Test Bank For Maternal & Child Health Nursing
Test Bank For Maternal & Child Health Nursing
Care of the Childbearing & Childrearing Family
9th Edition By JoAnne Silbert-Flagg.
|GRADED A+| (EXAM READY)
(Solved) SCORE A
A client receives local infiltration anesthesia. For which situation is this most commonly used?
A. Cesarean birth
B. Repair of an episiotomy or laceration
C. Induction of labor
D. External cephalic version
A+ TEST BANK 1
, Test Bank For Maternal & Child Health Nursing
B. Repair of an episiotomy or laceration
RATIONALE:
Local infiltration anesthesia is injected directly into the tissue where pain control is needed. It is
commonly used after birth when repairing an episiotomy or perineal tear. The medication numbs the
specific area so suturing can be completed comfortably. This method is quick and simple to
administer.
Cesarean birth requires broader anesthesia. Labor induction does not involve local tissue anesthesia.
External cephalic version uses different management techniques.
A client receiving an epidural opioid reports severe itching. Which adverse effect is the nurse
recognizing?
A. Respiratory failure
B. Pruritus
C. Tachysystole
D. Placental abruption
B. Pruritus
RATIONALE:
Pruritus means itching and is a common side effect of opioid medications used in epidurals. Although
uncomfortable, it is usually not dangerous. The nurse should assess the severity and notify the
provider if treatment is needed. Many clients experience itching of the face, nose, chest, or upper
body.
Respiratory depression is a more serious opioid complication but does not primarily present as itching.
Tachysystole involves uterine contractions. Placental abruption is unrelated to epidural opioids.
During delivery, the fetal head delivers but retracts against the perineum. The nurse recognizes this as:
A. Cord prolapse
B. Placenta previa
A+ TEST BANK 2
, Test Bank For Maternal & Child Health Nursing
C. Shoulder dystocia
D. Uterine rupture
C. Shoulder dystocia
RATIONALE:
Shoulder dystocia occurs when the fetal shoulders become stuck after the head has been delivered.
The head may appear to retract toward the perineum, creating what is known as the "turtle sign." This
is an obstetric emergency because delivery cannot continue normally. Immediate interventions are
required to prevent fetal injury and oxygen deprivation.
Cord prolapse involves the umbilical cord descending ahead of the fetus. Placenta previa involves
placental placement over the cervix. Uterine rupture presents with different signs and symptoms.
What is the first maneuver commonly used to relieve shoulder dystocia?
A. Fundal pressure
B. McRoberts maneuver
C. Amnioinfusion
D. Vacuum extraction
B. McRoberts maneuver
RATIONALE:
The McRoberts maneuver involves sharply flexing the mother's thighs toward her abdomen. This
changes the angle of the pelvis and often frees the impacted shoulder. It is simple, safe, and usually
attempted first. Many shoulder dystocias are resolved with this maneuver alone.
Fundal pressure can worsen the impaction and should not be used. Amnioinfusion treats cord
compression, not shoulder dystocia. Vacuum extraction is not the first intervention after shoulder
dystocia occurs.
A+ TEST BANK 3
, Test Bank For Maternal & Child Health Nursing
During management of shoulder dystocia, which action should the nurse anticipate?
A. Suprapubic pressure
B. Fundal pressure
C. Oxytocin infusion
D. Vaginal examination every minute
A. Suprapubic pressure
RATIONALE:
Suprapubic pressure is often used together with the McRoberts maneuver. Pressure is applied
above the pubic bone to help rotate and dislodge the fetal shoulder. This maneuver increases the
likelihood of a successful vaginal delivery. It is a standard intervention during shoulder dystocia
emergencies.
Fundal pressure can worsen shoulder impaction. Oxytocin does not relieve the obstruction.
Frequent vaginal examinations do not solve the problem.
A client receiving oxytocin develops tachysystole and fetal bradycardia. What is the nurse's priority
action?
A. Increase the oxytocin rate
B. Stop the oxytocin infusion
C. Encourage pushing
D. Place the client supine
B. Stop the oxytocin infusion
RATIONALE:
Tachysystole means the uterus is contracting too frequently, reducing oxygen delivery to the fetus.
Fetal bradycardia suggests the fetus is already showing signs of compromise. Since oxytocin is causing
stronger contractions, the nurse should stop the infusion immediately. This is the fastest way to
reduce uterine activity and improve fetal oxygenation.
