NR 327 Chapter 16 Nursing Care After Obstetric Procedures

Nursing Care During Obstetric Procedures Chapter 16: Nursing Care During Obstetric Procedures MULTIPLE CHOICE 1. The nurse knows that a urinary catheter is added to the instrument table if a forceps-assisted birth is anticipated. The correct rationale for this intervention is that: a. a sterile urine specimen is needed preoperatively. b . an empty bladder provides more room in the pelvis. spontaneous release of urine might contaminate the c. sterile field. d a Foley catheter prevents the membranes from . spontaneously rupturing. 2. After a forceps-assisted birth, the client is observed to have continuous bright red lochia but a firm fundus. Which other data would indicate the presence of a potential vaginal wall hematoma? a. Lack of an episiotomy b . Mild, intermittent perineal pain c. Lack of pain in the perineal area d . Edema and discoloration of the labia and perineum 3. The nurse is positioning the Foley catheter prior to a cesarean birth. Which position should the nurse use to place the catheter drainage tubing and catheter bag? a. Place near the head of the table. b . Position on top of the patient’s leg. c. Place at the foot and clamp during the cesarean section. d Position at the foot of the surgeon under the sterile . drapes. 4. Which condition is a contraindication for an amniotomy? a. –2 station b . Breech presentation c. Dilation less than 3 cm d . Right occiput posterior position 5. Which client status is an acceptable indication for serial oxytocin induction of labor? a. Multiple fetuses b . Polyhydramnios c. History of long labors d . Past 42 weeks of gestation 6. The nurse is explaining the technique of internal version to a group of nursing students. Which describes the technique of internal version? Manipulation of the fetus from a breech to a cephalic a. presentation before labor begins b Manipulation of the fetus from a transverse lie to a . longitudinal lie before cesarean birth Manipulation of the second twin from an oblique lie to a c. transverse lie before labor begins d Manipulation of the second twin from a transverse lie to . a breech presentation during vaginal birth 7. The greatest risk to the newborn after an elective cesarean birth is: a. tachypnea because of maternal anesthesia. b . tachycardia because of maternal narcotics. c. trauma because of manipulation during birth. d . prematurity because of miscalculation of gestation. 8. Which client is most at risk for a uterine rupture? a. A gravida 4 who had a classic cesarean incision b A gravida 5 who had two vaginal births and one cesarean . birth A gravida 3 who has had two low-segment transverse c. cesarean births d A gravida 2 who had a low-segment vertical incision for . birth of a 10-lb infant 9. Before the health care provider performs an external version, the nurse should expect an order for a: a. Foley catheter. b . tocolytic drug. c. local anesthetic. d . contraction stress test (CST). 10. A maternal indication for the use of vacuum extraction is: a. a wide pelvic outlet. b . maternal exhaustion. c. a history of rapid deliveries. d . failure to progress past 0 station. 11. The priority nursing intervention following an amniotomy is to: a. change the client’s gown. b . assess the fetal heart rate. c. assess the color of the amniotic fluid. d . estimate the amount of amniotic fluid. 12. For which client should the oxytocin (Pitocin) infusion be discontinued immediately? A client in transition with contractions every 2 minutes a. lasting 90 seconds each b A client in early labor with contractions every 5 minutes . lasting 40 seconds each A client in active labor with contractions every 3 minutes c. lasting 60 seconds each d A client in active labor with contractions every 2 to 3 . minutes lasting 70 to 80 seconds each 13. The priority nursing care associated with an oxytocin infusion is: a. measuring urinary output. b . evaluating cervical dilation. c. monitoring uterine response. d . increasing infusion rate every 30 minutes. 14. Which event indicates a complication of an external version? a. Maternal pulse rate of 100 bpm b . Fetus returning to the original position c. Increased maternal anxiety after the version d . Fetal bradycardia persisting 10 minutes after the version 15. Immediately following the forceps-assisted birth of an infant, which action should the nurse implement? a. Assess the infant for signs of trauma. b . Apply a cold pack to the infant’s scalp. c. Give the infant prophylactic antibiotics. d . Measure the circumference of the infant’s head. 16. Nursing care before a cesarean birth should include: a. full perineal shave preparation. b . administering a clear oral antacid. c. injection of narcotic preoperative medications. d . straight catheterization to empty the bladder. 17. A gravida 2, para 1 client is admitted to the labor and birth unit in labor. She states that she had a cesarean birth with her first pregnancy. The most critical information the nurse must obtain at this point is: a. the onset of contractions. b . her estimated date of birth. c. when the client ate last and what she consumed. d . the type of uterine incision with the first pregnancy. ........................................CONTINUED.......................................