Test Bank for Safe Maternity Pediatric Nursing Care By Palmer Coats

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Test Bank for Safe Maternity Pediatric Nursing Care By Palmer Coats




Safe Maternity Pediatric Nursing Care Palmer Coats

Chapter 1: Healthy People 2020 and Initiatives for Healthy Families


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Which statement is accurate regarding the Healthy People 2020 initiative related to families, children, and infants?

1) Most of the Healthy People documents apply specifically to infants and children.
2) Healthy People documents address the good health of adults, which benefits children.
3) There are no Healthy People initiatives specifically addressing infants or children.
4) The only initiative impacting families, infants, and children encourages breastfeeding.



____    2.   What two federal agencies oversee objectives related to maternal, infant, and child health in the Healthy People 2020 initiative?

1) The Department of Agriculture and the Centers for Disease Control and Prevention
2) The Department of Children and Youth Services and the Health Resources and Services Administration
3) The Centers for Medicare & Medicaid Services and the Health Resources and Services Administration
4) The Centers for Disease Control and Prevention and the Health Resources and Services Administration



____    3.   Who created the original Healthy People initiative?

1) The Centers for Disease Control and Prevention
2) The Health Resources and Services Administration
3) President Jimmy Carter
4) The surgeon general of the United States



____    4.   Which initiative did not demonstrate improvement over the past decades?

1) Air quality
2) Childhood exposure to secondhand smoke
3) Suicide and depression in adolescents
4) Increased physical activity for adults



____    5.   One initiative of Healthy People 2020 is to increase the proportion of infants who are breastfed. What is the maternity nurses primary role in helping to meet this initiative?

1) All nurses should become lactation consultants.
2) Increasing the percentage of employers that offer a place to pump breast milk
3) Providing support and teaching immediately after birth
4) Increasing the percentage of live births in hospitals



____    6.   How can maternal and pediatric nurses promote Healthy People objectives for their clients?

1) Provide all patients with a copy of the current Healthy People objectives
2) Plan care that includes teaching and support for Healthy People objectives
3) Require all new mothers to breastfeed while hospitalized
4) Discourage the father from ever bottle feeding the newborn



____    7.   When the Healthy People 2020 initiatives are reviewed, which initiative related to infants and young children has shown improvement?

1) Suicide rates in adolescents
2) Increased life expectancy
3) Babies put to bed on their backs
4) Infant mortality rates

Chapter 3: Human Reproduction and Fetal Development


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   The nurse is teaching a class about female reproduction for middle school girls. Which statement made by one of the students requires the nurse to correct a misunderstanding?

1) Boys have a penis that gets erect when they are excited, but girls dont have anything like that.
2) Bartholin glands secrete a lubricant to make sexual intercourse more comfortable.
3) The ovaries secrete eggs that, when fertilized, start a baby growing in the womans body.
4) The fallopian tubes are the passageways for eggs to travel to the uterus.



____    2.   A pregnant woman lives in a community that is experiencing a measles outbreak because of a lack of immunization. The woman says she heard that measles are teratogenic and does not know what that means. Which statement by the nurse best explains this concept?

1) The growing baby can catch measles and get very sick.
2) The measles virus acts as a harmful substance that could hurt the fetus.
3) A teratogen, such as the measles virus, can cause fetal death.
4) It means that a mother exposed to measles will probably miscarry.



____    3.   The nurse is caring for a young man with testicular cancer who is preparing for removal of the left testicle. The patient asks, Does this mean I wont be able to father a child? Which is the nurses best response?

1) You can arrange with your doctor to have sperm frozen and stored for when you want children.
2) Although your sperm count will be lower, there is still a chance you could father a child. However, it may take longer.
3) This is an important discussion to have with your physician, who can discuss the chances of fathering a child.
4) Removal of one testicle will have no impact on your ability to father a child because the other testicle will function.



