Question 1

Each uterine contraction consists of three phases. The contraction is at strongest during which phase?

Accepted Answer

A) Increment 
B) Acme 
C) Climax 
D) Decrement 
A) Increment 
B) Acme 
C) Climax 
D) Decrement B

Question 2

A few weeks before labor, the client may experience subtle signs that indicate the onset of labor. One of these signs is lightening. The nurse midwife teaches the client to recognize the signs of lightening. Which of the following is not a sign of lightening?

Accepted Answer

A) Relief from diaphragmatic pressure and shortness of breath. 
B) Abdominal contour changes. 
C) Increased urinary frequency. 
D) Decreased amounts of vaginal discharge. 
A) Relief from diaphragmatic pressure and shortness of breath. 
B) Abdominal contour changes. 
C) Increased urinary frequency. 
D) Decreased amounts of vaginal discharge. D

Question 3

A nurse midwife is monitoring a G3P2 client who is in labor. Cervical changes are assessed, and the findings are noted. Which of the following cervical changes would the nurse midwife expect when caring for the client?

Accepted Answer

A) Cervical effacement is accomplished before dilatation begins. 
B) Cervical effacement and dilatation occur at the same time. 
C) Cervical dilatation proceeds before full effacement. 
D) Cervical dilatation is the only cervical change determined during labor 
A) Cervical effacement is accomplished before dilatation begins. 
B) Cervical effacement and dilatation occur at the same time. 
C) Cervical dilatation proceeds before full effacement. 
D) Cervical dilatation is the only cervical change determined during labor C

Question 4

A nurse midwife performs combined abdominal inspection and palpation on a client who is in labor and determines that the fetal position is ROA. Which of the following statements about the ROA fetal position is false?

Accepted Answer

A) The fetal landmark is pointing the client's right. 
B) The occiput is the fetal landmark. 
C) The fetus is in a transverse lie. 
D) The back of the fetal head is pointing toward the client's anterior side. 
A) The fetal landmark is pointing the client's right. 
B) The occiput is the fetal landmark. 
C) The fetus is in a transverse lie. 
D) The back of the fetal head is pointing toward the client's anterior side.

Question 5

A client in labor begins to complain of severe abdominal pain and chest pain. On assessment, the nurse midwife notes that uterine contractions have stopped and that the abdomen is rigid. Fetal heart tone is not noted. The client's blood pressure decreases, and her heart rate increases to over 100 beats per minute. Which of the following is the next action of the nurse midwife?

Accepted Answer

A) Maintain bed rest in a side-lying position. 
B) Prepare the client for cesarean delivery. 
C) Administer oxytocin. 
D) Initiate intubation and mechanical ventilation. 
A) Maintain bed rest in a side-lying position. 
B) Prepare the client for cesarean delivery. 
C) Administer oxytocin. 
D) Initiate intubation and mechanical ventilation.

Question 6

A client in labor, who is administered with epidural anesthesia, develops hypotension. Which of the following is the immediate action of the nurse midwife?

Accepted Answer

A) Raise the client's legs. 
B) Administer oxygen. 
C) Administer IV fluids. 
D) Administer ephedrine. 
A) Raise the client's legs. 
B) Administer oxygen. 
C) Administer IV fluids. 
D) Administer ephedrine.

Question 7

A G2P1 client at 39 weeks' gestation is admitted to the labor and delivery unit. A pudendal block is ordered. Which of the following statements about pudendal block is the most accurate?

Accepted Answer

A) It is administered after labor is established. 
B) It blocks uterine and perineal pain and numbs the lower extremities, vagina and perineum. 
C) It has no effects on contractions or the fetus. 
D) It may cause postpartum headache. 
A) It is administered after labor is established. 
B) It blocks uterine and perineal pain and numbs the lower extremities, vagina and perineum. 
C) It has no effects on contractions or the fetus. 
D) It may cause postpartum headache.

Question 8

A nurse midwife notes that presenting part of the fetus is at the +2 station. This finding indicates that that the fetal presenting part is:

Accepted Answer

A) At the level of the ischial spine. 
B) 2 cm below the ischial spine. 
C) 2 cm above the ischial spine. 
D) 2 inches above the ischial spine. 
A) At the level of the ischial spine. 
B) 2 cm below the ischial spine. 
C) 2 cm above the ischial spine. 
D) 2 inches above the ischial spine.

