Review | Graded A+| Grand Canyon University
1. If a nurse observes meconium-stained amniotic fluid during labor, what
should be the immediate nursing action to ensure fetal safety?
Prepare the delivery room for a surgical intervention.
Monitor the fetal heart rate continuously.
Administer intravenous fluids to the mother.
Encourage the mother to push immediately.
2. If a laboring patient is taken off an IV drip and begins to show signs of
dehydration, what nursing intervention should be prioritized?
Encourage the patient to drink fluids orally.
Reassess the patient's hydration status and consider reinitiating IV
fluids.
Administer an epidural for pain relief.
Increase the frequency of fetal heart rate monitoring.
3. A primigravida client is having contractions. The nurse is assessing her and
knows that the most reliable indicator that the onset of true labor has begun
is the following:
Regular contractions that occur every 15 minutes
Increased ease of breathing with the contractions
A sudden urge to do household tasks
Change in the dilation and effacement of the cervix
,4. Interpret the significance of identifying a round, movable fetal part in the
fundal area during the Leopold maneuver.
It suggests that the fetus may be in a breech position, which can
affect delivery options.
It shows that the fetus is engaged in the pelvis.
It indicates that the fetus is in a vertex position, which is optimal for
delivery.
It means the fetus is experiencing distress.
5. If a nurse identifies a round, movable fetal part in the fundal portion during
the Leopold maneuver, what should be the next step in the care plan?
Administer pain relief medication.
Continue with routine monitoring without any changes.
Consult with the healthcare provider about the delivery plan.
Immediately prepare for a cesarean section.
6. Which of the following best describes an epidural anesthetic?
It is induced paralysis of the respiratory muscles
It is a type of nerve block anesthesia
It is a type of local, topical anesthetic
It is a type of general anesthesia
7. If a pregnant patient tests positive for opioids, what steps should the nursing
team take to ensure the safety of both the mother and the fetus?
The nursing team should immediately report the mother to child
protective services.
, The nursing team should conduct a thorough assessment, provide
appropriate referrals for substance use treatment, and monitor both
maternal and fetal health closely.
The nursing team should ignore the results if the mother denies
substance use.
The nursing team should only inform the mother about the positive
test without further action.
8. Describe the significance of palpating the fetal head during labor
assessment.
Palpating the fetal head is used to assess maternal blood pressure.
Palpating the fetal head is primarily for fetal heart rate monitoring.
Palpating the fetal head indicates the need for a cesarean section.
Palpating the fetal head helps determine the fetal position and
engagement in the birth canal.
9. What is the primary nursing intervention to monitor after a patient receives an
epidural?
Checking the fetal heart rate only.
Administering additional pain medication.
Assessing the patient's vital signs and level of consciousness.
Encouraging the patient to walk.
10. 26 years old patient is in her first labour. Gestational age is 41+2 weeks.
Gestational diabetes was diagnosed in pregnancy. Estimated fetal weight is
approximately 4 kg. Obstetrician is urgently called to thedelivery room. In
the delivery room doctor discovers that head of the baby is delivered, but
shoulders and trunk fail to deliver. Your tactics?
, Caesarean Section
Instrumental delivery (vacuumextraction)
Oxytocin for labour augmentation
McRoberts maneuver
External cephalic version
11. If a nurse notices an abnormal fetal heart rate pattern during the third stage
of labor, what should be the immediate course of action?
Administer pain relief medication.
Continue monitoring without intervention.
Notify the healthcare provider and assess the mother and fetus.
Prepare for immediate delivery without further assessment.
12. A nurse is caring for a postpartum patient who had a C-section and is
struggling to breastfeed. Which intervention should the nurse prioritize to
facilitate breastfeeding?
Suggest the mother breastfeed while standing.
Encourage the mother to sit upright immediately.
Assist the mother into a side-lying position.
Advise the mother to wait until her pain medication takes effect.
13. Communicating with a patient, the physician utilizes complex medical terms.
To ensure understanding the nurse should:
Encourage the patient to ask questions about the discussion with
the doctor