____    4.   An adult womans laboratory studies indicate a lack of estrogen production. As a result, the nurse anticipates the patients history will report which finding?

1) Inability to produce breast milk
2) Small breast size
3) Inability to carry a pregnancy to term
4) Inability to become pregnant



____    5.   The nurse admits a woman in the second trimester of pregnancy to the obstetric clinic for her regular examination. The patient asks the nurse if it is safe to take acetaminophen for minor pain during pregnancy. Which is the nurses best response?

1) Acetaminophen is a Category A medication, so it is safe to take during pregnancy.
2) The safest thing for the growing fetus is to avoid all medications during pregnancy.
3) What kind of medication have you taken in the past for minor pain?
4) Talk with the provider about the safest medications to take during pregnancy.



____    6.   The nurse caring for a family shortly after a birth overhears the father of the baby say, Well, you gave me another daughter. I guess you cant produce boys. Which is the nurses best response?

1) It is the father who determines the sex of the baby.
2) Girls are nice, too, and are often closer to their father than boys.
3) It isnt the mothers fault when girls are produced instead of boys.
4) There are scientific methods of producing male children if you are interested.



____    7.   The newborn nursery nurse admits a baby born with a congenital defect of the digestive tract and recognizes this is due to an anomaly in which layer during cell differentiation?

1) Ectoderm
2) Mesoderm
3) Endoderm
4) Pyloderm



____    8.   A fetal ultrasound demonstrates a cardiac anomaly in a 22-week fetus. The mother says, My baby is sick, all because I insisted on having a cup of coffee last week. Which statement by the nurse is most appropriate?

1) Caffeine is a stimulant and impacts the baby by speeding up the heartbeat and increasing activity, which can result in metabolic problems.
2) The fetal heart is beating and pumping blood by 4 weeks and is fully formed by 8 weeks, so your actions last week did not affect your babys heart.
3) Whats done is done and cant be undone, but try to follow the doctors advice from this point onward in your pregnancy.
4) Drinking coffee doesnt cause any problem for the fetus, so dont feel bad about what you did last week.



____    9.   A mother goes into preterm labor and delivers a baby who weighs 435 g and has fused eyelids. The nurse assesses the infant at what stage of gestational development?

1) 4 months
2) 5 months
3) 6 months
4) 7 months



____  10.   A woman delivers an infant assessed prenatally at 34 weeks gestation. Which nursing assessment indicates the babys gestation is closer to term than anticipated?

1) Fused eyelids
2) Hand grip reflex present
3) Sole creases on the heel of the foot
4) Earlobes that are firm and not easily creased



____  11.   Which statement indicates a mother understood the information about the function of the placenta taught by the nurse?

1) My blood flows through the placenta into the baby and returns to my body to oxygenate.
2) My body removes wastes and provides nutrients and oxygen to the baby when our blood mixes.
3) The placenta grows and functions because of the production of progesterone from the ovaries.
4) The placenta separates my blood from the babys and produces hormones until delivery.



____  12.   Which finding is normal when assessing a newborn shortly after birth?

1) The umbilical cord has two arteries and one vein.
2) The umbilical cord has one artery and one vein.
3) The umbilical cord has one artery and two veins.
4) The umbilical cord is 0.25 in. in diameter.



____  13.   The mother of a premature newborn is crying and tells the nurse the neonatologist said the baby will need surgery to close the patent ductus arteriosus. She asks what this is. Which is the best explanation?

1) It is an opening in the blood vessel that shunts blood away from the liver and needs to close after birth.
2) It is an opening in the aorta that shunts blood away from the lungs, which is normal in the fetus but needs to close after birth.
3) It is a small hole in the atria of the heart that shunts blood from the right atrium to the left atrium, reducing blood flow to the lungs.
4) It is a small hole in the atria of the heart that shunts blood from the left atrium to the right atrium, reducing blood flow to the lungs.



