Question 1

The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative,rubella titer less than 1:8/1:10,Rh-negative with Rh-positive infant.Which injections will the nurse expect to be ordered?

Accepted Answer

The woman needs RhoGAM today and will need an MMR since her rubella titer is low.Because it is a live vaccine,the MMR should be given in 3 months.She does not need hepatitis B immune globulin.

Question 2

The nurse administers meperidine (Demerol)to a woman who is in early labor.Immediately after the drug is given,the woman's labor progresses quickly,and she delivers her infant.The nurse will monitor the infant closely for which condition?

Accepted Answer

Narcotic analgesics cause respiratory depression in the infant if given shortly before delivery.The nurse should monitor the infant closely and prepare to give naloxone (Narcan)if this occurs.Opioid withdrawal occurs with prolonged exposure to opioids.Orthostatic hypotension and tachycardia are not common effects.

Question 3

A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases.She has 3-year-old and 5-year-old children who have not been immunized.The nurse will counsel the patient to perform which action?

Accepted Answer

Pregnant women should not receive MMR vaccine because it is a live virus and there is risk to the fetus.Her children should be vaccinated so they do not contract rubella and pass it to her.

Question 4

When teaching a postpartal patient about the use of mineral oil as a laxative,the nurse will explain that mineral oil

Accepted Answer

Mineral oil should be given with fruit juice or soda to disguise the taste.It can be aspirated,causing aspiration pneumonia-a serious side effect.It should not be taken with food and should not be taken with other laxatives.

Question 5

The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation.What information will the nurse include when teaching this patient about this medication?

Accepted Answer

Bisacodyl tablets should be stored in a cool,dry place.They should not be crushed.It is not necessary to give with a carbonated beverage.Bisacodyl tablets should not be taken within 1-2 h of milk or antacid.

Question 6

The nurse is preparing a woman who is in labor for a lumbar epidural and explains that she will receive a continuous infusion of epidural anesthesia.She asks what will happen if that isn't effective.What response by the nurse is correct?

Accepted Answer

Continuous epidural anesthesia provides a consistent drug level and more effective pain relief than with intermittent epidural anesthesia.Patients may have rescue doses as needed.Postdural headache occurs with accidental puncture of the dura with epidural anesthesia.

Question 7

The nurse is caring for a woman who is in labor.The woman is anxious and reports increasing nausea after receiving an opioid analgesic medication.The nurse will contact the provider and request an order for which intravenous medication?

Accepted Answer

Phenergan is used as an adjunct to narcotic analgesics to potentiate pain relief,control anxiety,and reduce nausea.Hydroxyzine may have similar effects but is not given intravenously.Pentobarbital and secobarbital are used for anxiety only.

Question 8

The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section.The mother's blood type is Rh-negative,and the infant's blood type is Rh-positive.The provider has ordered human D immune globulin (RhoGAM).The nurse understands that this patient will need

Accepted Answer

For women with abruption,previa,caesarean births,or manual placental removal,more than 15 mL of fetal-maternal hemorrhage of Rh-positive red blood cells may have occurred,necessitating an increased dose of D immune globulin.

Question 9

The nurse is assisting with placement of epidural anesthesia for a woman who is in labor.To help prevent maternal hypotension,which is the nurse's initial action?

Accepted Answer

To decrease maternal hypotension before epidural placement,an IV bolus of 500-1000 mL of crystalloid solution is given.When hypotension develops,the woman should be turned to her left side and administered a rapid bolus of crystalloid solution.Phenylephrine is given if hypotension does not improve.Blood pressure should be monitored throughout the procedure.

Question 10

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response.The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?

Accepted Answer

Sedative-hypnotic drugs,such as secobarbital,can cause neonatal respiratory depression,hypotonia,and a poor sucking response up to 4 days.Butorphanol tartrate,fentanyl,and nalbuphine do not have prolonged effects.

Question 11

The nurse is caring for a woman who is in early labor.The woman wants to avoid pain medications as long as possible.What will the nurse tell her?

Accepted Answer

Breathing and relaxation techniques are often used as nonpharmacologic measures to control pain during labor.Sedatives are often used to decrease maternal anxiety during false labor,latent labor,or with ruptured membranes without true labor.Fentanyl is generally not given until active labor.Ibuprofen can cause premature closure of the ductus arteriosis.

Question 12

The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately.Her intravenous line has just infiltrated.The nurse will perform which action?

Accepted Answer

Meperidine may be given IM and is the most commonly used opioid during labor.Fentanyl is best given intravenously.Promethazine is given in combination with opioids during active labor to potentiate the analgesic action of the opioids and minimize emesis.Hydroxyzine is given for nausea.

Question 13

The nurse has just administered Rh₀(D)immune globulin (RhoGAM)to a postpartal woman.What information will the nurse include when teaching this patient?

Accepted Answer

Patients receiving Rh₀(D)immune globulin should be cautioned to avoid live vaccines for 3 months.Patients can experience hypersensitivity reactions to the immune globulin,and Rh₀(D)immune globulin crosses into breast milk.Women will need to have the immune globulin with future deliveries if the infant is Rh-positive.

Question 14

The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant.She asks why she cannot use drugs to suppress lactation.Which response by the nurse is correct?

Accepted Answer

Estrogenic drug therapy is less common than in the past because of the increased risk of thrombophlebitis.They are more effective than complementary drugs.They do not increase constipation or promote uterine atony.

