PRACTICE EXAMS FOR MATERNITY AND PEDIATRICS EXAM 2

PRACTICE EXAMS FOR MATERNITY AND PEDIATRICS EXAM 2 When determining the frequency of contractions, the nurse would measure which of the following? a. Start of one contraction to the start of next contraction b. Beginning of one contraction to the end of the same contraction c. Peak of one contraction to the peak of the next contraction d. End of one contraction to the beginning of the next contraction - CORRECT ANSWER-A. Frequency is measured by the start of one contraction to the start of the next one. Which fetal lie is most conducive to a spontaneous vaginal birth? a. Transverse b. Longitudinal C. Perpendicular D. Oblique - CORRECT ANSWER-B. Longitudinal - places fetus in a vertical position Which of the following observations would suggest that placental separation is occuring? A. Uterus stops contracting altogether B. Umbilical cord pulsations stop C. Uterine shape changes to globular D. Maternal blood pressure drops - CORRECT ANSWER-C. After the placenta separates from the uterine wall, the shape of the uterus changes from discoid to globular. As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is: A. Discomfort level is greater with false labor B. Progressive cervical changes occur in true labor C. There is a feeling of nausea with false labor D. There is more fetal movement with true labor - CORRECT ANSWER-B. Progressive cervical changes occur in true labor, not in false labor. The shortest but most intense phase of labor is the: A. Latent phase B. Active phase C. Transition phase D. Placental expulsion phase - CORRECT ANSWER-C. Transition phase. Is when contractions are 1-2 min apart and the final dilation is taking place. A laboring woman is admitted to the labor and birth suite at 6 cm dilation. She would be in which phase of the first stage of labor? A. Latent B. Active C. Transition D. Early - CORRECT ANSWER-B. Active. In this stage the cervix dilates from 3-7cm with 40-80% effacement occurring. Which assessment would indicate that a woman is in true labor? A. Membranes are ruptures and fluid is clear. B. Presenting part is engaged and not floating C. Cervix is 4 cm dilated, 90% effeced. D. Contractions last 30 seconds every 5-10 min. - CORRECT ANSWER-D. True labor is characterized by contractions occurring at regular intervals that increase in frequency, duration, and intensity Interventions that are underutilized in promoting a normal birth. Select all that apply. A. Oral nutrition and fluids in labor. B. Open glottis pushing in the second stage of labor. C. Skin-to-skin contact after birth for infant bonding. D.Routine artificial rupture of membranes (amniotomy) E. Labor induction with Pitocin given intravenously F. Routine episiotomy to shorten labor length - CORRECT ANSWER-"A," "B,"and "C" since all of these are evidence-based interventions that are physiologically sound without placing the mother or the neonate in any danger. Food and clear fluids provide hydration and nutrition and give comfort to laboring women. Fasting during labor will increase gastric acid production. Open glottis while pushing allows the woman's body to sense the urge to push naturally. Skin-to-skin contact promotes mother-infant bonding and warmth. Physiologic preparation for labor would be demonstrated by: A. Decrease in Braxton Hicks contractions felt by mother B. Weight gain and increase in appetite by mother C. Lightening, whereby the fetus drops into true pelvis D. Fetal heart rate accelerations and increased movements - CORRECT ANSWER-C" since as labor nears, the fetus gets into position by descending into the maternal true pelvis in preparation for birth. The cardinal movements of labor include which of the following? Select all that apply. A. Extension and rotation B. Descent and engagement C. Presentation and position D. Attitude and lie E. Flexion and expulsion - CORRECT ANSWER-A. Extension and rotation B. Descent and engagement E. Flexion and expulsion When a client in labor is fully dilated, which instruction would be most effective to assist her in encouraging effective pushing? a. Hold your breath and push through entire contraction. b. Use chest-breathing with the contraction. c. Pant and blow during each contraction. d. Instruct her to wait until she feels the urge to push. - CORRECT ANSWER-D, since nondirected pushing, based on current research, leads to better outcomes for both mother and infant During the fourth stage of labor, the nurse assesses the woman at frequent intervals after giving childbirth. What assessment date would cause the nurse the most concern A. Moderate amount of dark red lochia drainage of peripad B. Uterine fundus palpated to the right of the umbilicus C. An oral temperature reading of 100.6 F D. Perineal area brusied and edematous beneath her ice pack - CORRECT ANSWERB. A full bladder causes displacement of the uterus above it, and increased bleeding results secondary to the uncontracted status of the uterus. When managing a client's pain during labor, nurses should: A. Make sure the agents given to not prolong labor B. Know that all pain relief measures are similar C. Support the client's decisions and requests D. Not recommend nonpharmacologic methods - CORRECT ANSWER-C. Support the client's decisions and requests When caring for a client during the active phase of labor without continuous electronic fetal monitoring, the nurse would intermitently assess FHR every: A. 15-30 min B. 5-10 min C. 45-60 min D. 60-75 min - CORRECT ANSWER-A. 15-30min The nurse notes the presence of transient fetal accelerations on the fetal monitoring strip. Which intervention would be most apporpriate? A. Reposition the client on the left side B. Begin 100% oxygen via face mask C. Document this as indicating a normal pattern D. Call the health care provider immediately - CORRECT ANSWER-C. Fetal accelerations denote an intact central nervous system and appropriate oxygenation