____  14.   A patient who recently delivered twins has learned that each baby has a different father. How does the nurse interpret this finding?

1) The twins are monozygotic.
2) The twins are dizygotic.
3) There was a mistake in testing because this is not possible.
4) The twins have different gestational ages.



____  15.   Which finding during a nursing assessment of twins supports the diagnosis of dizygotic twins?

1) Both twins are boys.
2) One twin weighs more than the other.
3) One twin is blonde, the other is brunette.
4) One twin required oxygen at birth.



____  16.   The nurse receives an order to administer a Category A medication to a pregnant patient. Which is the nurses best action?

1) Holding the medication until verifying the order with the obstetrician
2) Administering the medication as ordered
3) Calling the pharmacist and verifying the safety of this medication
4) Giving the medication only if essential to the womans well-being



____  17.   The nurse receives an order to administer a Category X medication to a woman of childbearing age who denies pregnancy. Which action will the nurse take before administering this medication?

1) Asking the woman if there is any chance of pregnancy
2) Requesting an order to perform a serum pregnancy test
3) Administering the medication
4) Requesting an order for a different medication



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  18.   The nurse reviews the chart of a man undergoing testing to determine the cause of infertility. Which hormone levels will the nurse review as a possible cause of the patients low sperm count? (Select all that apply.)

1) Follicle-stimulating hormone
2) Luteinizing hormone
3) Testosterone
4) Estrogen
5) Progesterone



____  19.   The nurse performs a cervical examination on a woman in labor and recognizes that the elasticity of the cervix results from which characteristics of the anatomy? (Select all that apply.)

1) High fibrous content of the supportive tissue
2) Large number of folds in the cervical lining
3) High collagenous content of the supportive tissue
4) Location of the uterosacral ligaments
5) Mucus-secreting glands




Complete each statement.


  1. Rank these events in the order in which they occur. (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)

1) Secretion of luteinizing hormone

2) Release of an egg

3) Release of progesterone by the corpus luteum

4) Fertilization of the ovum

5) Implantation into the endometrium

Chapter 5: Antepartal Nursing Assessment


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   The nurse cares for a newly diagnosed pregnant woman with a history of three spontaneous abortions in the first trimester and an emergency Cesarean section because of breech presentation with her last pregnancy. Which health-care provider is most appropriate to care for this patient?

1) Family physician
2) Obstetrician-gynecologist
3) Certified nurse midwife
4) Doula



____    2.   A woman arrives at the clinic and tells the nurse she thinks she is pregnant. Which symptom, as related by the patient, does the nurse consider the best indicator of pregnancy?

1) Amenorrhea
2) Irritability
3) Positive urine human chorionic gonadotropin (hCG; home test)
4) Enlarged abdomen



____    3.   Which information should the nurse include when teaching a pregnant patient who is scheduled to have an abdominal ultrasound?

1) Pain medication will be administered before the procedure.
2) Do not eat or drink anything for 4 hours prior to the procedure.
3) The probe will be inserted through the vagina.
4) Do not empty your bladder prior to the procedure.



____    4.   Using Naegeles rule, calculate the estimated date of delivery for a patient whose first day of the last menstrual period was October 8, 2016.

1) July 15, 2017
2) January 1, 2017
3) July 1, 2016
4) June 14, 2017



____    5.   The nurse is collecting a patients personal information to contribute to the client history. How should the nurse question the woman regarding physical abuse and safety in her living situation?

1) Does your significant other ever hit you?
2) Are you happily married?
3) Tell me about your home life.
4) Tell me about your husband.



____    6.   The clinical instructor observes a student nurse collecting the client history of a new prenatal patient. Which question asked by the student indicates that he or she needs further education?

1) Do you use drugs?
2) Have you ever been pregnant before?
3) Are your parents and siblings living?
4) What is your current living situation?



____    7.   A woman comes for her first prenatal visit and learns the obstetrician will perform a complete physical examination. She asks the nurse, Why is a complete physical required? Which is the nurses best response?

