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NURS368 Exam 2 Questions With
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The organization that publishes standards and guidelines for maternity nursing is the: A: National Perinatal Association B: American Nurses Association C: American Academy of Pediatrics D: Association of Women's Health, Obstetrics and Neonatal Nursing - ANSWER D: Association of Women's Health, Obstetrics and Neonatal Nursing Autonomy is defined as the right to: A: Do good B: Equal treatment C: Self-determination D: Be valued - ANSWER C: Self-determination An ethical dilemma is: A: A violation of patient autonomy B: A choice that violates ethical principles C: A conflict between advocacy and respect D: A conflict between what is just and good - ANSWER B: A choice that violates ethical principles Evidence-based decision making should include consideration of: A: Best research evidence, patient's clinical state, and clinical setting B: Best research evidence, patient's acuity, and financial considerations C: Best research evidence, clinical expertise, and patient values D: Best research evidence, clinical resources, and patient values - ANSWER C: Best research evidence, clinical expertise, and patient values Risk management is an approach to the prevention of:
A: Morbidity and mortality B: Litigation C: Staff conflicts D: Poor care - ANSWER B: Litigation A response to nursing interventions that are measurable and observable are: A: Variables B: Guidelines C: Health dimensions D: Expected outcomes - ANSWER D: Expected outcomes A _____________ is a framework developed through expert consensus and review of the literature. A: Guideline B: Outcome C: Standard D: Evaluation - ANSWER C: Standard Failing to use the latest health care research is: A: Unsafe B: Costly and harmful C: Costly, harmful, and can lead to use of ineffective care D: Risky - ANSWER C: Costly, harmful, and can lead to use of ineffective care Nurses have the professional responsibility to provide high-quality, impartial nursing care to all patients in ___________, regardless of the nurse's personal beliefs. A: Emergency situations B: Urgent situations C: Safe situations D: Every situation - ANSWER A: Emergency situations To be effective advocates for patients and their families, the nurse needs to: A: Talk to patients about their concerns
D: Pelvic rocking E: Abdominal massage - ANSWER C: Muscle relaxation D: Pelvic rocking E: Abdominal massage Which of the following responses is the primary rationale for the inclusion of the information taught in childbirth education classes?
A: Mothers who are performing breathing exercises during labor refrain from yelling B: Breathing and relaxation exercises are less exhausting than crying and moaning C: Knowledge learned at childbirth education classes helps to break the fear-tension-pain cycle D: Childbirth education classes help to promote positive maternal-newborn bonding - ANSWER C: Knowledge learned at childbirth education classes helps to break the fear-tension-pain cycle
The childbirth educator is teaching a class of pregnant couples the breathing technique that is most appropriate during the second stage of labor. Which of the following techniques did the nurse teach the women to do?
A: Alternately pant and blow. B: Take rhythmic, shallow breaths. C: Push down with an open glottis. D: Do slow chest breathing. - ANSWER C: Push down with an open glottis.
A nurse is teaching a childbirth education classes to a group of pregnant teens. Which of the following strategies would promote learning by the young women?
A: Avoiding the discussion of uncomfortable procedures like vaginal exams and blood tests B: Focusing the discussion on baby care rather than on labor and delivery
C: Utilizing visual aids like movies and posters during the classes D: Having the classes at a location other than high school to reduce their embarrassment - ANSWER C: Utilizing visual aids like movies and posters during the classes
A nurse is teaching a class of pregnant couples the most therapeutic breathing technique for the latent phase of labor. Which of the following techniques did the nurse teach?
A: Alternately panting and blowing B: Rapid, deep breathing C: Grunting and pushing with contractions D: Slow chest breathing - ANSWER D: Slow chest breathing
A woman, G2 P0101, 5 cm dilated and 30% effaced, is doing first-level Lamaze breathing with contractions. The nurse detects that the woman's shoulder and face muscles are beginning to tense during the contractions. Which of the following interventions should the nurse perform first?
A: Encourage the woman to have an epidural B: Encourage the woman to accept intravenous analgesia C: Assist the woman in changing position. D: Urge the woman to perform the next level breathing - ANSWER D: Urge the woman to perform the next level breathing
In addition to breathing with contractions, which of the following actions can help a woman in the first stage of labor to work with her pain?
A: Lying in the lithotomy position B: Performing effleurage C: Practicing Kegel exercises
A woman is in active labor and is being monitored electronically. She has just received Stadol 2 mg IM for pain. Which of the following fetal heart responses would the nurse expect to see on the internal monitor tracing?
A: Variable decelerations B: Late decelerations C: Decreased variability D: Transient accelerations - ANSWER C: Decreased variability
*Analgesics are CNS depressants, so the variability will decrease
A nurse is coaching a woman who is in the second stage of labor. Which of the following should the nurse encourage the woman to do?
