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maternity 4
| Question | Answer |
|---|---|
| What would make a patient seek immediate medical attention during pregnancy? | No fetal movement after the sixth month of pregnancy |
| After reviewing the maternal serum screening results of a pregnant patient, the nurse infers that the patient may be carrying a child with Down syndrome. What is the potential finding in the report? | Trisomy |
| A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? | "A baby in utero does respond to the mother's voice." |
| Conjoined twins are monozygotic twins who have had incomplete embryonic division. | Cesarean section is recommended for the patient having conjoined twins, because it minimizes the trauma in both the mother and the fetuses. |
| During the assessment of a 19-year-old male patient, the nurse finds that the patient is worried. The patient reports an inability to grow a mustache or a beard. The laboratory results indicate that the patient has an extra X-linked chromosome. What would | I advise visiting a genetic counselor for follow-up." |
| Oxytocin hormone stimulates | uterine contractions and milk ejection from the breasts. These contractions cause labor pain in the pregnant woman. |
| the condition in which the fetus begins to descend and engage in the pelvis. It occurs at the start of labor. | Lightening |
| Hegar and Chadwick are seen during first trimester of pregnancy. Hegar sign refers | to the softening and compressibility of the lower uterine segment. Chadwick sign refers to the violet-bluish discoloration of the vaginal mucosa and the cervix as a result of increased vascularity. |
| The nurse is assessing a pregnant woman who reports to have noticed the appearance of bluish channels on the surface of the breast. What is the possible reason for such observation in the patient? | Dilation of the blood vessels |
| The laboratory reports of a pregnant female reveal severe hyponatremia. Which hormone supplementation helps in normalizing sodium levels in the patient? | Aldosterone |
| During the prenatal examination of a pregnant woman, the nurse finds that the patient has hemorrhoids. What does the nurse interpret from this finding? | The venous pressure has increased, and there is reduced blood flow to the legs. |
| What are the factors that enable the baby to initiate respiration immediately postpartum? | Fetal lung fluid is cleared from the air passage as the infant passes through the birth canal during labor and vaginal birth. |
| Which pelvic shape is most conducive to vaginal labor and birth? | Gynecoid |
| the presenting part is usually the occiput. | cephalic presentation |
| the presenting part is the sacrum. | breech presentation |
| During a prenatal evaluation, the nurse notes that the patient has a flat pelvis. What term does the nurse use to refer to this type of pelvis? | Platypelloid |
| While assessing a newborn immediately after vaginal birth, the mother is concerned that the newborn’s head has assumed an abnormal shape. What should the nurse inform the mother of the baby? | our baby’s head should assume a normal shape within 3 days." "This molding of the head allowed your child to adapt to the shape of your pelvis during labor." |
| The nurse palpates the fontanels and sutures to determine the fetal presentation. What is the feature of the anterior fontanel? | It is diamond shaped in appearance and measures about 3 cm by 2 cm. It closes by 18 months after birth. It lies at the junction of the sagittal, coronal, and frontal sutures. |
| What are the factors that speed up the dilation of the cervix? | a. Strong uterine contractions c. Pressure by amniotic fluid e. Force by fetal presenting part |
| The nurse is assessing a client who is 6 months pregnant. The nurse determines that the fetus is lying in a longitudinal position with the sacrum as the presenting part and with general flexion. What fetal position should the nurse document? | Complete breech position |
| The nurse assisting a laboring patient recognizes the Ferguson reflex in the patient. What is the Ferguson reflex? | urge to bear down |
| The nurse is studying the chart of a patient in labor. If the patient's chart indicates "RMA," what is the presenting part? | chin |
| The nurse assisting a patient in the second stage of labor asks the patient to avoid the Valsalva maneuver. What is the effect of the Valsalva maneuver? | Causes fetal hypoxia |
| In which stage of labor does the nurse expect the placenta to be expelled? | third stage |
| The nurse is caring for a pregnant client who is in the second stage of labor. The nurse instructs the client not to hold her breath or tighten the abdominal muscles while having intense labor pain. What is the rationale for this instruction? | To prevent the onset of fetal hypoxia |
| When the lowermost portion of the presenting part | is 1 cm above the ischial spine, it is noted as being minus (-)1. |
| The nurse is teaching a patient, who is pregnant for the first time, about the signals that indicate the beginning of labor. Which sign will the nurse mention as a signal for the beginning of labor? | Involuntary contractions |
| Fetal well-being during labor is assessed by what? | The response of the fetal heart rate (FHR) to uterine contractions (UCs) |
| The nurse instructs a pregnant patient to breathe through the mouth and keep it open while pushing during labor. What is the rationale for this nursing intervention? | To facilitate increased oxygen to the fetus |
| While assessing a pregnant patient using a fetoscope, the nurse also palpates the abdomen of the patient. What is the purpose of palpating the abdomen of the patient? | Assessment of changes in FHR during and after contraction |
| FHR decelerations are not identified by palpating the abdomen. It is assessed | using the electronic fetal monitoring system. |
| While assessing a pregnant patient who is in labor, the nurse observes W-shaped waves on the fetal heart rate (FHR) monitor. What would the nurse infer from this observation? | Umbilical cord compression |
| Late decelerations in the FHR may be caused by | maternal hypotension. Elevating the lower extremities helps control maternal hypotension and increase the blood flow to the uterus. |