1) Your general health will influence your pregnancy, so the doctor needs to do a complete examination.
2) If you have health problems, the doctor needs to know so you can receive the treatment you need to return to health.
3) This is a requirement for all newly pregnant women because the doctor wants to learn as much about you as possible.
4) The doctor wants to make sure that the baby is healthy and that your pregnancy will progress without complications.



____    8.   The nurse reviews a patients medical record and sees the measurement of the ischial tuberosity is 8.5 cm. How does the nurse interpret this measurement?

1) The woman may be unable to carry the pregnancy to term.
2) The woman has an adequate blood supply to the fetus.
3) The woman may require a Cesarean section.
4) The woman will experience a prolonged labor.



____    9.   Which laboratory test does the nurse recognize as not part of the routine order set required for pregnant women?

1) Complete blood cell count (CBC)
2) Blood type and Rh
3) Papanicolaou (PAP) screen
4) Serum calcium level



____  10.   A pregnant woman looks over the required laboratory tests and asks the nurse why they need a rubella titer and varicella titer when she knows she has already received these immunizations as a child. Which is the nurses best response?

1) We have to be sure that you actually received these vaccines.
2) Some people require booster shots to attain full immunity.
3) Maybe the doctor didnt notice that you reported having had the vaccines.
4) Even when people have received the vaccine, they still need to be tested for immunity.



____  11.   The nurse reviews a womans quadruple screen. Which finding indicates a higher risk for Down syndrome in the fetus?

1) Elevated alpha-fetoprotein level
2) Elevated hCG level
3) Elevated unconjugated estriol level
4) Low level of inhibin A



____  12.   Which potential complication is the nurse unlikely to associate with amniocentesis?

1) Spontaneous abortion
2) Leaking of amniotic fluid
3) Infection
4) Maternal liver damage



____  13.   At which point will the nurse begin scheduling a pregnant woman for weekly obstetric visits?

1) 22 weeks
2) 28 weeks
3) 36 weeks
4) 38 weeks



____  14.   A patient is late for her prenatal visit, and when she arrives she blames symptoms, suggesting a urinary tract infection for her late arrival. Upon examination, the nurse finds mild spotting and notes bruising on the womans abdomen. What does the nurse suspect?

1) Preterm labor
2) Placental abruption
3) Pre-eclampsia
4) Domestic abuse



____  15.   The nurse caring for a woman at 32 weeks gestation finds elevated protein and nitrate levels in the urine. What will the nurse assess for next?

1) Symptoms of pre-eclampsia
2) Symptoms of a urinary tract infection
3) Symptoms of gestational diabetes
4) Inadequate nutrition



____  16.   The nurse admits a patient who arrives late for her appointment. The examination demonstrates vaginal spotting, anxiety and depression, reports of alcohol abuse, and bruising on the chest and abdomen. Which question is most appropriate for the nurse to ask?

1) Do you have reliable transportation?
2) Have you considered giving the baby up for adoption?
3) Are you experiencing any rhythmic abdominal pain?
4) Has your partner ever hit you during a fight?



____  17.   The nurse is unable to locate fetal heart tones in a woman who is at 10 weeks gestation. What is the nurses priority action?

1) Reassuring the woman that this is a normal finding
2) Notifying the provider immediately
3) Recommending complete bedrest
4) Scheduling the patient for an abdominal ultrasound



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  18.   The nurse reviews a pregnant patients medical record and sees G5, T2, P5, A1, L5. Which statements reflect an accurate analysis of this information? (Select all that apply.)

1) The woman has been pregnant a total of five times, including the current pregnancy.
2) The woman requested to have one pregnancy terminated.
3) Two of the children born alive died after birth.
4) One pregnancy resulted in the birth of quintuplets.
5) The woman adopted one of her children.