A: Hold her breath for 20 seconds during every contraction B: Blow out forcefully during every contraction C: Push between contractions until the fetal head is visible D: Take a slow cleansing breath before bearing down - ANSWER D: Take a slow cleansing breath before bearing down
A multipara, LOA, station +3, who has had no pain medication during her labor, is now in stage 2. She states that her pain is 6 on a 10-point scale and that she wants an epidural. Which of the following responses by the nurse is appropriate?
A: "Epidurals do not work well when the pain level is above level 5." B: "I will contact the doctor to get an order for an epidural right away." C: "The baby is going to be born very soon. It is really too late for an epidural." D: "I will check the fetal heart rate. You can have an epidural if it is over 120." - ANSWER C: "The baby is going to be born very soon. It is really too late for an epidural."
A GI P0, 8 cm dilated, is to receive pain medication. The health care practitioner has decided to order an opiate analgesic with an analgesic-potentiating medication, Which of the following medications would the nurse expect to be ordered as the analgesic-potentiating medication?
A: Seconal (Secobarbital) B: Vistaril (Hydroxyzine) C: Benadryl (Diphenhydramine) D: Tylenol (Acetaminophen) - ANSWER B: Vistaril (Hydroxyzine)
On vaginal examination, it is noted that a woman with a well-functioning epidural is in the second stage of labor. The station is -2 and the baseline FHR is 130 with no decelerations. Which of the following nursing actions is appropriate at this time?
A: Coach the woman to hold her breath while pushing 3-4 times with each contraction B: Administer O2 via face mask at 8-10 lpm C: Delay pushing until the baby descends further and the mother has a strong urge to push D: Place the woman on her side and assess her O2 sat - ANSWER C: Delay pushing until the baby descends further and the mother has a strong urge to push
A nurse is assisting an anesthesiologist who is inserting an epidural catheter. Which of the following positions should the nurse assist the woman into?
A: Fetal position B: Lithotomy position C: Trendelenburg position D: Lateral recumbent position - ANSWER A: Fetal position
Which of the following actions would the nurse expect to perform before a woman is to have regional anesthesia? Select all that apply:
A: On the malleolus of the wrist B: Above the patella of the knee C: On the medial aspect of the lower leg D: At the top one third of the sole of the foot E: Below the medial epicondyle of the elbow - ANSWER C: On the medial aspect of the lower leg D: At the top one third of the sole of the foot
The primary reason for administering Nubain to a woman in active labor is to:
A: Slow uterine contractions B: Relieve N/V C: Relieve pain D: Promote dilation - ANSWER C: Relieve pain
Labor pain in active labor is primarily caused by:
A: Cervical dilation B: Uterine contractions C: Fetal descent D: Perineal tearing - ANSWER B: Uterine contractions
True or false: nurses manage the care of patients receiving regional anesthesia.
A: True B: False - ANSWER B: False
Supportive activities in labor are:
A: Interventions ordered by the care provider B: Techniques used to help women in labor C: Derived from adhering to the birth plan D: Pharmacological interventions - ANSWER B: Techniques used to help women in labor
Women who have a support person with them in labor are more likely to:
A: Have epidural anesthesia B: Have a precipitous labor C: Experience fewer birth complications D: Experience more interventions - ANSWER C: Experience fewer birth complications
A common side effect of epidural anesthesia in labor includes:
A: Maternal hypotension B: Maternal hypertension C: Variable decelerations in the FHR D: Hypertonic labor pattern - ANSWER A: Maternal hypotension
Which laceration degree involves the perineal skin and vaginal mucous membrane?
A: 1st degree B: 2nd degree C: 3rd degree D: 4th degree - ANSWER A: 1st degree
B: Changing the woman's position C: Discontinuing oxytocin D: Infusing IV fluids - ANSWER C: Discontinuing oxytocin
A laboring woman reports SROM and you assess severe decelerations in the FHR. Examination reveals a cord in the vagina. The first nursing action is to:
A: Manually elevate the presenting part B: Administer a tocolytic agent C: Administer an IV fluid bolus D: Empty the patient's bladder - ANSWER A: Manually elevate the presenting part
An increased risk for shoulder dystocia is associated with:
A: Preterm labor B: Maternal diabetes C: VBAC D: Previous precipitous birth - ANSWER B: Maternal diabetes
A high probability of successful induction is associated with a Bishop score of:
A: Greater than 4 B: Greater than 6 C: Less than 4 D: Less than 6 - ANSWER B: Greater than 6
When fetal vessels are unsupported by placenta or the umbilical cord traverses the membranes over the cervix, below the presenting part, this is referred to as:
A: Anterior dystocia B: Vasa Previa C: Breech D: Placenta Previa - ANSWER B: Vasa Previa
Women 40 years or older have a cesarean rate of:
A: 25.5% B: 62.5% C: 35.5% D: 49.5% - ANSWER D: 49.5%
Preeclampsia, thrombosis, gestational and type II diabetes are associated risk factors for what?