| positioning the woman on the left side, applying oxygen via a face mask, and notifying the health care provider are correct actions for | late deceleration |
| When using intermittent auscultation (IA) to assess uterine activity, nurses should be aware of what? | The examiner's hand should be placed over the fundus before, during, and after contractions. |
| The nurse has performed vibroacoustic stimulation and determines that the fetal heart rate (FHR) has increased by 15 beats/min from the baseline within 15 seconds. Which condition does this acceleration indicate? | A normal pH level in the fetus |
| What category of fetal heart rate (FHR) tracing includes tachycardia with minimal variability and periodic variable decelerations? | Category 2 |
| The nurse is caring for a newly admitted nulliparous patient in the ninth month of pregnancy. What should the nurse do to provide effective care? | Explain the various labor stages to the patient. |
| The nurse observes that a pregnant patient has a blood glucose level of 180 mg/dL in early labor. Which prescription does the nurse expect to receive from the primary health care provider (PHP)? | Ringer's lactate solution to the patient |
| A patient has given birth to a baby 1 hour ago. Which intervention should the nurse perform while caring for the patient? | Check the perineal pads and linen under the patient's buttock FOR .lochia and note the color, odor, and size of the clots. This helps to detect the presence of intrauterine complication after birth. |
| The nurse observes that a pregnant patient is very reluctant to participate in the birthing process. Which interventions should the nurse follow to ensure fetal well-being? | Ask the patient to take deep breaths. Encourage the patient to change positions. Suggest that the patient hold her breath for short periods |
| The nurse palpates the abdomen of a pregnant patient and reports that the fetus lies in longitudinal position with cephalic presentation. Which observation enabled the nurse to report about the fetal position? | The head feels round, firm, freely movable, and palpable by ballottement. |
| The nurse is caring for a patient in labor whose cervix is dilated to 10 cm and who is exhibiting copious amounts of bloody mucus show. What behavior does the nurse anticipate finding in this patient? | The patient expresses the need to defecate. The patient doubts her ability to continue with the labor. |
| The laboratory reports of a pregnant patient revealed that the patient has maternal ketosis. Which intravenous (IV) medication administration does the nurse expect to be ordered for the patient? | Dextrose solution |
| A nurse is caring for a woman whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of what? | A fetal heart rate (FHR) of 180 beats/min with absence of variability |
| The nurse finds that the amniotic membranes in a pregnant patient who is in labor have ruptured and that the amniotic fluid is meconium-stained. The nurse should infer from the findings that the baby has a high risk of presenting with what? | Aspiration pneumonia |
| The LBW of the newborn is the result of IUGR, | It may be caused by various conditions, such as gestational hypertension that interferes with uteroplacental perfusion. Interference with uteroplacental perfusion limits the flow of nutrients into the fetus and causes the LBW. |
| During the first stage of labor, a pregnant patient complains of having severe back pain. What would the nurse infer about the patient's clinical condition from the observation? | Occipitoposterior position of the fetus |
| While caring for a patient who is treated with terbutaline (Brethine), the nurse tries to reduce pressure on the patient's cervix to prevent preterm labor. Which nursing action would be most relevant? | Suggesting that the patient lie on her side |
| For a woman at 42 weeks of gestation, which finding requires more assessment by the nurse? | One fetal movement noted in 1 hour of assessment by the mother. post term pregnancy should include performing daily fetal kick counts three times per day. |
| Which technique is least effective for the woman with persistent occipitoposterior position? | Lie supine and relax; Lying supine increases discomfort. The woman typically complains of severe back pain from the pressure of the fetal head (occiput) pressing against her sacrum. |
| A pregnant patient who has chorioamnionitis gave birth to a child through cesarean section. Which medication does the nurse expect the primary health care provider (PHP) to prescribe? | Clindamycin (Cleocin) |
| Which nursing action should be initiated first when there is evidence of prolapsed cord? | Reposition the woman with her hips higher than her head. |
| According to research, the patients who have periodontal diseases like gingivitis, inflammation around the teeth, and bleeding of gums may have an increased | RISK OF PRETERM LABOR |
| A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage is: | Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus |
| f uterine hypertonicity occurs, the nurse immediately would intervene to reduce uterine activity and increase fetal oxygenation. The nurse would (1) stop the Pitocin infusion and | increase the rate of the nonadditive solution, (4) check maternal BP for hyper or hypotension, (3) position the woman in a side-lying position, and (5) administer oxygen by snug face mask at 8-10 L/min (2) perform a vaginal exam to check for prolapsed c |
| A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician’s orders and would expect to note which of the following prescribed treatments for this condition? | Oxytocin (Pitocin) infusion |
| client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa? | Hemorrhage |
| A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action? | Place the client in Trendelenburg’s position |
| Excessive fundal pressure, forceps delivery, violent bearing down efforts, tumultuous labor, and shoulder dystocia can place a woman at risk for | traumatic uterine rupture. |
| A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus’ head is: | Below the ischial spines |
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