Question 1

A pulsating structure is felt during a vaginal examination of a woman in labor. To prevent compression of a prolapsed cord, the nurse would position the woman:

Accepted Answer

The Trendelenburg (head down) position displaces the fetus upward to stop compression of the prolapsed cord.

Question 2

Several hours after delivery the nurse finds a woman crying. The woman says repeatedly, "My baby is beautiful, but I was planning on a vaginal delivery. Instead I needed an emergency C-section." The most appropriate nursing diagnosis is:

Accepted Answer

Women who have cesarean birth usually need greater support than those having vaginal births. They may feel grief, guilt, or anger because the expected course of birth did not occur.

Question 3

The frustrated patient in hypotonic labor complains "My doctor won't induce my labor because of some silly Bishop score. He said I was a 4. What kind of magic number do I need?" The nurse explains that prior to induction the patient should be a Bishop score of at least:

Accepted Answer

The Bishop Score evaluated the suitability of the patient for a vaginal delivery. A minimum score of 6 is recommended by the ACOG.

Question 4

The initial vaginal examination of a woman admitted to the labor unit reveals that the cervix is dilated 9 cm. The panicked woman asks the nurse, "Please give me something." The most appropriate pain relief intervention for a woman in precipitate labor is to:

Accepted Answer

The nurse would stay with the woman experiencing precipitate labor and breathe with her during contractions to help the woman focus and cope with each contraction.

Question 5

When a woman is admitted to the labor and delivery unit, she tells the nurse that she is anxious about delivery, anxious about the welfare of her baby, anxious about how quickly she will recover…in short, anxious about everything. The nurse is aware that anxiety can affect labor by:

Accepted Answer

Excessive anxiety reduces uterine blood flow, making uterine contractions less effective, and creates muscle tension that counteracts the expulsion powers of contractions.

Question 6

The nurse is administering terbutaline (Brethine) to a pregnant woman to prevent preterm labor. The nurse would assess for which adverse effect?

Accepted Answer

Maternal tachycardia is the common negative side effect of terbutaline which should be corrected with a dose of propranolol.

Question 7

The statement that indicates a woman understands activity limitations for the management of preterm labor is:

Accepted Answer

Lengthy activity restrictions are often needed to prevent preterm birth. The nurse can help the woman identify ways to organize necessary activities and maximize rest.

Question 8

A woman who is 33 weeks pregnant is admitted to the obstetrical unit because her membranes ruptured spontaneously. She must be closely observed for signs of:

Accepted Answer

Infection of the amniotic sac, called chorioamnionitis, may cause prematurely ruptured membranes, or it may be a consequence of rupture because the barrier to the uterine cavity is broken.

Question 9

When a hypotonic labor dysfunction occurs in a patient who is dilated to 5 cm with membranes intact, the nurse informs the patient that the physician most likely will:

Accepted Answer

Medical treatment for hypotonic labor dysfunction includes an amniotomy if the membranes are intact as the first remedy.

Question 10

A woman 2 weeks past her expected delivery date who is receiving an oxytocin infusion to induce labor begins to have contractions every 90 seconds. The nurse's initial action should be to:

Accepted Answer

Oxytocin is discontinued if signs of fetal compromise or excessive uterine contractions occur.

Question 11

Following an amniotomy, the nursing assessment that should be reported immediately is:

Accepted Answer

Amniotic fluid should be clear. Green fluid indicates the fetus has passed meconium, which is associated with fetal compromise.

Question 12

A woman who is 24 weeks pregnant is placed on an IV infusion of magnesium sulfate. The nurse should inform the patient that she might experience the side effect of this drug which is:

Accepted Answer

Magnesium sulfate is the drug of choice for initiating therapy to stop labor. The patient will notice a warm flush with the initiation of the drug.

Question 13

The new mother is distressed and tearful about the elevated dome over her baby's posterior fontanelle. The nurse's best response is, "This condition will resolve itself in a few days. It is caused by:

Accepted Answer

The "chignon" is due to the effect of the vacuum extractor and will disappear in a few days.

Question 14

A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP). To encourage fetal rotation and pain relief the nurse would position the patient:

Accepted Answer

A position that favors fetal rotation and descent and that is helpful for the woman with back labor is to sit or kneel leaning forward on a support.

Question 15

After several hours of labor, a nursing assessment reveals that a woman's cervix is 5 cm dilated but contractions are becoming shorter and less frequent. The nurse knows that this labor pattern is described as:

Accepted Answer

The woman with hypotonic labor dysfunction begins labor normally, but contractions diminish after the active phase.

Question 16

The nursing care of a woman with a third-degree laceration immediately after delivery would include:

Accepted Answer

Ice is applied to the perineum to reduce bruising and edema.

Question 17

The nurse would assess an infant delivered with the use of forceps for:

Accepted Answer

Pressure from forceps may injure the infant's facial nerve, which is evidenced by facial asymmetry.

Question 18

A pregnant woman's membranes ruptured prematurely at 34 weeks. She will be discharged to her home for the next few weeks. The nurse planning discharge instructions would teach the woman to:

Accepted Answer

For the woman with PROM who is not having labor induced right away, teaching combines information about infection and preterm labor. The woman should monitor her temperature and report a temperature greater than 37.8°C.

Question 19

During a strenuous labor, the woman asks for some pain remedy for the sudden pain between her scapulae which seems to occur with every breath she takes. The nurse should:

Accepted Answer

Sudden pain between the scapulae during a strenuous labor is an indicator of uterine rupture. This should be immediately reported.

Question 20

A student nurse questions the instructor as to what alteration should be made for the assessment of the fundus of a new postoperative cesarean section patient. The best response is that the fundus of a patient with a cesarean section is:

Accepted Answer

Assessment of the fundus following a cesarean section is done as usual, but using especially gentle fundal massage.

Quiz 8: Nursing Care of Women With Complications During Labor and Birth