A+ TEST BANK 4
Test Bank For Maternal & Child Health Nursing
Care of the Childbearing & Childrearing Family
9th Edition By JoAnne Silbert-Flagg.
|GRADED A+| (EXAM READY)
(Solved) SCORE A
A client receives local infiltration anesthesia. For which situation is this most commonly used?
A. Cesarean birth
B. Repair of an episiotomy or laceration
C. Induction of labor
D. External cephalic version
A+ TEST BANK 1
, Test Bank For Maternal & Child Health Nursing
B. Repair of an episiotomy or laceration
RATIONALE:
Local infiltration anesthesia is injected directly into the tissue where pain control is needed. It is
commonly used after birth when repairing an episiotomy or perineal tear. The medication numbs the
specific area so suturing can be completed comfortably. This method is quick and simple to
administer.
Cesarean birth requires broader anesthesia. Labor induction does not involve local tissue anesthesia.
External cephalic version uses different management techniques.
A client receiving an epidural opioid reports severe itching. Which adverse effect is the nurse
recognizing?
A. Respiratory failure
B. Pruritus
C. Tachysystole
D. Placental abruption
B. Pruritus
RATIONALE:
Pruritus means itching and is a common side effect of opioid medications used in epidurals. Although
uncomfortable, it is usually not dangerous. The nurse should assess the severity and notify the
provider if treatment is needed. Many clients experience itching of the face, nose, chest, or upper
body.
Respiratory depression is a more serious opioid complication but does not primarily present as itching.
Tachysystole involves uterine contractions. Placental abruption is unrelated to epidural opioids.
During delivery, the fetal head delivers but retracts against the perineum. The nurse recognizes this as:
A. Cord prolapse
B. Placenta previa
A+ TEST BANK 2
, Test Bank For Maternal & Child Health Nursing
C. Shoulder dystocia
D. Uterine rupture
C. Shoulder dystocia
RATIONALE:
Shoulder dystocia occurs when the fetal shoulders become stuck after the head has been delivered.
The head may appear to retract toward the perineum, creating what is known as the "turtle sign." This
is an obstetric emergency because delivery cannot continue normally. Immediate interventions are
required to prevent fetal injury and oxygen deprivation.
Cord prolapse involves the umbilical cord descending ahead of the fetus. Placenta previa involves
placental placement over the cervix. Uterine rupture presents with different signs and symptoms.
What is the first maneuver commonly used to relieve shoulder dystocia?
A. Fundal pressure
B. McRoberts maneuver
C. Amnioinfusion
D. Vacuum extraction
B. McRoberts maneuver
RATIONALE:
The McRoberts maneuver involves sharply flexing the mother's thighs toward her abdomen. This
changes the angle of the pelvis and often frees the impacted shoulder. It is simple, safe, and usually
attempted first. Many shoulder dystocias are resolved with this maneuver alone.
Fundal pressure can worsen the impaction and should not be used. Amnioinfusion treats cord
compression, not shoulder dystocia. Vacuum extraction is not the first intervention after shoulder
dystocia occurs.
A+ TEST BANK 3
, Test Bank For Maternal & Child Health Nursing
During management of shoulder dystocia, which action should the nurse anticipate?
A. Suprapubic pressure
B. Fundal pressure
C. Oxytocin infusion
D. Vaginal examination every minute
A. Suprapubic pressure
RATIONALE:
Suprapubic pressure is often used together with the McRoberts maneuver. Pressure is applied
above the pubic bone to help rotate and dislodge the fetal shoulder. This maneuver increases the
likelihood of a successful vaginal delivery. It is a standard intervention during shoulder dystocia
emergencies.
Fundal pressure can worsen shoulder impaction. Oxytocin does not relieve the obstruction.
Frequent vaginal examinations do not solve the problem.
A client receiving oxytocin develops tachysystole and fetal bradycardia. What is the nurse's priority
action?
A. Increase the oxytocin rate
B. Stop the oxytocin infusion
C. Encourage pushing
D. Place the client supine
B. Stop the oxytocin infusion
RATIONALE:
Tachysystole means the uterus is contracting too frequently, reducing oxygen delivery to the fetus.
Fetal bradycardia suggests the fetus is already showing signs of compromise. Since oxytocin is causing
stronger contractions, the nurse should stop the infusion immediately. This is the fastest way to
reduce uterine activity and improve fetal oxygenation.
A+ TEST BANK 4