Question 9

A client at 38 weeks' gestation comes to the facility after experiencing leakage of clear fluid from the vagina without contractions. Premature rupture of membranes is suspected. Which of the following actions by the nurse midwife would be inappropriate for a client with this condition?

Accepted Answer

A) Perform digital vaginal examination. 
B) Administer ampicillin IV. 
C) Assess the client's cervix and vaginal cavity through sterile speculum vaginal examination. 
D) Order L/S ratio. 
A) Perform digital vaginal examination. 
B) Administer ampicillin IV. 
C) Assess the client's cervix and vaginal cavity through sterile speculum vaginal examination. 
D) Order L/S ratio.

Question 10

A client at 39 weeks' gestation is admitted to the labor and delivery unit. An external fetal heart rate monitor is attached to the client. Physical examination and laboratory test results reveal that the fetus is in breech position, and a cesarean delivery is recommended. Physical examination is conducted and laboratory tests are ordered. Before the pregnancy, the client's average heart rate was 80 beats per minute. Which of the following assessment findings necessitates immediate physician notification?

Accepted Answer

A) Hematrocrit = 38% 
B) WBC = 18,000 cells/mm3 
C) Maternal heart rate = 95 beats per minute 
D) Fetal heart rate = 180 beats per minute 
A) Hematrocrit = 38% 
B) WBC = 18,000 cells/mm3 
C) Maternal heart rate = 95 beats per minute 
D) Fetal heart rate = 180 beats per minute

Question 11

A client with a multiple pregnancy is scheduled for cesarean delivery and is transported to the delivery operating room. The nurse midwife reminds the staff nurse to position the client in which of the following positions in the operating room?

Accepted Answer

A) Left side-lying position 
B) Semi-Fowler position 
C) Supine position, with a wedge placed under the right hip. 
D) Supine position, with a wedge placed under the left hip. 
A) Left side-lying position 
B) Semi-Fowler position 
C) Supine position, with a wedge placed under the right hip. 
D) Supine position, with a wedge placed under the left hip.

Question 12

A client is admitted to the labor and delivery unit. A nurse midwife is assessing the fetal heart tone monitor tracing and notes late decelerations. Which of the following is the most effective intervention?

Accepted Answer

A) Administer oxygen through a face mask. 
B) Position the client in knee-chest position. 
C) Administer oxytocin. 
D) Document the findings and continue monitoring the client. 
A) Administer oxygen through a face mask. 
B) Position the client in knee-chest position. 
C) Administer oxytocin. 
D) Document the findings and continue monitoring the client.

Question 13

After an ultrasound, a client in labor is informed that she has a low-lying placenta. Which of the following statements accurately describes the client's diagnosis?

Accepted Answer

A) The placenta is improperly implanted in the upper uterine segment. 
B) The placenta attaches in the lower uterine segment but it does not reach the cervical os. 
C) Only the edge of the placenta extends to the os. 
D) The internal os is covered entirely by the placenta. 
A) The placenta is improperly implanted in the upper uterine segment. 
B) The placenta attaches in the lower uterine segment but it does not reach the cervical os. 
C) Only the edge of the placenta extends to the os. 
D) The internal os is covered entirely by the placenta.

Question 14

A nurse midwife is monitoring a client who was admitted to the labor and delivery unit about 5 hours ago. The nurse midwife notes a cervical dilatation of 5 cm. The contractions occurring every 5 minutes usually last between 50 and 55 seconds. The client is in which phase of labor?

Accepted Answer

A) Latent phase 
B) Active phase 
C) Transition phase 
D) Second stage of labor 
A) Latent phase 
B) Active phase 
C) Transition phase 
D) Second stage of labor

Question 15

A nurse midwife is assessing a client in labor by auscultating the fetal heart tone using the Doppler ultrasound. The fetal position is LOA. The nurse midwife should not:

Accepted Answer

A) Place the Doppler probe on the left side of the client's abdomen, just below the belly button. 
B) Apply generous amounts of ultrasound gel to the client's abdomen and to the face of the probe. 
C) Palpate the client's carotid pulse before auscultating the fetal heart tone. 
D) Simultaneously palpate the client's radial pulse and auscultate the fetal heart tone. 
A) Place the Doppler probe on the left side of the client's abdomen, just below the belly button. 
B) Apply generous amounts of ultrasound gel to the client's abdomen and to the face of the probe. 
C) Palpate the client's carotid pulse before auscultating the fetal heart tone. 
D) Simultaneously palpate the client's radial pulse and auscultate the fetal heart tone.

