N144 Week 2 Elsevier Skills Modules Exam
Questions With Correct Answers
A pregnant patient presents to the labor and delivery unit reporting
| | | | | | | | | | |
contractions every 3 minutes. The patient denies leaking any fluid or
| | | | | | | | | | |
having any vaginal bleeding. What must the nurse review before
| | | | | | | | | |
performing an SVE? | |
A. Gestational age and placental location
| | | | |
B. Patient's preferences
| |
C. Last Pap smear and history of herpes
| | | | | | |
D. Previous deliveries and past illnesses
| | | | |
A. Gestational age and placental location
| | | | |
Rationale: Assessing gestational age before performing an SVE is
| | | | | | | | |
important to prevent inducing preterm labor. The nurse must also
| | | | | | | | | |
determine the placental location via the perinatal history; SVE is
| | | | | | | | | |
contraindicated for patients with placenta previa because of the risk of
| | | | | | | | | | |
bleeding. Although the patient may prefer not to undergo the SVE,
| | | | | | | | | | |
determining cervical dilation, effacement, and station; status of the
| | | | | | | | |
membranes (intact, bulging, or ruptured); fetal presenting part,
| | | | | | | |
position, station, molding of the fetal head with caput succedaneum,
| | | | | | | | | |
and characteristics of amniotic fluid (color, clarity, and odor) if the fetal
| | | | | | | | | | | |
,membranes are ruptured is necessary. Information about the last Pap
| | | | | | | | | |
smear and history of herpes is obtained from the prenatal records
| | | | | | | | | | |
during the admission interview, but only herpetic lesions noted in the
| | | | | | | | | | |
genital area would affect whether an SVE is performed. The patient’s
| | | | | | | | | | |
history of deliveries and illnesses also is obtained during the admission
| | | | | | | | | | |
interview but does not affect whether an SVE is performed.
| | | | | | | | |
A patient has been in labor for 6 hours. The patient received epidural
| | | | | | | | | | | | |
anesthesia about 1 hour ago and is resting comfortably. The nurse notes
| | | | | | | | | | |
the onset of early fetal heart rate decelerations with each contraction.
| | | | | | | | | | | |
What is the nurse's first intervention?
| | | | |
A. Reposition the patient to see if the early decelerations resolve.
| | | | | | | | | |
B. Notify the practitioner of a change in the fetal heart rate pattern.
| | | | | | | | | | | |
C. Perform an SVE.
| | |
D. Ask another nurse to set up for emergency cesarean delivery and
| | | | | | | | | | | |
notify the practitioner.| |
C. Perform an SVE.
| | |
Rationale: The nurse should ask the patient about feeling any urge to
| | | | | | | | | | | |
push or increased perineal pressure; however, because of the effective
| | | | | | | | | |
epidural, these feelings may not be present. Therefore, the nurse should
| | | | | | | | | |
,perform an SVE to determine cervical dilation and effacement, fetal
| | | | | | | | | | |
station, and presentation because early decelerations are indicative of
| | | | | | | | |
head compression from labor progression. The report to the
| | | | | | | | |
practitioner should include the SVE findings. Early decelerations are not
| | | | | | | | | |
considered ominous and do not indicate a need for an emergency
| | | | | | | | | | |
cesarean delivery. Although the nurse may reposition the patient for
| | | | | | | | | |
comfort, a position change will not resolve early decelerations.
| | | | | | | |
The nurse admits a laboring patient to the labor and delivery unit and
| | | | | | | | | | | | |
plans to perform an SVE as a part of the initial assessment. Along with
| | | | | | | | | | | | | |
information regarding the cervix, which fetal information will the
| | | | | | | | |
practitioner request? |
A. Presenting part, membranes, and position
| | | | |
B. Presenting part, position, and station
| | | | |
C. Dilation, position, and station
| | | |
D. Effacement, dilation, and position
| | | |
B. Presenting part, position, and station
| | | | |
, Rationale: Information relating to the fetus includes the presenting part,
| | | | | | | | |
|the position, and the station. The practitioner will expect to have this
| | | | | | | | | | | |
information included in the admission assessment. The status of the
| | | | | | | | | |
amniotic membranes does not pertain to either the cervix or the fetus.
| | | | | | | | | | | |
The cervical information includes dilation, effacement, and position; this
| | | | | | | |
|information reflects the maternal labor progress, which is not specific
| | | | | | | | | |
to the fetus.