Question 15

The nurse is caring for a patient after the third stage of labor,and the provider orders 20 units of oxytocin to be given intramuscularly.The nurse will explain to the patient that this drug for which purpose?

Accepted Answer

After delivery of the infant,oxytocin is given to help the uterus stay contracted and prevent uterine atony.It may be given intravenously or intramuscularly.It does not constrict the cervix.Intranasal oxytocin may be given later to enhance letdown of breast milk.Oxytocin does not suppress lactation.

Question 16

The nurse examines a primipara woman who has received an epidural block.The woman's cervix has been dilated at 5 cm for an hour after having shown steady progression earlier.The nurse will notify the provider and anticipate a need for

Accepted Answer

Regional anesthetics may slow labor,and therefore the patient may need to be administered a drug to enhance uterine contractions.Intravenous oxytocin is given to stimulate contractions.If oxytocin is not effective,the other measures may be necessary.

Quiz 50: Labor, Delivery, and Postpartum

The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative,rubella titer less than 1:8/1:10,Rh-negative with Rh-positive infant.Which injections will the nurse expect to be ordered?

The nurse administers meperidine (Demerol) to a woman who is in early labor.Immediately after the drug is given,the woman's labor progresses quickly,and she delivers her infant.The nurse will monitor the infant closely for which condition?

A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases.She has 3-year-old and 5-year-old children who have not been immunized.The nurse will counsel the patient to perform which action?

When teaching a postpartal patient about the use of mineral oil as a laxative,the nurse will explain that mineral oil

The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation.What information will the nurse include when teaching this patient about this medication?

The nurse is preparing a woman who is in labor for a lumbar epidural and explains that she will receive a continuous infusion of epidural anesthesia.She asks what will happen if that isn't effective.What response by the nurse is correct?

The nurse is caring for a woman who is in labor.The woman is anxious and reports increasing nausea after receiving an opioid analgesic medication.The nurse will contact the provider and request an order for which intravenous medication?

The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section.The mother's blood type is Rh-negative,and the infant's blood type is Rh-positive.The provider has ordered human D immune globulin (RhoGAM) .The nurse understands that this patient will need

The nurse is assisting with placement of epidural anesthesia for a woman who is in labor.To help prevent maternal hypotension,which is the nurse's initial action?

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response.The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?

The nurse is caring for a woman who is in early labor.The woman wants to avoid pain medications as long as possible.What will the nurse tell her?

The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately.Her intravenous line has just infiltrated.The nurse will perform which action?

The nurse has just administered Rh₀(D) immune globulin (RhoGAM) to a postpartal woman.What information will the nurse include when teaching this patient?

The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant.She asks why she cannot use drugs to suppress lactation.Which response by the nurse is correct?

The nurse is caring for a patient after the third stage of labor,and the provider orders 20 units of oxytocin to be given intramuscularly.The nurse will explain to the patient that this drug for which purpose?

The nurse examines a primipara woman who has received an epidural block.The woman's cervix has been dilated at 5 cm for an hour after having shown steady progression earlier.The nurse will notify the provider and anticipate a need for

Quiz 50: Labor, Delivery, and Postpartum

The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative,rubella titer less than 1:8/1:10,Rh-negative with Rh-positive infant.Which injections will the nurse expect to be ordered?

The nurse administers meperidine (Demerol) to a woman who is in early labor.Immediately after the drug is given,the woman's labor progresses quickly,and she delivers her infant.The nurse will monitor the infant closely for which condition?

A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases.She has 3-year-old and 5-year-old children who have not been immunized.The nurse will counsel the patient to perform which action?

When teaching a postpartal patient about the use of mineral oil as a laxative,the nurse will explain that mineral oil

The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation.What information will the nurse include when teaching this patient about this medication?

The nurse is preparing a woman who is in labor for a lumbar epidural and explains that she will receive a continuous infusion of epidural anesthesia.She asks what will happen if that isn't effective.What response by the nurse is correct?

The nurse is caring for a woman who is in labor.The woman is anxious and reports increasing nausea after receiving an opioid analgesic medication.The nurse will contact the provider and request an order for which intravenous medication?

The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section.The mother's blood type is Rh-negative,and the infant's blood type is Rh-positive.The provider has ordered human D immune globulin (RhoGAM) .The nurse understands that this patient will need

The nurse is assisting with placement of epidural anesthesia for a woman who is in labor.To help prevent maternal hypotension,which is the nurse's initial action?

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response.The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?

The nurse is caring for a woman who is in early labor.The woman wants to avoid pain medications as long as possible.What will the nurse tell her?

The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately.Her intravenous line has just infiltrated.The nurse will perform which action?

The nurse has just administered Rh0(D) immune globulin (RhoGAM) to a postpartal woman.What information will the nurse include when teaching this patient?

The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant.She asks why she cannot use drugs to suppress lactation.Which response by the nurse is correct?

The nurse is caring for a patient after the third stage of labor,and the provider orders 20 units of oxytocin to be given intramuscularly.The nurse will explain to the patient that this drug for which purpose?

The nurse examines a primipara woman who has received an epidural block.The woman's cervix has been dilated at 5 cm for an hour after having shown steady progression earlier.The nurse will notify the provider and anticipate a need for

The nurse has just administered Rh₀(D) immune globulin (RhoGAM) to a postpartal woman.What information will the nurse include when teaching this patient?