Question 16

A nurse midwife is monitoring a client at 38 weeks' gestation who is in labor. The most recent findings include full dilatation and cervical effacement. The client says, "I feel this uncontrollable urge to push." The client is in which stage of labor?

Accepted Answer

A) First 
B) Second 
C) Third 
D) Fourth 
A) First 
B) Second 
C) Third 
D) Fourth

Question 17

A client at 38 weeks' gestation is admitted to the facility after a nurse midwife suspects that she has a case of premature rupture of the amniotic membranes. Which of the following information given by the client supports this diagnosis?

Accepted Answer

A) Fewer than 5 fetal movements per hour for the past 24 hours. 
B) Uterine contractions with leakage of clear fluid from the vagina. 
C) Contractions are not alleviated with ambulation. 
D) Leakage of clear fluid from the vagina without contractions. 
A) Fewer than 5 fetal movements per hour for the past 24 hours. 
B) Uterine contractions with leakage of clear fluid from the vagina. 
C) Contractions are not alleviated with ambulation. 
D) Leakage of clear fluid from the vagina without contractions.

Question 18

An epidural block is ordered for a client in labor. The nurse midwife maintains the client in which of the following positions after the anesthetic is administered?

Accepted Answer

A) Dorsal recumbent 
B) Side-lying position 
C) Flat on bed for 12 hours 
D) Supine with a rolled blanket beneath left hip 
A) Dorsal recumbent 
B) Side-lying position 
C) Flat on bed for 12 hours 
D) Supine with a rolled blanket beneath left hip

Question 19

A nurse midwife is assessing whether or not induction of labor can be initiated for a client at 41 weeks' gestation. The nurse midwife specifically assesses for cervical ripening using the Bishop criteria. Assessment findings include the following: cervical dilatation = 2 cm; effacement = 70%; station = -2; consistency = medium; position = mid-position. Is the client's cervix ripe enough for induction of labor?

Accepted Answer

A) Yes. The Bishop score is 8. 
B) No. The Bishop score is 7. 
C) No. The Bishop score is 6. 
D) No. The Bishop score is 5. 
A) Yes. The Bishop score is 8. 
B) No. The Bishop score is 7. 
C) No. The Bishop score is 6. 
D) No. The Bishop score is 5.

Question 20

A nurse midwife is monitoring a client who is about to deliver the placenta. The client begins to complain of severe pain in the abdominal area. On assessment, the nurse midwife notes that there is a depression in the fundal area of the uterus. Increased flow of vaginal blood is also noted. The client is demonstrating signs of shock. The nurse suspects that the client is mostly experiencing:

Accepted Answer

A) Rupture of uterus. 
B) Uterine inversion. 
C) Placenta previa. 
D) Abruptio placenta. 
A) Rupture of uterus. 
B) Uterine inversion. 
C) Placenta previa. 
D) Abruptio placenta.

Each uterine contraction consists of three phases. The contraction is at strongest during which phase?

A few weeks before labor, the client may experience subtle signs that indicate the onset of labor. One of these signs is lightening. The nurse midwife teaches the client to recognize the signs of lightening. Which of the following is not a sign of lightening?

A nurse midwife is monitoring a G3P2 client who is in labor. Cervical changes are assessed, and the findings are noted. Which of the following cervical changes would the nurse midwife expect when caring for the client?

A nurse midwife performs combined abdominal inspection and palpation on a client who is in labor and determines that the fetal position is ROA. Which of the following statements about the ROA fetal position is false?

A client in labor, who is administered with epidural anesthesia, develops hypotension. Which of the following is the immediate action of the nurse midwife?

A G2P1 client at 39 weeks' gestation is admitted to the labor and delivery unit. A pudendal block is ordered. Which of the following statements about pudendal block is the most accurate?

A nurse midwife notes that presenting part of the fetus is at the +2 station. This finding indicates that that the fetal presenting part is:

A client at 38 weeks' gestation comes to the facility after experiencing leakage of clear fluid from the vagina without contractions. Premature rupture of membranes is suspected. Which of the following actions by the nurse midwife would be inappropriate for a client with this condition?