| |
A 23-year-old patient with a twin gestation presents to the unit having
| | | | | | | | | | | |
leakage of a large amount of watery mucus for the last 3 hours. The
| | | | | | | | | | | | | |
patient denies feeling any contractions. The nurse notes from the
| | | | | | | | | |
prenatal record that the patient is 32 weeks pregnant. Based on this
| | | | | | | | | | | |
information, which precaution should the nurse take? | | | | | |
A. No special precautions are necessary under these circumstances.
| | | | | | | |
B. Use a very small amount of lubricant when performing the SVE.
| | | | | | | | | | |
C. Use only a speculum for the SVE.
| | | | | | |
D. Defer the SVE until the practitioner provides further orders.
| | | | | | | | |
D. Defer the SVE until the practitioner provides further orders.
| | | | | | | | |
Questions With Correct Answers
A pregnant patient presents to the labor and delivery unit reporting
| | | | | | | | | | |
contractions every 3 minutes. The patient denies leaking any fluid or
| | | | | | | | | | |
having any vaginal bleeding. What must the nurse review before
| | | | | | | | | |
performing an SVE? | |
A. Gestational age and placental location
| | | | |
B. Patient's preferences
| |
C. Last Pap smear and history of herpes
| | | | | | |
D. Previous deliveries and past illnesses
| | | | |
A. Gestational age and placental location
| | | | |
Rationale: Assessing gestational age before performing an SVE is
| | | | | | | | |
important to prevent inducing preterm labor. The nurse must also
| | | | | | | | | |
determine the placental location via the perinatal history; SVE is
| | | | | | | | | |
contraindicated for patients with placenta previa because of the risk of
| | | | | | | | | | |
bleeding. Although the patient may prefer not to undergo the SVE,
| | | | | | | | | | |
determining cervical dilation, effacement, and station; status of the
| | | | | | | | |
membranes (intact, bulging, or ruptured); fetal presenting part,
| | | | | | | |
position, station, molding of the fetal head with caput succedaneum,
| | | | | | | | | |
and characteristics of amniotic fluid (color, clarity, and odor) if the fetal
| | | | | | | | | | | |
,membranes are ruptured is necessary. Information about the last Pap
| | | | | | | | | |
smear and history of herpes is obtained from the prenatal records
| | | | | | | | | | |
during the admission interview, but only herpetic lesions noted in the
| | | | | | | | | | |
genital area would affect whether an SVE is performed. The patient’s
| | | | | | | | | | |
history of deliveries and illnesses also is obtained during the admission
| | | | | | | | | | |
interview but does not affect whether an SVE is performed.
| | | | | | | | |
A patient has been in labor for 6 hours. The patient received epidural
| | | | | | | | | | | | |
anesthesia about 1 hour ago and is resting comfortably. The nurse notes
| | | | | | | | | | |
the onset of early fetal heart rate decelerations with each contraction.
| | | | | | | | | | | |
What is the nurse's first intervention?
| | | | |
A. Reposition the patient to see if the early decelerations resolve.
| | | | | | | | | |
B. Notify the practitioner of a change in the fetal heart rate pattern.
| | | | | | | | | | | |
C. Perform an SVE.
| | |
D. Ask another nurse to set up for emergency cesarean delivery and
| | | | | | | | | | | |
notify the practitioner.| |
C. Perform an SVE.
| | |
Rationale: The nurse should ask the patient about feeling any urge to
| | | | | | | | | | | |
push or increased perineal pressure; however, because of the effective
| | | | | | | | | |
epidural, these feelings may not be present. Therefore, the nurse should
| | | | | | | | | |
,perform an SVE to determine cervical dilation and effacement, fetal
| | | | | | | | | | |
station, and presentation because early decelerations are indicative of
| | | | | | | | |
head compression from labor progression. The report to the
| | | | | | | | |
practitioner should include the SVE findings. Early decelerations are not
| | | | | | | | | |
considered ominous and do not indicate a need for an emergency
| | | | | | | | | | |
cesarean delivery. Although the nurse may reposition the patient for
| | | | | | | | | |
comfort, a position change will not resolve early decelerations.
| | | | | | | |
The nurse admits a laboring patient to the labor and delivery unit and
| | | | | | | | | | | | |
plans to perform an SVE as a part of the initial assessment. Along with
| | | | | | | | | | | | | |
information regarding the cervix, which fetal information will the
| | | | | | | | |
practitioner request? |
A. Presenting part, membranes, and position
| | | | |
B. Presenting part, position, and station
| | | | |
C. Dilation, position, and station
| | | |
D. Effacement, dilation, and position
| | | |
B. Presenting part, position, and station
| | | | |
, Rationale: Information relating to the fetus includes the presenting part,
| | | | | | | | |
|the position, and the station. The practitioner will expect to have this
| | | | | | | | | | | |
information included in the admission assessment. The status of the
| | | | | | | | | |
amniotic membranes does not pertain to either the cervix or the fetus.
| | | | | | | | | | | |
The cervical information includes dilation, effacement, and position; this
| | | | | | | |
|information reflects the maternal labor progress, which is not specific
| | | | | | | | | |
to the fetus.
| |
A 23-year-old patient with a twin gestation presents to the unit having
| | | | | | | | | | | |
leakage of a large amount of watery mucus for the last 3 hours. The
| | | | | | | | | | | | | |
patient denies feeling any contractions. The nurse notes from the
| | | | | | | | | |
prenatal record that the patient is 32 weeks pregnant. Based on this
| | | | | | | | | | | |
information, which precaution should the nurse take? | | | | | |
A. No special precautions are necessary under these circumstances.
| | | | | | | |
B. Use a very small amount of lubricant when performing the SVE.
| | | | | | | | | | |
C. Use only a speculum for the SVE.
| | | | | | |
D. Defer the SVE until the practitioner provides further orders.
| | | | | | | | |
D. Defer the SVE until the practitioner provides further orders.
| | | | | | | | |
