Deck 27: Labor and Delivery

Question 1

The nurse is alarmed as she assesses a protruding umbilical cord from the vagina.What immediate action should the nurse take?

A) Monitor intensity of contractions.
B) Place the patient in the knee-chest position.
C) Notify the charge nurse.
D) Ask the patient to perform a Valsalva's maneuver.

Answer 1

Place the patient in the knee-chest position.

Question 2

Why is the size and shape of the true pelvis more important than that of the false pelvis?

A) The fetal head must be able to pass through the true pelvis.
B) The true pelvis are the mother's measurements.
C) The size of the false pelvis can change.
D) The size of the true pelvis needs to be larger.

Answer 2

The fetal head must be able to pass through the true pelvis.

Question 3

A nurse is assessing the printout from the fetal monitor.What is the legal responsibility of the nurse?

A) Correctly identifying abnormal FHR patterns and prescribing medication
B) Correctly identifying abnormal FHR patterns and notifying the health care provider
C) The nurse is not legally responsible for fetal monitoring
D) Providing technical assessment to the monitor technicians

Answer 3

Correctly identifying abnormal FHR patterns and notifying the health care provider

Question 4

A woman is admitted in active labor,and the nurse assesses the fetal heart rate (FHR)at 124 beats/min.What action should the nurse take based on the assessment?

A) Position patient on her left side.
B) Start oxygen per nasal cannula.
C) Reassure the mother the rate is normal.
D) Notify the health care provider at once.

Question 5

What method is used to visualize soft tissue and to determine adequacy of the pelvis with no detrimental effects to the fetus?

A) Pelvimetry
B) Palpation
C) Ultrasonography
D) X-ray

Question 6

When observing the fetal heart monitor,the nurse recognizes the fetal heart rate (FHR)decreases to 120 beats/min at the beginning of a contraction and returns to a baseline of 155 beats/min at the end of the contraction.What should this indicate to the nurse?

A) Early deceleration due to head compression
B) That the fetus is in acute distress
C) Variable decelerations due to cord compression
D) That these are late decelerations

Question 7

A patient arrives at the hospital having contractions.How should the nurse determine that the patient is in true labor?

A) There is no dilation.
B) The contractions are in the fundus.
C) The cervix has softened and effaced.
D) The contractions are irregular.

Question 8

How do Braxton-Hicks contractions,which may begin in the first trimester and become increasingly stronger during the pregnancy,differ from labor contractions?

A) Last several minutes.
B) Are always regular.
C) Do not dilate the cervix.
D) Are only mild.

Question 9

During the second stage of labor,how often should the nurse should monitor the fetal heart rate?

A) Every 5 minutes
B) Every 15 minutes
C) Every 30 minutes
D) Every hour

Question 10

What is the ideal attitude for the fetal body during labor?

A) Extension
B) Lateral
C) Flexion
D) Transverse

Question 11

The patient's membranes have just ruptured.What is the first priority of the nurse?

A) Turn the patient on the left side.
B) Perform a Nitrazine test.
C) Check the fetal heart rate (FHR).
D) Perform a vaginal examination.

Question 12

A woman who is 38 weeks' pregnant tells the nurse that the baby has dropped and she is having urinary frequency again.What do these symptoms describe?

A) Lightening
B) Braxton-Hicks contractions
C) Initiation of labor
D) Engagement

Question 13

When trying to differentiate false labor from true labor,the nurse realizes which of the following statements regarding true labor is correct?

A) Discomfort of the contraction is in the fundus.
B) Contractions do not follow a pattern.
C) Contractions get stronger with ambulation.
D) Contractions may stop with ambulation.

Question 14

Which type of monitor will assesses the intensity of contractions?

A) External monitor
B) Fetal monitor
C) Maternal monitor
D) Internal monitor

Question 15

What area of the uterus provides the force during a contraction?

A) Lower portion
B) Middle portion
C) Upper portion
D) Cervical portion

Question 16

A mother is in early labor and asks the nurse how long the labor will last.The nurse explains that the first stage of labor lasts from the beginning of regular contractions until when?

A) The cervix is completely effaced.
B) The baby is in position.
C) The cervix is fully dilated.
D) The woman begins pushing.

Question 17

The first-time mother has been told by the nurse that the first stage of labor is the longest.What would be an appropriate nursing intervention for comfort during this time?