____  19.   The nurse is examining a woman who is at 20 weeks gestation. Which findings does the nurse consider appropriate at this stage of pregnancy? (Select all that apply.)

1) Fundal height 20 cm
2) Fetal heart rate 148 bpm
3) Quickening
4) +1 glycosuria
5) 3-lb weight loss




Complete each statement.


  1. The nurse is caring for a woman who is 16 weeks pregnant. One child was born at term, and a set of triplets were born at 26 weeks gestation (one of whom died at 3 years of age). She experienced two spontaneous abortions prior to 8 weeks of pregnancy and had one therapeutic abortion many years ago as a young teen. Document the GTPAL for this patient by filling in the appropriate number for each letter.



Chapter 7: Nursing Care of the Woman With Complications During Pregnancy


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   The nurse provides teaching for a patient with hyperemesis gravidarum and determines further teaching is needed when the patient makes which statement?

1) I will sip water throughout the day.
2) I will call the provider if there is any blood in the vomit.
3) I will be sure to eat three good meals a day.
4) I will not eat spicy or fatty foods till I feel better.



____    2.   The nurse teaches a patient with hyperemesis gravidarum when to notify the provider. The nurse recognizes clarification is needed when the patient says she will notify the provider for which sign?

1) Dark urine
2) Bloody vomit
3) Inability to keep food down for 24 hours
4) Frequent urination



____    3.   A pregnant woman presents to the clinic at 16 weeks gestation with lack of fetal movement. Ultrasonography reveals fetal demise. How does the nurse document this pregnancy?

1) Threatened abortion
2) Inevitable abortion
3) Complete abortion
4) Missed abortion



____    4.   A woman presents to the emergency department with a history of pelvic inflammatory disease after a medical abortion, with acute vaginal bleeding and abdominal pain accompanied by shoulder pain. What does the nurse suspect as the cause?

1) Threatened abortion
2) Ectopic pregnancy
3) Gestational trophoblastic disease
4) Hyperemesis gravidarum



____    5.   The nurse is caring for a patient with blood type O-negative following a spontaneous abortion. Which is the priority of care?

1) Providing emotional support
2) Administering oxytocin
3) Notifying the laboratory for a blood type and crossmatch
4) Administering RhoGAM



____    6.   When discharging a woman following a spontaneous abortion, the nurse instructs her to report which priority complication?

1) Difficulty becoming pregnant again
2) Increased risk of future fetal demise
3) Infection
4) Weakness and lethargy



____    7.   The nurse caring for a patient 1 hour post-salpingostomy recognizes which priority of care?

1) Psychosocial support
2) Administration of RhoGAM
3) Pain management
4) Fertility planning



____    8.   When planning care, the nurse recognizes which pregnant woman as being at greatest risk for gestational diabetes?

1) A Caucasian adolescent with a diabetic mother who participates on the high school swim team
2) A 28-year-old Native American whose last pregnancy ended with a stillbirth
3) An African American adolescent with a history of cystic fibrosis and hypertension
4) A 22-year-old Caucasian woman whose last baby weighed 11 lb 3 oz at birth



____    9.   A nursing assessment reveals heavy vaginal bleeding; a firm, boardlike abdomen; contractions lasting 3 minutes with less than 30 seconds between them; and uterine tenderness in a woman last assessed to be 3 cm dilated and in early labor. Which is the nurses priority of care?

1) Frequent vital signs and fetal heart tones
2) Notification of the health-care provider
3) Assessment and documentation of pain levels
4) Providing emotional support



____  10.   A patient is informed that her pregnancy is a complete molar pregnancy and says to the nurse, So my baby died? What is the nurses best response?

1) Yes, Im afraid thats true, but you can get pregnant again.
2) The pregnancy resulted in the development of a placenta, but there was no baby.
3) This is a genetic abnormality that resulted in a nonviable fetus.
4) Have you ever experienced a molar pregnancy before?



