and PIH
- Which symptom indicates increasing severity of pregnancy-induced hypertension and signs of HELLP syndrome?A)Edema in hands and feet of +2B)Fatigue and headache unrelieved by analgesicC)Low platelets and elevated liver enzymesD)Weight gain and shortness of breath
- A client is on magnesium sulfate for pre-eclampsia, what assessments should be done hourly. Select all that apply.A)deep tendon reflexesB)edemaC)respirationsD)level of consciousnessE)heart rateF)urine output
Exam Review
- 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 soundsB)Oxygen saturationC)Deep Tendon ReflexesD)Magnesium sulfate level
- The painful phenomenon known as "back labor" occurs in a client whose fetus is in what position?A)LOPB)breechC)browD)ROA
- If shoulder dystocia occurs during a delivery, the nurse should immediatelyA)put the client in a knee-chest positionB)turn the client to the left side and administer oxygenC)perform McRoberts maneuverD)prepare for a cesarean section delivery
- 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 toA)help the fetal head descend fasterB)prevent head compression during contractionsC)facilitate rapid dilation of the cervixD)relieve compression of the cord through gravity and manipulation
Exam Review
- Which assessment is the best indication that a client is in true labor?A)Bloody show presentB)Nitrazine test positiveC)Vertex presentation at -1 stationD)Cervical changes noted from last exam 2 hours ago
- 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 positionB)Assist the client to a supine position.C)Prepare the client for a forceps rotation.D)Prepare the client for a cesarean delivery.
- 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
- 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)LatentB)ActiveC)SecondD)Transition