A client with a multiple pregnancy is scheduled for cesarean delivery and is transported to the delivery operating room. The nurse midwife reminds the staff nurse to position the client in which of the following positions in the operating room?

A client is admitted to the labor and delivery unit. A nurse midwife is assessing the fetal heart tone monitor tracing and notes late decelerations. Which of the following is the most effective intervention?

After an ultrasound, a client in labor is informed that she has a low-lying placenta. Which of the following statements accurately describes the client's diagnosis?

A nurse midwife is monitoring a client who was admitted to the labor and delivery unit about 5 hours ago. The nurse midwife notes a cervical dilatation of 5 cm. The contractions occurring every 5 minutes usually last between 50 and 55 seconds. The client is in which phase of labor?

A nurse midwife is assessing a client in labor by auscultating the fetal heart tone using the Doppler ultrasound. The fetal position is LOA. The nurse midwife should not:

A nurse midwife is monitoring a client at 38 weeks' gestation who is in labor. The most recent findings include full dilatation and cervical effacement. The client says, "I feel this uncontrollable urge to push." The client is in which stage of labor?

A client at 38 weeks' gestation is admitted to the facility after a nurse midwife suspects that she has a case of premature rupture of the amniotic membranes. Which of the following information given by the client supports this diagnosis?

An epidural block is ordered for a client in labor. The nurse midwife maintains the client in which of the following positions after the anesthetic is administered?

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Exam 3: Intrapartum

Each uterine contraction consists of three phases. The contraction is at strongest during which phase?

A few weeks before labor, the client may experience subtle signs that indicate the onset of labor. One of these signs is lightening. The nurse midwife teaches the client to recognize the signs of lightening. Which of the following is not a sign of lightening?

A nurse midwife is monitoring a G3P2 client who is in labor. Cervical changes are assessed, and the findings are noted. Which of the following cervical changes would the nurse midwife expect when caring for the client?

A nurse midwife performs combined abdominal inspection and palpation on a client who is in labor and determines that the fetal position is ROA. Which of the following statements about the ROA fetal position is false?

A client in labor, who is administered with epidural anesthesia, develops hypotension. Which of the following is the immediate action of the nurse midwife?

A G2P1 client at 39 weeks' gestation is admitted to the labor and delivery unit. A pudendal block is ordered. Which of the following statements about pudendal block is the most accurate?

A nurse midwife notes that presenting part of the fetus is at the +2 station. This finding indicates that that the fetal presenting part is:

A client at 38 weeks' gestation comes to the facility after experiencing leakage of clear fluid from the vagina without contractions. Premature rupture of membranes is suspected. Which of the following actions by the nurse midwife would be inappropriate for a client with this condition?

A client with a multiple pregnancy is scheduled for cesarean delivery and is transported to the delivery operating room. The nurse midwife reminds the staff nurse to position the client in which of the following positions in the operating room?

A client is admitted to the labor and delivery unit. A nurse midwife is assessing the fetal heart tone monitor tracing and notes late decelerations. Which of the following is the most effective intervention?

After an ultrasound, a client in labor is informed that she has a low-lying placenta. Which of the following statements accurately describes the client's diagnosis?

A nurse midwife is monitoring a client who was admitted to the labor and delivery unit about 5 hours ago. The nurse midwife notes a cervical dilatation of 5 cm. The contractions occurring every 5 minutes usually last between 50 and 55 seconds. The client is in which phase of labor?

A nurse midwife is assessing a client in labor by auscultating the fetal heart tone using the Doppler ultrasound. The fetal position is LOA. The nurse midwife should not:

A nurse midwife is monitoring a client at 38 weeks' gestation who is in labor. The most recent findings include full dilatation and cervical effacement. The client says, "I feel this uncontrollable urge to push." The client is in which stage of labor?

A client at 38 weeks' gestation is admitted to the facility after a nurse midwife suspects that she has a case of premature rupture of the amniotic membranes. Which of the following information given by the client supports this diagnosis?

An epidural block is ordered for a client in labor. The nurse midwife maintains the client in which of the following positions after the anesthetic is administered?

Antepartum

Gynecology

Newborn

Postpartum

Primary-Care

Professional-Issues

Filters