____  11.   The nurse is caring for a patient who is 18 weeks pregnant and has a complete placenta previa. Which risk factor will the nurse assess for?

1) Multiple pregnancies
2) History of premature delivery
3) Endometriosis
4) Excessive exercise



____  12.   While caring for a patient diagnosed with an ectopic pregnancy, the nurse recognizes which sign as an indication of hypovolemic shock?

1) Elevated blood pressure
2) Decreased heart rate
3) Lethargy
4) Confusion



____  13.   Which woman is at greatest risk for Rh incompatibility?

1) A mother who has O- blood type, the father has A- blood type
2) A mother who has AB- blood type, the father has O+ blood type
3) A mother who has O+ blood type, the father has B- blood type
4) A mother who has A+ blood type, the father has B+ blood type



____  14.   The nurse is caring for a pregnant woman with a positive indirect Coombs test and type O- blood. Her last pregnancy resulted in the delivery of an infant with hemolytic anemia. Which is the priority of care?

1) Administer RhoGAM
2) Monitor the woman for anemia
3) Administer immunoglobulin at 28 weeks gestation
4) Prepare the patient for premature delivery



____  15.   The nurse is caring for a woman carrying multiple gestations. When providing nutritional teaching, the nurse encourages which dietary changes?

1) Increased calcium and reduced fat and calories
2) Increased folic acid and calcium and reduced protein
3) Increased calories, protein, and iron
4) Increased fat and calories with reduced protein



____  16.   The labor nurse admits a patient who is known to be carrying quadruplets at 28 weeks gestation and is in active labor. The nursing plan of care will include all of the following except what?

1) Encouraging the woman to verbalize her fears and ask questions
2) Continuous monitoring of fetal heart rates
3) Preparing the woman for prolonged vaginal delivery times
4) Ensuring that extra nurses and physicians will attend the birth



____  17.   The nurse is caring for one patient with chronic hypertension and another patient with gestational hypertension and recognizes which as the primary difference between the two?

1) The patient with gestational hypertension does not require medication.
2) The patient with chronic hypertension needs to maintain a low-sodium diet.
3) Blood pressure in gestational hypertension returns to normal 12 weeks postpartum.
4) Chronic hypertension carries greater risk of fetal complications.



____  18.   The nurse is caring for a patient who is in the third trimester of pregnancy and has been diagnosed with severe pre-eclampsia. Which is the nurses priority intervention to prevent seizures?

1) Monitoring hourly urine output and protein
2) Monitoring fetal well-being
3) Checking for hyperreflexia
4) Maintaining a low-stimulation environment



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  19.   The nurse who is caring for a pregnant woman diagnosed with gestational diabetes includes which topics in the teaching plan? (Select all that apply.)

1) Blood sugar monitoring four times a day
2) Eating six meals per day
3) Including carbohydrates with every meal
4) Maintaining blood sugar level at less than 120 mg/dL
5) Reducing daily activity



____  20.   When caring for a pregnant patient with a history of recreational cocaine use, the nurse recognizes the woman is at risk for which disorders? (Select all that apply.)

1) Placenta previa
2) Placenta abruption
3) Placenta accreta
4) Hydatidiform mole
5) Pre-eclampsia

Chapter 9: Nursing Assessment During Labor


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   The nurse reviews the charts of patients who have expressed an interest in home birth and recommends which patient as a potential candidate?

1) A woman whose 1-year-old child was born via Cesarean section
2) A primipara with a history of infertility
3) A woman desiring an epidural for pain control
4) A woman whose last child was stillborn



____    2.   A woman considering options for where to give birth asks the nurse if home birth is safe. Which is the nurses best response?

1) Home birth is safe if there are no complications for the mother or infant.
2) Home delivery is an option you should talk with the physician about.
3) Delivering at home is safe as long as theres a hospital within a 5-minute drive.
4) I would never consider delivering my baby at home because of the rate of poor outcomes.



