OBGYN: Nursing Management of Labor and Birth at Risk Exam Questions and Answers 100% Pass

OBGYN: Nursing Management of Labor and Birth at Risk Exam Questions and Answers 100% Pass After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? - Answer- A) Supine B) Side-lying C) Sitting D) Knee-chest 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? - Answer- 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? - Answer- 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: - Answer- 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? - Answer- 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? - Answer- 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? - Answer- A) Asphyxia B) Clavicular fracture C) Caput succedaneum / Cephalohematoma 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? - Answer- A) Fetal heart rate of 150 beats/minute B) Contractions every 2 minutes, lasting 45 seconds C) Uterine resting tone of 14 mm Hg D) Urine output of 20 mL/hour Ans: D