NUR 353 Exam 2 Review Questions with
Verified Correct Answers
The observance of a woman and her fetus for a reasonable period (e.g., 4 to 6 hours) of
spontaneous active labor to assess the safety of vaginal birth for the mother and infant.
It may be initiated if the mother's pelvis is of questionable size or shape or if the fetus is
in an abnormal presentation or position. By far the most common reason for this is if
the woman wishes to have a vaginal birth after a previous cesarean birth. A planned
attempt to labor by a woman who has previously undergone a cesarean delivery and
desires a subsequent vaginal delivery
Trial of Labor
List 6 indications for caesarean birth.
1. Dysfunctional labor
2. Breech presentation
3. Abnormal FHR or patterns
4. Inadequate pelvic shape
5. Maternal or fetal demise
6. STIs such as HIV or herpes
List 4 obstetric emergencies.
1. Meconium stained amniotic fluid
2. Rupture of the uterus
3. Prolapsed umbilical cord
4. Shoulder dystocia
Meconium-stained amniotic fluid is which color?
,Green
If a baby is born covered with meconium, what are the priority nursing interventions?
(3)
1. Assess the baby's respiratory efforts, heart rate, and muscle tone.
2. Suction only the baby's mouth and nose if the baby has strong respiratory efforts, good
muscle tone, and a HR >100.
3. Suction the trachea using an endotracheal tube (inserted by a specialist) to remove any
meconium present if the baby has depressed respirations, decreased muscle tone, and a HR
<100.
A condition in which the head is born but the anterior shoulder cannot pass under the
pubic arch.
Shoulder dystocia
List nursing interventions for a patient experiencing shoulder dystocia.
1. Suprapubic pressure to the anterior shoulder in an attempt to push the shoulder under the
symphysis pubis.
2. Instruct patient to perform McRoberts manuever. (Pulling legs back)
3. Gaskin maneuver (Hands and knees)
A maneuver in which the mom lays on her back and spreads her legs and pulls her
knees to her chest to open up the pelvis. Can help resolve shoulder dystocia.
McRoberts maneuver
A maneuver in which the mom goes on her hands and knees to help resolve shoulder
dystocia.
,Gaskin maneuver
List 6 nursing interventions for a woman with a prolapsed umbilical cord.
(Call HCP)
1. Insert a sterile gloved hand into the vagina and hold the presenting part off the umbilical
cord.
2. Assist mom into modified Sims, Trendelenburg, or knee-chest position.
3. Assist with a forceps- or vacuum-assisted birth if the cervix is fully dilated.
4. Administer O2 by nonrebreather mask.
5. Start IV fluids, or increase existing drip rate.
6. CONTINUOUS assessment!
Modified Sim's position
(With pillows under mom's hips)
Helps treat umbilical cord prolapse
Knee-chest position
Takes pressure off of umbilical cord
Helps treat umbilical cord prolapse
What is the nurse's role during a uterine rupture? (4)
1. Start IV fluids
2. Transfuse blood products
3. Administer O2
4. Assist with preparation for immediate surgery
A pregnant woman's amniotic membranes rupture. Prolapsed cord is suspected. Which
intervention is the nurse's top priority?
, a. Place the woman in the knee-chest position.
b. Cover the cord in a sterile towel saturated with warm normal saline.
c. Prepare the woman for a cesarean birth.
d. Start oxygen by face mask.
A (A. The woman is assisted into a position (e.g., modified Sims position, Trendelenburg
position, or the knee-chest position) in which gravity keeps the pressure of the presenting part
off the cord.
B. If the cord is protruding from the vagina, it may be covered with a sterile towel soaked in
saline. Although this is an appropriate intervention, relieving pressure on the cord is the
nursing priority.
C. If the cervix is fully dilated, the nurse should prepare for immediate vaginal delivery.
Cesarean birth is indicated only if cervical dilation is not complete.
D. The nurse should administer O2 by facial mask at 8 to 10 L/min until delivery is complete.
This intervention should be initiated after pressure is relieved on the cord. Not only should
the woman be placed in knee-chest position, the nurse may also use her gloved hand or two
fingers to lift the presenting part off the cord.)
The labor and delivery nurse is admitting a woman complaining of being in labor. The
nurse completes the admission database and notes that which factors may prohibit the
woman from having a vaginal birth? (Select all that apply.)
a. Unstable coronary artery disease
b. Previous cesarean birth
c. Placenta previa
d. Initial blood pressure of 132/87
e. History of three spontaneous abortions
Verified Correct Answers
The observance of a woman and her fetus for a reasonable period (e.g., 4 to 6 hours) of
spontaneous active labor to assess the safety of vaginal birth for the mother and infant.
