OB Exam #1
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately
places the woman in which position?
A) Supine
B) Side-lying
C) Sitting
D) Knee-chest A) Supine
Ans: D
Pressure on the cord needs to be relieved. Therefore, the nurse would position the woman in a modified
Sims, Trendelenburg, or knee-chest position. Supine, side-lying, or sitting would not provide relief of
cord compression.
A primigravida whose labor was initially progressing normally is now experiencing a decrease in the
frequency and intensity of her contractions. The nurse would assess the woman for which condition?
A) A low-lying placenta
B) Fetopelvic disproportion
C) Contraction ring
D) Uterine bleeding A) A low-lying placenta
B) Fetopelvic disproportion
C) Contraction ring
D) Uterine bleeding
Ans: B
,The woman is experiencing dystocia most likely due to hypotonic uterine dysfunction and fetopelvic
disproportion associated with a large fetus. A low-lying placenta, contraction ring, or uterine bleeding
would not be associated with a change in labor pattern.
The nurse would be alert for possible placental abruption during labor when assessment reveals which
of the following?
A) Macrosomia
B) Gestational hypertension
C) Gestational diabetes
D) Low parity
Ans: B
Risk factors for placental abruption include preeclampsia, gestational hypertension, seizure activity,
uterine rupture, trauma, smoking, cocaine use, coagulation defects, previous history of abruption,
domestic violence, and placental pathology. Macrosomia, gestational diabetes, and low parity are not
considered risk factors.
Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal
contractions that are:
A) Well coordinated
B) Poor in quality
C) Rapidly occurring
D) Erratic A) Well coordinated
B) Poor in quality
C) Rapidly occurring
D) Erratic
,Ans: D
Hypertonic contractions occur when the uterus never fully relaxes between contractions, making the
contractions erratic and poorly coordinated because more than one uterine pacemaker is sending
signals for contraction. Hypotonic uterine contractions are poor in quality and lack sufficient intensity to
dilate and efface the cervix. Contractions of precipitous labor occur rapidly such that labor is completed
in less than 3 hours.
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic
disproportion. Which group of medications would the nurse expect to administer?
A) Sedatives
B) Tocolytics
C) Oxytocin
D) Corticosteroids A) Sedatives
B) Tocolytics
C) Oxytocin
D) Corticosteroids
Ans: C
For hypotonic labor, a uterine stimulant such as oxytocin may be ordered once fetopelvic disproportion
is ruled out. Sedatives might be helpful for the woman with hypertonic uterine contractions to promote
rest and relaxation. Tocolytics would be ordered to control preterm labor. Corticosteroids may be given
to enhance fetal lung maturity for women experiencing preterm labor.
The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which of the
following would the nurse identify as the priority intervention?
A) Position changes
, B) Pain relief measures
C) Immediate cesarean birth
D) Oxytocin administration
Ans: B
Intense back pain is associated with persistent occiput posterior position. Therefore, a priority is to
provide pain relief measures. Position changes that can promote fetal head rotation are important after
the nurse institutes pain relief measures. Additionally, the woman's ability to cooperate and participate
in these position changes is enhanced when she is experiencing less pain. Immediate cesarean birth is
not indicated unless there is evidence of fetal distress. Oxytocin would add to the woman's already high
level of pain.
A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse
would be alert for which of the following in the newborn?
A) Asphyxia
B) Clavicular fracture
C) Caput succedaneum
D) Central nervous system injury
Ans: C
Use of forceps or a vacuum extractor poses the risk of tissue trauma, such as ecchymoses, facial and
scalp lacerations, facial nerve injury, cephalhematoma, and caput succedaneum. Asphyxia may be
related to numerous causes but it is not associated with use of a vacuum extractor. Clavicular fracture is
associated with shoulder dystocia. Central nervous system injury is not associated with the use of a
vacuum extractor.
A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following
findings would require immediate intervention?
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately
places the woman in which position?
A) Supine
B) Side-lying
C) Sitting
D) Knee-chest A) Supine
Ans: D
Pressure on the cord needs to be relieved. Therefore, the nurse would position the woman in a modified
Sims, Trendelenburg, or knee-chest position. Supine, side-lying, or sitting would not provide relief of
cord compression.
A primigravida whose labor was initially progressing normally is now experiencing a decrease in the
frequency and intensity of her contractions. The nurse would assess the woman for which condition?
A) A low-lying placenta
B) Fetopelvic disproportion
C) Contraction ring
D) Uterine bleeding A) A low-lying placenta
B) Fetopelvic disproportion
C) Contraction ring
D) Uterine bleeding
Ans: B
,The woman is experiencing dystocia most likely due to hypotonic uterine dysfunction and fetopelvic
disproportion associated with a large fetus. A low-lying placenta, contraction ring, or uterine bleeding
would not be associated with a change in labor pattern.
The nurse would be alert for possible placental abruption during labor when assessment reveals which
of the following?
A) Macrosomia
B) Gestational hypertension
C) Gestational diabetes
D) Low parity
Ans: B
Risk factors for placental abruption include preeclampsia, gestational hypertension, seizure activity,
uterine rupture, trauma, smoking, cocaine use, coagulation defects, previous history of abruption,
domestic violence, and placental pathology. Macrosomia, gestational diabetes, and low parity are not
considered risk factors.
Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal
contractions that are:
A) Well coordinated
B) Poor in quality
C) Rapidly occurring
D) Erratic A) Well coordinated
B) Poor in quality
C) Rapidly occurring
D) Erratic
,Ans: D
Hypertonic contractions occur when the uterus never fully relaxes between contractions, making the
contractions erratic and poorly coordinated because more than one uterine pacemaker is sending
signals for contraction. Hypotonic uterine contractions are poor in quality and lack sufficient intensity to
dilate and efface the cervix. Contractions of precipitous labor occur rapidly such that labor is completed
in less than 3 hours.
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic
disproportion. Which group of medications would the nurse expect to administer?
A) Sedatives
B) Tocolytics
C) Oxytocin
D) Corticosteroids A) Sedatives
B) Tocolytics
C) Oxytocin
D) Corticosteroids
Ans: C
For hypotonic labor, a uterine stimulant such as oxytocin may be ordered once fetopelvic disproportion
is ruled out. Sedatives might be helpful for the woman with hypertonic uterine contractions to promote
rest and relaxation. Tocolytics would be ordered to control preterm labor. Corticosteroids may be given
to enhance fetal lung maturity for women experiencing preterm labor.
The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which of the
following would the nurse identify as the priority intervention?
A) Position changes
, B) Pain relief measures
C) Immediate cesarean birth
D) Oxytocin administration
Ans: B
Intense back pain is associated with persistent occiput posterior position. Therefore, a priority is to
provide pain relief measures. Position changes that can promote fetal head rotation are important after
the nurse institutes pain relief measures. Additionally, the woman's ability to cooperate and participate
in these position changes is enhanced when she is experiencing less pain. Immediate cesarean birth is
not indicated unless there is evidence of fetal distress. Oxytocin would add to the woman's already high
level of pain.
A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse
would be alert for which of the following in the newborn?
A) Asphyxia
B) Clavicular fracture
C) Caput succedaneum
D) Central nervous system injury
Ans: C
Use of forceps or a vacuum extractor poses the risk of tissue trauma, such as ecchymoses, facial and
scalp lacerations, facial nerve injury, cephalhematoma, and caput succedaneum. Asphyxia may be
related to numerous causes but it is not associated with use of a vacuum extractor. Clavicular fracture is
associated with shoulder dystocia. Central nervous system injury is not associated with the use of a
vacuum extractor.
A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following
findings would require immediate intervention?
