Deck 33: Labor and Birth Complications

Question 1

Nurses should be aware that the induction of labor:

A)Can be achieved by external and internal version techniques
B)Is also known as a trial of labor (TOL)
C)Is almost always done for medical reasons
D)Is rated for viability by a Bishop score

Answer 1

Is rated for viability by a Bishop score

Question 2

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions.What clinical cues alert the nurse that the woman is experiencing uterine hyperstimulation? Choose all that apply.

A)Uterine contractions lasting <90 seconds and occurring >2 minutes in frequency
B)Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency
C)Uterine tone <20 mm Hg
D)Uterine tone >20 mm Hg
E)Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR)and pattern

Answer 2

Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency
Uterine tone >20 mm Hg
Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR)and pattern

Question 3

Obese women are at risk for several complications during pregnancy and birth.These include all except:

A)Thromboembolism
B)Cesarean birth
C)Wound infection
D)Breech presentation

Answer 3

Breech presentation

Question 4

Complications and risks associated with cesarean births include (choose all that apply):

A)Pulmonary edema
B)Wound dehiscence
C)Hemorrhage
D)Urinary tract infections
E)Fetal injuries

Question 5

A woman is having her first child.She has been in labor for 15 hours.Two hours ago her vaginal examination revealed the cervix to be dilated to 5 cm and 100% effaced,and the presenting part was at station 0.Five minutes ago her vaginal examination indicated that there had been no change.What abnormal labor pattern is associated with this description?

A)Prolonged latent phase
B)Protracted active phase
C)Secondary arrest
D)Protracted descent

Question 6

A nurse providing care for a woman with preterm labor on terbutaline includes which intervention to identify side effects of the drug?

A)Assess deep tendon reflexes (DTRs).
B)Assess for dyspnea and crackles.
C)Assess for bradycardia.
D)Assess for hypoglycemia.

Question 7

A primigravida at 40 weeks of gestation is having uterine contractions every 1 1/2 to 2 minutes and says that they are very painful.Her cervix is dilated 2 cm and has not changed in 3 hours.The woman is crying and wants an epidural.What is the likely status of this woman's labor?

A)She is exhibiting hypotonic uterine dysfunction.
B)She is experiencing a normal latent stage.
C)She is exhibiting hypertonic uterine dysfunction.
D)She is experiencing pelvic dystocia.

Question 8

Which statement related to cephalopelvic disproportion (CPD)is the least accurate?

A)CPD can be related to either fetal size or fetal position.
B)The fetus cannot be born vaginally.
C)CPD can be accurately predicted.
D)The cause may be of maternal or fetal origin.

Question 9

With regard to the process of inducing labor,nurses should be aware that:

A)Ripening the cervix usually results in a decreased success rate for induction
B)Labor sometimes can be induced with balloon catheters or laminaria tents
C)Oxytocin is less expensive than prostaglandins and more effective but creates greater health risks
D)Amniotomy can be used to make the cervix more favorable for labor

Question 10

The exact cause of preterm labor is unknown and believed to be multifactorial.Infection is thought to be a major factor in many preterm labors.Select the type of infection that has not been linked to preterm births:

A)Viral
B)Periodontal
C)Cervical
D)Urinary tract

Question 11

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation.The nurse recognizes that this medication is administered to:

A)Enhance uteroplacental perfusion in an aging placenta
B)Increase amniotic fluid volume
C)Ripen the cervix in preparation for labor induction
D)Stimulate the amniotic membranes to rupture

Question 12

Nurses should know some basic definitions concerning preterm birth,preterm labor,and low birth weight.For instance:

A)The terms preterm birth and low birth weight can be used interchangeably
B)Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy
C)Low birth weight is anything below 3.7 lb
D)In the United States early in this century,preterm birth accounted for 18% to 20% of all births

Question 13

With regard to the care management of preterm labor,nurses should be aware that:

A)Because all women must be considered at risk for preterm labor and prediction is so hit and miss,teaching pregnant women the symptoms probably causes more harm through false alarms
B)Braxton Hicks contractions often signal the onset of preterm labor
C)Because preterm labor is likely to be the start of an extended labor,a woman with symptoms can wait several hours before contacting the primary caregiver
D)The diagnosis of preterm labor is based on gestational age,uterine activity,and progressive cervical change

Question 14

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor,which finding alerts the nurse to possible side effects?

A)Urine output of 160 ml in 4 hours
B)Deep tendon reflexes 2+ and no clonus
C)Respiratory rate (RR)of 16 breaths/min
D)Serum magnesium level of 10 mg/dl

Question 15

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor.Her labor is being controlled with tocolytic medications.She asks when she might be able to go home.What response by the nurse is most accurate?

A)"After the baby is born."
B)"When we can stabilize your preterm labor and arrange home health visits."
C)"Whenever the doctor says that it is okay."
D)"It depends on what kind of insurance coverage you have."

Question 16

With regard to the process of augmentation of labor,a nurse should be aware that it:

A)Is part of the active management of labor that is instituted when the labor process is unsatisfactory
B)Relies on more invasive methods when oxytocin and amniotomy have failed
C)Is a modern management term to cover up the negative connotations of forceps-assisted birth
D)Uses vacuum cups

Question 17

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly.The purpose of this pharmacologic treatment is to:

A)Stimulate fetal surfactant production
B)Reduce maternal and fetal tachycardia associated with ritodrine administration
C)Suppress uterine contractions
D)Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy

Question 18

A client is to have an amniotomy to induce labor.The nurse recognizes that the priority intervention after the amniotomy is to:

A)Apply clean linens under the woman
B)Take the client's vital signs
C)Perform a vaginal examination
D)Assess the fetal heart rate (FHR)

Question 19

In planning for home care of a woman with preterm labor,the nurse needs to address which concern?

A)Nursing assessments are different from those done in the hospital setting.
B)Restricted activity and medications are necessary to prevent recurrence of preterm labor.
C)Prolonged bed rest may cause negative physiologic effects.
D)Home health care providers are necessary.

Question 20

In evaluating the effectiveness of an oxytocin induction,the nurse expects:

A)Contractions lasting 40 to 90 seconds,2 to 3 minutes apart
B)The intensity of contractions to be at least 110 to 130 mm Hg
C)Labor to progress at least 2 cm/hr dilation
D)At least 30 milliunits/min of oxytocin are needed to achieve cervical dilation

Question 21

____________________ is defined as long,difficult,or abnormal labor.It is caused by various conditions associated with the five factors affecting labor.

Question 22

The nurse is teaching a client with PPROM about self-care activities.Which activities should the nurse include in her teaching? Choose all that apply.

A)Report a temperature higher than 40° C.
B)It is safe to use a tampon to absorb the leaking amniotic fluid.
C)Do not engage in sexual activity.
D)It is safe to take frequent tub baths.
E)It is acceptable to douche to cleanse the vagina of foul-smelling fluids.

Question 23

Nurses need to know that when any woman is admitted to the hospital and is __________ to __________ weeks pregnant,she should receive antenatal glucocorticoids unless she has chorioamnionitis.Because these drugs require a 24-hour period to become effective,timely administration is essential.

Question 24

A nurse is caring for a client in the active phase of labor.The woman's bag of waters spontaneously ruptures.Suddenly the woman complains of dyspnea and appears restless and cyanotic.Additionally,she becomes hypotensive and tachycardic.The nurse immediately suspects the presence of ___________________________________.