____    3.   Which statement by the nurse is most appropriate when a patient is reluctant to sign the consent for admission?

1) Signing this form gives us permission to take care of you.
2) If you dont sign this form, we cannot take care of you.
3) Everyone admitted to the hospital needs to sign this form.
4) Its your choice whether to sign or not sign this form.



____    4.   Upon admitting a laboring patient, the nurse collects maternal assessment for which purpose?

1) To learn about the patients medication usage
2) To learn about any complications during the pregnancy
3) To establish a baseline of the patients condition
4) To determine any cultural needs the patient may have



____    5.   The nurse assesses a fetal heart rate as 190 bpm, with minimal baseline variability and recurring variable decelerations with moderate variability. How does the nurse classify these findings?

1) Category I
2) Category II
3) Category III
4) Falling between category II and category III



____    6.   The nurse performs an assessment of fetal heart rate and determines that the findings indicate a category I on the basis of which assessment finding?

1) Marked baseline variability
2) Recurring late
3) Fetal heart rate of 110 bpm
4) Prolonged decelerations of 5 minutes



____    7.   Under which circumstance does the nurse avoid performing a cervical examination?

1) When the membranes have ruptured
2) When vaginal bleeding is noted
3) When the woman has a multiple pregnancy
4) When the woman has complained of pain on past cervical examinations



____    8.   After Leopolds maneuver is performed, the patient asks the nurse, Why did you do that? Which is the nurses best explanation?

1) This is a check for fetal well-being.
2) This tells me if there will be any complications during delivery.
3) I was checking to see what position the fetus is in.
4) I was checking to see how you are progressing.



____    9.   While the nurse is talking to a laboring woman, her amniotic membranes rupture. Which is the nurses priority of care?

1) Vital signs
2) Cervical examination
3) Assessment of fluid
4) Assessment of fetal heart rate



____  10.   The nurse is assisting with the care of multiple patients in labor and recognizes the need to notify the health-care provider for which patient?

1) A primipara whose dilation has progressed from 4 to 5 cm over the past 2 hours
2) A primipara who dilated to 6 cm, and then her contractions stopped
3) A multipara who is 7 cm dilated with an intact amniotic membrane
4) A multipara who is 8 cm dilated and is becoming irritable and restless



____  11.   When planning care, the nurse determines that which patient is appropriate for intermittent fetal monitoring?

1) The woman whose pregnancy is at 38 weeks gestation
2) The woman receiving an epidural anesthetic
3) The woman with controlled gestational diabetes
4) The woman whose 5-year-old was born by Cesarean section



____  12.   A patient with pregnancy-induced hypertension asks the nurse to please remove the continuous fetal monitor to allow for easier movement. Which is the nurses best response?

1) I cannot remove the fetal monitor without a direct order from your provider, and there is an order to keep it on.
2) The fetal monitor allows me to make sure the baby is okay during contractions, so we need to leave it on.
3) Fetal monitoring restricts movement, but you dont want something to happen to the baby, do you?
4) Let me try to adjust the monitor to give you more freedom to move about in bed so you can be more comfortable.



____  13.   The nurse is caring for an obese pregnant woman in preterm labor with intact amniotic membranes who is receiving medications to stop labor. Which type of monitoring is best for this patient?

1) Internal fetal and contraction monitoring
2) Internal fetal and external contraction monitoring
3) External fetal and internal contraction monitoring
4) External fetal and contraction monitoring



____  14.   The nurse, while assessing a fetal monitor strip for a woman in term labor, determines there is significant fetal distress when she notes which finding?

1) Fetal heart rate of 160 bpm
2) Moderate variability
3) Accelerations of 25 bpm with contractions
4) Recurrent late decelerations with minimal variability



____  15.   When analyzing a fetal monitor strip, the nurse recognizes that which decelerations are not an indication for concern and require no nursing interventions?