A) Cool fluids to drink
B) A backrub in the sacral area
C) Assisting to lie in a supine position
D) Decreasing illumination in the room

Question 18

A nurse is teaching a group of primigravidas that during delivery,pressure on the fetal skull may produce changes in the shape of the skull.What is the reshaping of the skull called?

A) Pressure response
B) Overlapping
C) Molding
D) Spacing

Question 19

What is the largest diameter of the fetal skull?

A) Temporal
B) Biparietal
C) Lateral
D) Frontal-occipital

Question 20

Using Leopold maneuvers to assess fetal position,the nurse finds a soft rounded prominence at the level of the fundus,a hard round prominence just above the symphysis pubis,and nodulations on the left side of the uterus.How should the nurse document the fetal position?

A) Right occiput anterior (ROA),vertex
B) Left occiput anterior (LOA),vertex
C) Right occiput transverse (ROT),breech
D) Left occiput anterior (LOA),breech

Question 21

Why is oxytocin administered in the third stage of labor?

A) To stimulate lactation
B) To relieve postpartum pain
C) To stimulate uterine contractions
D) To sedate the mother so she can rest

Question 22

During labor,the patient screams at her husband to get out of her sight.What would be the most appropriate action for the nurse?

A) Ask the husband to leave the room.
B) Assure the husband that such behavior is normal.
C) Remind the patient that the husband wants to help.
D) Change the patient's position.

Question 23

The health care provider has decided to induce labor with prostaglandin gel and an amniotomy.When should the nurse expect that labor will start?

A) 1 hour
B) 4 hours
C) 8 hours
D) 12 hours

Question 24

After the delivery of a newborn,what is the priority action of the nurse?

A) Place the newborn on the right side.
B) Cover the cord stump.
C) Dry the infant immediately.
D) Suction nose and mouth.

Question 25

A mother has entered the second stage of labor.When does the second stage of labor end?

A) When the mother begins to push
B) When the baby's head crowns
C) With delivery of the baby
D) With delivery of the placenta

Question 26

Which assessment findings suggest probable fetal distress? (Select all that apply. )

A) Fetal heart rate (FHR)of 120
B) Meconium-stained amniotic fluid
C) Decreased FHR during contractions
D) Strong contractions 10 seconds apart
E) Slow return of FHR to baseline

Question 27

A pregnant woman is discussing her desire to have her baby in a birthing center.Which factors could exclude the patient from delivering in a birthing center? (Select all that apply. )

A) The patient is a primigravida.
B) The patient will be having a planned cesarean delivery.
C) The mother has preeclampsia.
D) The baby is a boy.
E) The mother has no support system.

Question 28

A primigravida has a pelvis of the android type,which usually means the delivery will be a _______________.

Question 29

The nurse is admitting a patient to the labor and delivery unit.While performing the initial assessment,which assessment is the priority?

A) The number of previous pregnancies
B) When the baby is due
C) When the patient last ate
D) The timing of contractions

Question 30

An infant presents 5 minutes after delivery with a heart rate of 105,is crying,has some flexion in the arms,sneezes,and has a pink body and blue limbs.What Apgar score should be assigned to this infant?

A) 5
B) 7
C) 8
D) 10

Question 31

For the first hour following delivery,how often should the nurse assess the mother?

A) Every 5 minutes
B) Every 10 minutes
C) Every 15 minutes
D) Every 30 minutes

Question 32

When the nurse performs the Nitrazine test on vaginal secretions of a patient who thinks her membranes have ruptured,the paper turns yellow.What does this finding indicate?

A) Acidic discharge,membranes intact
B) Acidic discharge,membranes have ruptured
C) Neutral,not enough discharge to measure
D) Alkaline,membranes have ruptured

Question 33

A primigravida patient is admitted to the labor and delivery unit.During initial assessment,the baby is found to be engaged.Which statement is true?

A) The narrowest diameter of the presenting part has reached the pelvic outlet.
B) The descending part is being initiated through the midpelvis.
C) The widest diameter of the presenting part crosses the pelvic inlet.
D) The narrowest diameter of the presenting part is at the ischial spines.

Question 34

A nurse shows the patient an x-ray of the fetal spine in parallel alignment with the mother's to demonstrate a ________ lie.

Question 35

The nurse explains to the patient whose membranes ruptured an hour ago that delivery is usually accomplished in ____ to 24 hours postrupture.