It may be initiated if the mother's pelvis is of questionable size or shape or if the fetus is
in an abnormal presentation or position. By far the most common reason for this is if
the woman wishes to have a vaginal birth after a previous cesarean birth. A planned
attempt to labor by a woman who has previously undergone a cesarean delivery and
desires a subsequent vaginal delivery
Trial of Labor
List 6 indications for caesarean birth.
1. Dysfunctional labor
2. Breech presentation
3. Abnormal FHR or patterns
4. Inadequate pelvic shape
5. Maternal or fetal demise
6. STIs such as HIV or herpes
List 4 obstetric emergencies.
1. Meconium stained amniotic fluid
2. Rupture of the uterus
3. Prolapsed umbilical cord
4. Shoulder dystocia
Meconium-stained amniotic fluid is which color?
,Green
If a baby is born covered with meconium, what are the priority nursing interventions?
(3)
1. Assess the baby's respiratory efforts, heart rate, and muscle tone.
2. Suction only the baby's mouth and nose if the baby has strong respiratory efforts, good
muscle tone, and a HR >100.
3. Suction the trachea using an endotracheal tube (inserted by a specialist) to remove any
meconium present if the baby has depressed respirations, decreased muscle tone, and a HR
<100.
A condition in which the head is born but the anterior shoulder cannot pass under the
pubic arch.
Shoulder dystocia
List nursing interventions for a patient experiencing shoulder dystocia.
1. Suprapubic pressure to the anterior shoulder in an attempt to push the shoulder under the
symphysis pubis.
2. Instruct patient to perform McRoberts manuever. (Pulling legs back)
3. Gaskin maneuver (Hands and knees)
A maneuver in which the mom lays on her back and spreads her legs and pulls her
knees to her chest to open up the pelvis. Can help resolve shoulder dystocia.
McRoberts maneuver
A maneuver in which the mom goes on her hands and knees to help resolve shoulder
dystocia.
,Gaskin maneuver
List 6 nursing interventions for a woman with a prolapsed umbilical cord.
(Call HCP)
1. Insert a sterile gloved hand into the vagina and hold the presenting part off the umbilical
cord.
2. Assist mom into modified Sims, Trendelenburg, or knee-chest position.
3. Assist with a forceps- or vacuum-assisted birth if the cervix is fully dilated.
4. Administer O2 by nonrebreather mask.
5. Start IV fluids, or increase existing drip rate.
6. CONTINUOUS assessment!
Modified Sim's position
(With pillows under mom's hips)
Helps treat umbilical cord prolapse
Knee-chest position
Takes pressure off of umbilical cord
Helps treat umbilical cord prolapse
What is the nurse's role during a uterine rupture? (4)
1. Start IV fluids
2. Transfuse blood products
3. Administer O2
4. Assist with preparation for immediate surgery
A pregnant woman's amniotic membranes rupture. Prolapsed cord is suspected. Which
intervention is the nurse's top priority?
, a. Place the woman in the knee-chest position.
b. Cover the cord in a sterile towel saturated with warm normal saline.
c. Prepare the woman for a cesarean birth.
d. Start oxygen by face mask.
A (A. The woman is assisted into a position (e.g., modified Sims position, Trendelenburg
position, or the knee-chest position) in which gravity keeps the pressure of the presenting part
off the cord.
B. If the cord is protruding from the vagina, it may be covered with a sterile towel soaked in
saline. Although this is an appropriate intervention, relieving pressure on the cord is the
nursing priority.
C. If the cervix is fully dilated, the nurse should prepare for immediate vaginal delivery.
Cesarean birth is indicated only if cervical dilation is not complete.
D. The nurse should administer O2 by facial mask at 8 to 10 L/min until delivery is complete.
This intervention should be initiated after pressure is relieved on the cord. Not only should
the woman be placed in knee-chest position, the nurse may also use her gloved hand or two
fingers to lift the presenting part off the cord.)
The labor and delivery nurse is admitting a woman complaining of being in labor. The
nurse completes the admission database and notes that which factors may prohibit the
woman from having a vaginal birth? (Select all that apply.)
a. Unstable coronary artery disease
b. Previous cesarean birth
c. Placenta previa
d. Initial blood pressure of 132/87
e. History of three spontaneous abortions
