NUR 533 Exam 3 Full Study Guide Practice Questions for Guaranteed 100% Success 2025

What components are measured in a Bishop score? - Correct Answer-Dilation Effacement Station Cervical consistency Cervix position What does a Bishop score indicate? - Correct Answer-Cervical ripening - likelihood of a successful vaginal delivery What Bishop score is considered most indicative of a success vaginal delivery? - Correct Answer-Greater than 8 out of 13 What do lower Bishop scores indicate? - Correct Answer-Cervical ripening is necessary before induction What dilation corresponds to which Bishop scores? - Correct Answer-0 cm = 0 1-2 cm = 1 3-4cm = 2 5+ cm = 3 What effacement corresponds to which Bishop scores? - Correct Answer-0-30% = 0 40-50% = 1 60-70% = 2 80+% = 3 What station corresponds to which Bishop scores? - Correct Answer--3 cm = 0 -2 cm = 1 -1,0 cm = 2 +1, +2 cm = 3 What cervical consistency corresponds to which Bishop scores? - Correct Answer-Firm = 0 Medium = 1 Soft = 2 What cervical position corresponds to which Bishop scores? - Correct Answer-Posterior = 0 Mid position = 1 NUR 533 Anterior = 2 What are some chemical methods for cervical ripening? - Correct Answer-Prostaglandin gel or suppository Cervadil Cytotec (misopristol) How is cervidil administered? - Correct Answer-Placed and left for 12-24 hours, it can be taken out if it's stimulating too much How is Cytotec administered? - Correct Answer-Inserted vaginally - it's a pill that cannot be taken back out What are some mechanical and physical methods for cervical ripening? - Correct Answer-Balloon catheter Hygroscopic dilators How is a balloon catheter used for cervical ripening? - Correct Answer-Inflate with 4 6ccs, then mother goes home and comes back when the balloon falls out How are hygroscopic dilators used? - Correct Answer-The dilator is inserted to absorb fluid from surrounding tissues and then enlarge. Fresh dilators can be inserted if further dilation is required What are two types of hygroscopic dilators? - Correct Answer-Laminaria tents - desiccated seaweed Synthetic dilators - magnesium sulfate What is labor induction? - Correct Answer-The deliberate initiation of uterine contractions to stimulate labor before spontaneous onset What is augmentation of labor? - Correct Answer-The stimulation of hypotonic contractions once labor has spontaneously begun, but progress is inadequate What is typically used to chemically induce or augment labor? - Correct Answer Oxytocin Where is oxytocin released from? - Correct Answer-posterior pituitary gland What is the function of oxytocin? - Correct Answer-Constricts smooth muscle Stimulates uterine contractions Stimulates release of milk from mammary glands What is considered when titrating the dosage for oxytocin? - Correct Answer-Uterine response - contraction frequency, duration, and intensity Maternal tolerance NUR 533 NUR 533 Fetal response to contractions What are some mechanical and physical methods for labor induction and augmentation? - Correct Answer-AROM (amniotomy) Amniotic membrane stripping Nipple stimulation Walking What is AROM (amniotomy)? - Correct Answer-Artificial rupture of amniotic membranes by the provider using a hook, clamp, or other sharp instruments What is amniotic membrane stripping? - Correct Answer-Physician goes in with sterile glove and runs fingers between amniotic sac and uterine wall to try to get it to rupture - might be painful How does nipple stimulation work? - Correct Answer-If a woman stimulates her nipples, it may make the pituitary gland secrete oxytocin What is a trial of labor (TOL)? - Correct Answer-The observance of a woman and her fetus for a reasonable period (ex. 4-6 hrs) of spontaneous active labor to assess the safety of vaginal birth for the mother and infant What is the most common reason for a TOL? - Correct Answer-If a woman wants to have a vaginal birth after a previous c-section - VBAC What might be another reason for a TOL? - Correct Answer-If a mother's pelvis is of questionable size or shape or if the fetus is in an abnormal presentation or position What is evaluated during a TOL? - Correct Answer-Active labor, including adequate contractions Engagement and descent of presenting part Effacement and dilation of the cervix What should the nurse make sure the client does after misoprostol administration? - Correct Answer-Encourage the patient to void What should be considered when preparing a client for oxytocin administration? - Correct Answer-Confirm fetus is engaged in birth canal at minimum of station 0 Initiate oxytocin no sooner that 4 hours after misoprostol and 6-13 hrs after prostaglandin gel Check maternal blood pressure, pulse, and respirations every 30-60 mins AND with every change in dose How often to monitor FHR and contraction pattern during labor? - Correct Answer During stage 1 - every 15 mins During stage 2 - every 5 mins NUR 533 NUR 533 Reasons to maintain oxytocin - Correct Answer-Contraction frequency of 2-3 mins Contraction duration of 80-90 seconds Contraction intensity 40-90 on IUPC or strong to palpation Uterine testing tone to 10-15 on IUPC Cervical dilation of 1cm/hr Reassuring FHR between 110-160bpm Disadvantages/risks of forceps-assisted birth - Correct Answer-Facial bruising Skid marks in vaginal vault Facial nerve damage Fetal indications for forceps-assisted birth - Correct Answer-Fetal distress necessitating quick delivery Abnormal fetal presentations Failure of fetus to rotate Delivery of head during a breech delivery Maternal indications for forceps-assisted birth - Correct Answer-Stage 2 labor is arrested Maternal difficulty in pushing fetus What should you tell the mother before a forcep-assisted birth? - Correct Answer Explain to mother that the forceps fit the same way two tablespoons would fit around an egg and the blades are placed in front of baby's ears What should be assessed on mom after a forcep-assisted birth? - Correct Answer Vaginal or cervical lacerations Urinary retention Hematomas in pelvic soft tissues What should be assessed on baby after a forcep-assisted birth? - Correct Answer Bruising or abrasions Facial palsy (results from pressure of blades on facial nerve) Subdural hematoma What should you do if the cord if compressed during use of forceps? - Correct Answer FHR should be assessed and recorded before use of forceps and after - if the cord is compressed, it will cause a decrease in FHR How many times can the vacuum pop off during a vacuum-assisted birth? - Correct Answer-3 times This is the nurse's responsibility to track Before what gestational age would a vacuum-assisted birth typically not be performed? - Correct Answer-34 weeks NUR 533 NUR 533 What are disadvantages/risks of a vacuum-assisted birth? - Correct Answer Conehead/caput succedaneum (resolves in 3-5 days) Bruises Vaginal vault blisters Ecchymosis Intracranial hemorrhage (severe, can be deadly) Cephalohematoma (bruising that crosses suture lines) What does the situation need to be like before a vacuum-assisted birth? - Correct Answer-Completely dilated cervix Ruptured membranes Engaged head (at least +1 or +2) Vertex presentation Mom in lithotomy position No suspicion of CPD What are nursing responsibilities during a vacuum-assisted birth? - Correct Answer Assess for bladder distention - catheterize if needed Asses and record FHR before and during Alert postpartum & neonatal caregivers that vacuum was used Provide education, support, and encouragement for the m