Practice Questions

A labor nurse is measuring the uterine activity from the start of one contraction to the start of the next contraction. What characteristic is the nurse assessing?

a) contraction frequency

b) contraction duration

c) contraction intensity

d) labor duration

a

Jane is a 26 y/o G5P3012 who is now 24 weeks pregnant. Her OB history includes 2 LGA babies born at term and one unexplained still birth. Based on this history, it will be most important to monitor for s/s of which condition during jane’s pregnancy?

a) gestational diabetes

b) cardiac decompensation

c) anemia

d) substance abuse

The nurse is preparing to assess the fetus of a laboring client. Which should the nurse perform first?

a) place the client into a left lateral position

b) perform leopolds maneuver to determine fetal position

c) dry the external abdomen before using the doppler

d) count the fetal HR for 30 seconds and multiple by 2

b

The primiparous client at 39 weeks gestation calls the clinic and reports increased bladder pressure but easier breathing and irregular, mild contractions. She also states that she just cleaned the entire house. Which statement should the nurse make?

a) you should not work this much at this point in pregnancy

b) your body may be telling you its going into labor soon

c) if the bladder pressure continues come into the clinic tomorrow

d) what you are describing is not commonly experienced in the last weeks

b

A primigravida at 39 weeks gestation is observed for 2 hours in the intrapartum unit. The fetal HR has been normal. Contractions are 5-9 minutes apart, 20-30 seconds in duration, and of mild intensity. Cervical dilation is 1-2 centimeters and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be:

a) admitted and prepared for cesarean birth

b) admitted for extended observation

c) discharged home with a sedative

d) discharged home to await the onset of true labor

d

To teach patients about the process of labor adequately, the nurse knows which event is the best indicator of true labor?

a) bloody show

b) cervical dilation and effacement

c) fetal descent into the pelvic inlet

d) uterine contractions every 7 minutes

b

The nurse has received report regarding her patient in labor. The woman’s last vaginal exam was recorded 3cm, 30%, and -2. The nurses interpretation of this assessment is that:

a) the cervix is effaced 3cm, dilated 30%, and the presenting part is 2cm above the ischial spines

b) the cervix is 3cm dilated, it is effaced 30%, and the presenting part is 2cm above the ischial spine

c) the cervix is effaced 3cm, it is dilated 30%, and the presenting part is 2cm below the ischial spine

d) the cervix is dilated 3cm, effaced 30%, and the presenting part is 2cm below the ischial spines

b

What action is correct when palpation is used to assess the characteristics and pattern of uterine contractions?

a) place the hand on the abdomen below the umbilicus and palpate uterine tone with fingertips

b) determine the frequency by timing from the end of one contraction to the end of the next contraction

c) evaluate intensity by pressing the fingertips into the uterine fundus

d) assess uterine contractions every 30 minutes throughout the first stage of labor

c

Through vaginal examination the nurse determines that a women is 4cm dilated and the external fetal monitor shows uterine contractions every 5-6 minutes, palpating a mild intensity. The nurse would report this as:

a) first stage, latent (early) phase

b) first stage, active phase

c) first stage, transition phase

d) second stage, latent phase

a

The nurse is assessing the FHR tracing of an unmedicated, full-term gravida who is 9/100/+1. Which of the following heart rate patterns suggest the umbilical cord is being compressed?

a) baseline 140 with average (moderate) variability and v-shaped decelerations to 100 unrelated to contractions

b) baseline 140 with average (moderate) variability and decelerations to 12o that mirror each contraction

c) baseline 140 with minimal variability and decelerations to 120 that return to baseline after each contraction

d) baseline 140 with minimal variability and no obvious decelerations or accelerations

a

A client in labor with cervical dilation of 9cm is experiencing contractions every 2 minutes that are 60-90 seconds in duration and is complaining of excruciating rectal pressure. How should the nurse interpret this complaint?

a) the clients complaint is congruent with her current stage of labor

b) the patients complaint may indicate the need for delivery via cesarean section

c) based upon the clients complaint, she is experiencing the latent phase of labor

d) the patients complaint is consistent with placental separation, which is normal for her current stage of labor

a

While evaluating the FHR tracing, the nurse notes that decelerations are present. Which of the following assessments must the nurse make at this time?

a) the relationship between the decelerations and the contractions

b) maternal blood pressure

c) the gestational age of the fetus

d) the placement of the fetal heart electrode in relation to the fetal position

a

A patient is experiencing a hypotonic labor pattern. Which interventions may the nurse see implemented initially in this situation? SATA

a) amniotomy

b) cesarean section

c) nipple stimulation

d) terbutaline administration

e) oxytocin administration

f) epidural placement

a, c, e

The baseline fetal HR is 135 bpm. Following contractions, the fetus develops late decelerations. Which nursing intervention should be implemented?

a) facilitate a maternal left lateral position

b) alert the HCP of the fetal status

c) decrease the rate of IV fluids

d) administer oxygen to the client at 4L/min via nasal cannula

a

A woman in labor has just received an epidural block. The most important nursing intervention is to:

a) limit parenteral fluids

b) monitor the fetus for possible tachycardia

c) monitor the maternal BP for possible hypotension

d) monitor the maternal pulse for possible bradycardia

c

Which is the optimal position for delivery?