A: Good nutrition B: Maternal obesity C: Cardiac problems D: Maternal weight - ANSWER B: Maternal obesity
The first sign of shoulder dystocia is referred to as:
A: Unsuccessful vaginal delivery B: Breech C: Bishop score D: Turtle sign - ANSWER D: Turtle sign
A: Turn off the oxytocin infusion B: Administer O2 via face mask C: Reposition the patient D: Call the obstetrician - ANSWER A: Turn off the oxytocin infusion
A 40-week-gestation woman has received Cytotec (misoprostol) for cervical ripening. For which of the following signs/symptoms should the nurse carefully monitor the client?
A: Diarrhea and back pain B: Hypothermia and rectal pressure C: Urinary retention and rash D: Tinnitus and respiratory distress - ANSWER A: Diarrhea and back pain
A woman is to receive Prepidil (dinoprostone gel) for labor induction. The nurse should be prepared to administer this medication via which route?
A: IV B: Orally C: Endocervically D: Intraethically - ANSWER C: Endocervically
A nurse is monitoring the labor of a client who is receiving IV oxytocin at 6 mL per hour. Which clinical sign would lead the nurse to stop the infusion?
A: Change in maternal pulse from 76 to 98 bpm B: Change in FHR from 128 to 102 bpm C: Maternal BP of 150/
D: Maternal temperature of 102.4 F - ANSWER B: Change in FHR from 128 to 102 bpm
A primigravida client received Cervidil (dinoprostone) for induction 8 hours ago. The Bishop score is now 10. Which action by the nurse is appropriate?
A: Perform nitrazine analysis of amniotic fluid B: Report abnormal findings to the obstetrician C: Place woman on her side D: Monitor for onset of labor - ANSWER D: Monitor for onset of labor
During induction of labor using Cervidil (dinoprostone), which finding would warrant removal of the prostaglandin?
A: Bishop score of 4 B: FHR of 152 C: Respiratory rate of 24 D: Contraction frequency of 1 min - ANSWER D: Contraction frequency of 1 min
Four women request to labor in the hospital bathtub. Which situations is the procedure contraindicated? Select all that apply:
A: Woman during transition B: Woman during second stage of labor C: Woman receiving oxytocin for induction D: Woman with meconium-stained fluid E: Woman with fetus in the occiput posterior position - ANSWER C: Woman receiving oxytocin for induction D: Woman with meconium-stained fluid
B: Client will exhibit normal breathing function at discharge C: Client will exhibit normal GI function at discharge D: Client will void without pain at discharge - ANSWER B: Client will exhibit normal breathing function at discharge
A laboring woman, who has developed an apparent amniotic fluid embolism, is not breathing and has no pulse. In addition to calling for assistance, which of the following actions by the nurse, who is alone with the patient, is appropriate at this time?
A: Perform cardiac compressions and breaths in a 15 to 2 ratio B: Provide chest compressions at a depth of at least 2 inches C: Compress the chest at the lower 1/2 of the sternum D: Provide rescue breaths over a 10-second time frame - ANSWER B: Provide chest compressions at a depth of at least 2 inches
Which of the following signs/symptoms would the nurse expect to see in a woman with abruptio placentae?
A: Increasing fundal height measurements B: Pain-free vaginal bleeding C: Fetal heart accelerations D: Hyperthermia with leukocytosis - ANSWER A: Increasing fundal height measurements
A 29-week-gravid client is admitted to the labor and delivery unit with vaginal bleeding. To differentiate between placenta previa and abruptio placentae, the nurse should assess which of the following?
A: Leopold's maneuver results. B: Quantity of vaginal bleeding. C: Presence of abdominal pain.
D: Maternal blood pressure. - ANSWER C: Presence of abdominal pain.
An OB declares at the conclusion of the third stage of labor that a woman is diagnosed with placenta accrete. The nurse would expect to see which of the following signs/symptoms?
A: HTN B: Hemorrhage C: Bradycardia D: Hyperthermia - ANSWER B: Hemorrhage
Which of the following situations is considered a vaginal delivery emergency?
A: Third stage of labor lasting 20 mins B: FHR dropping during contractions C: Three-vessel cord D: Shoulder dystocia - ANSWER D: Shoulder dystocia
During a vaginal delivery, the OB declares that a shoulder dystocia has occurred. Which action by the nurse is appropriate at this time?
A: Administer oxytocin IV per order B: Flex the woman's thighs sharply toward her abdomen C: Apply O2 using a tight face mask D: Apply downward pressure on the woman's fundus - ANSWER B: Flex the woman's thighs sharply toward her abdomen
*McRobert's Maneuver