1) Early decelerations
2) Late decelerations
3) Variable decelerations
4) Absent decelerations



____  16.   When analyzing a fetal heart strip, the nurse notes the absence of accelerations for the past 15 minutes. Which is the nurses priority action?

1) Change the maternal position
2) Notify the health-care provider
3) Administer oxygen to the mother
4) Monitor for an additional 15 minutes



____  17.   A laboring patients amniotic membranes rupture, and a sudden variable deceleration is seen on the fetal heart monitor. Which is the nurses priority action before notifying the health-care provider?

1) Increase IV fluids
2) Perform amniotic infusion
3) Change the patients position
4) Administer oxygen



____  18.   The nurse is caring for a patient who is receiving oxytocin to promote labor and notes late decelerations on the fetal monitor. Which is the nurses priority of care?

1) Performing Leopolds maneuver to wake the sleeping fetus
2) Administering tocolytics
3) Discontinuing oxytocin
4) Increasing administration of IV fluids




Complete each statement.


  1. The nurse is preparing to perform a vaginal cervical examination. Place the steps the nurse will perform in the proper order, from first to last. (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)

1) Insert the index and middle finger into the vagina

2) Open the labia and observe for vaginal drainage

3) Document findings

4) Perform hand hygiene and provide privacy

5) Position the woman

6) Determine effacement, dilation, station, and presenting part


Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  20.   The nurse admits a laboring patient who is progressing rapidly and says she feels the need to push. Which priority data should be assessed with this patient? (Select all that apply.)

1) Cultural needs
2) Medication history
3) Timing of contractions
4) Cervical dilation
5) Fetal well-being

Chapter 11: Nursing Care of the Woman With Complications During Labor and Birth


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   The nurse admits a patient at 32 weeks gestation with a history of cervical cerclage to rule out preterm labor. Which finding is inconsistent with the patients history?

1) Rupture of membranes
2) Signs of infection
3) Cervical dilation to 3 cm
4) Mild vaginal bleeding



____    2.   A 28-year-old woman is a primipara who is pregnant with triplets, is at 18 weeks gestation, and is receiving regular prenatal care. The nurse identifies a risk for preterm labor related to which factor?

1) The patients age
2) 18 weeks gestation
3) Multiple gestations
4) Previous obstetric history



____    3.   The nurse questions an order to administer a tocolytic drug for which patient?

1) The patient under age 18
2) The patient with a history of multiple gestations
3) The patient who is 2 cm dilated
4) The patient with acute vaginal bleeding



____    4.   The experienced nurse recognizes that a graduate nurse needs guidance in caring for a woman at 38 weeks gestation with premature rupture of membranes when the graduate nurse is seen preparing to do what?

1) Fetal monitoring
2) Vital signs
3) Provide support and education
4) Conduct a cervical examination



____    5.   A patient is approaching 42 weeks gestation and has been admitted for induction of labor. The patient tells the nurse she does not want an induction and prefers to wait for labor to begin naturally. Which is the nurses best response?

1) Waiting for labor to begin naturally could result in the death of your baby.
2) The longer you wait, the bigger the baby gets and the harder delivery will be.
3) Complications for you and your baby increase after 42 weeks of gestation.
4) If you had controlled your weight gain during pregnancy, you might have gone into natural labor.



____    6.   The nurse is caring for a woman who has been admitted with a diagnosis of polyhydramnios and recognizes which as the most likely cause?

1) Fetal kidney failure
2) Gastrointestinal blockage
3) Rupture of the membranes
4) Fetal demise



____    7.   A womans labor is not progressing, and the fetus is found to be in the breech position. Which of the seven Ps of labor is involved with this womans failure to progress?

1) Presentation
2) Passenger
3) Passage
4) Powers



____    8.   A laboring patients water breaks, and the umbilical cord protrudes from the vagina. The nurse immediately places the patient in the Trendelenburg position. Which of the seven Ps is most impacted?

1) Passage
2) Pain

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