a) shoulder presentation

b) occiput anterior

c) military attitude

d) occiput posterior

b

Which of the following is not included in a category 1 FHR tracing?

a) late decelerations

b) accelerations

c) moderate variability

d) early decelerations

a

Which of the following patients does no require continuous fetal monitoring?

a) SROM with clear fluid

b) SROM with meconium stained fluid

c) current epidural infusion

d) current oxytocin augmentation

a

What is the correct way to measure frequency of contractions?

a) palpation

b) start to finish

c) peak to peak

d) variability

c

What is the cause of early decelerations?

a) cord compression

b) head compression

c) uteroplacental insufficiency

d) fetal movement

b

In latent labor, assessment of fetal wellbeing in low risk should occur how often?

a) EFM q 15

b) EFM q 60

c) EFM q 30

d) EFM q 5

b

Which of the following is not a sign of impending labor?

a) bladder pressure

b) contractions that dont radiate

c) loss of mucus plug

d) round ligament pain

d

All of the following are critical factors of labor *EXCEPT*

a) Platypelloid

b) Position

c) Power

d) Passenger

a

Position refers to

a) Fetal Attitude

b) Fetus is sitting in relation to mom

c) Uterine muscle contractions

d) Pelvic Shape

b

Which are nonpharmacologic methods of pain management?

a) Effleurage

b) Counterpressure

c) Breathing Techniques

d) All of the above

d

True labor is characterized by

a) Contractions occur mainly in the lower abdomen and groin

b) Progressive dilatation and effacement

c) Pain may be relieved by ambulation

d) Contractions do not increase in frequency, duration, and intensity

b

Latent Phase is defined by

a) Dilation 0-4 cm

b) Contractions every 3-4 minutes

c) Onset of regular contractions

d) Rapid effacement and dilation

c

Lightening is:

a) The fetus engaging into the pelvis

b) First felt fetal movements

c) The desire to clean and organize

d) Loss of the mucous plug

a

What is the FIRST intervention for late & variable decelerations?

a) Begining O2 at 10L via mask

b) Bolus IV fluids

c) Repositioning to the left side

d) Turn off pitocin

c

What is an early warning sign of potential infection in someone whose water is broken?

a) Elevated WBC

b) Low grade temperature

c) Meconium stained fluid

d) Foul Smell

b

Who of the following is a candidate for an induction of labor

a) 37 weeks with placenta previa

b) 42 weeks with estimated fetal weight >4500 gms

c) 39 weeks, SVE 2/75/0

d) 40 weeks with suspected CPD

c

All of the following are necessary for placement of internal monitors, EXCEPT:

a) ROM

b) Cervical dilation

c) Intact membranes

d) MD order

c

What is the most significant side effect of epidural placement?

a) Immobility

b) Hypotension

c) Urinary retention

d) Hypertension

b

What is our primary nursing intervention to prevent hypotension r/t epidural placement?

a) Bolus IV fluids

b) Administer Ephedrine

c) Laying Supine

d) Laying in Sims

a

When giving a narcotic which medication is essential to have on hand?

a) Narcan

b) Stadol

c) Nubain

d) Fentanyl

a

All of the following are concerning signs after ROM, EXCEPT:

a) Straw colored fluid

b) Dark green fluid

c) Nonreassuring FHTs

d) A foul odor

a

(true/false) after ROM you should limit vaginal exams

true

In active labor, assessment of fetal wellbeing in low risk, how often?

a) EFM q 15

b) EFM q 60

c) EFM q 30

d) EFM q 5

c

All of the following are potential causes of tachysystole, EXCEPT:

a) CPD

b) Malpositioning

c) Pitocin

d) SGA

d

Which medication is used for preterm labor?

a) Pitocin

b) Stadol

c) Magnesium Sulfate

d) Labatelol

c

All of the following interfere with the results of a FFN test except:

a) Vaginal Exam

b) Sex in the past 24 hours

c) Rupture of membranes

d) Intact membranes

d

Which of the following is NOT an indication for a C/S

a) CPD

b) Macrosomia

c) POP

d) Cord Prolapse

c

What is the MOST common malpresentation?

a) Brow

b) Occiput Posterior

c) Face

d) Breech

b

Which of the following is NOT a risk for post-term deliveries?

a) Vacuum-Assisted Delivery

b) Meconium Aspiration

c) Precipitous Delivery

d) Cesarean delivery

c

Which is a risk factor of fetal macrosomia?

a) Prolonged Labor

b) Precipitous Labor

c) Normal Labor Pattern

d) No perineal trauma

a

Which of the following risks are present with breech presentation?

a) Increased umbilical cord prolapse

b) Neonatal Asphyxia

c) Perinatal morbidity

d) All of the above

d

(true/false) cephalopelvic disproportion is common

false

What nursing intervention is appropriate for an umbilical cord prolapse?

a) Relieve pressure with gloved hand

b) Sit then in high-fowlers

c) Have them ambulate

d) Give no oxygen

a

Which nursing interventions would you do to prepare a pt for a c/s?

a) 18G IV with fluid bolus only

b) 22G IV, fluid bolus, urinary catheter

c) 18G IV, fluid bolus, urinary catheter, SCD's, shave prep

d) 22G IV, fluids at 125/hr, urinary catheter, SCD's, shave prep

c