OB EXAM 2 2024.COMPLETE QUESTIONS AND ANSWERS.

OB EXAM 2 2024.COMPLETE QUESTIONS AND ANSWERS. 1. The nurse would expect which maternal cardiovascular finding during labor? a. Increased cardiac output b. Decreased pulse rate c. Decreased white blood cell (WBC) count d. Decreased blood pressure CORRECT ANSWER: A 2. The factors that affect the process of labor and birth, known commonly as the five Ps, include all except: a. Passenger. c. Powers. b. Passageway. d. Pressure. CORRECT ANSWER: D (C13, #7) 3. As relates to fetal positioning during labor, nurses should be aware that: a. Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal. b. Birth is imminent when the presenting part is at +4 to +5 cm below the spine. c. The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter. d. Engagement is the term used to describe the beginning of labor. CORRECT ANSWER: B (C13, #11) 4. Which basic type of pelvis includes the correct description and percentage of occurrence in women? a. Gynecoid: classic female; heart shaped; 75% b. Android: resembling the male; wider oval; 15% c. Anthropoid: resembling the ape; narrower; 10% d. Platypelloid: flattened, wide, shallow; 3% CORRECT ANSWER: D (C13, #12) 5. While providing care to a patient in active labor, the nurse should instruct the woman that: a. The supine position commonly used in the United States increases blood flow. b. The “all fours” position, on her hands and knees, is hard on her back. c. Frequent changes in position will help relieve her fatigue and increase her comfort. d. In a sitting or squatting position, her abdominal muscles will have to work harder. CORRECT ANSWER: C (C13, #14) 6. Which description of the four stages of labor is correct for both definition and duration? a. First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours b. Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours c. Third state: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first-timer) d. Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour CORRECT ANSWER: A (C13, #15) 7. The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products: a. Continues except when placental functions are reduced. b. Increases as blood pressure decreases. c. Diminishes as the spiral arteries are compressed. d. Is not significantly affected. CORRECT ANSWER: C (C13, #18) 8. Which occurrence is associated with cervical dilation and effacement? a. Bloody show c. Lightening b. False labor d. Bladder distention CORRECT ANSWER: A (C13, #22) 9. A laboring woman received an opioid agonist (meperidine) intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate? a. Fentanyl (Sublimaze) c. Naloxone (Narcan) b. Promethazine (Phenergan) d. Nalbuphine (Nubain) CORRECT ANSWER: C (C14, #4) 10. A woman in labor has just received an epidural block. The most important nursing intervention is to: a. Limit parenteral fluids. b. Monitor the fetus for possible tachycardia. c. Monitor the maternal blood pressure for possible hypotension. d. Monitor the maternal pulse for possible bradycardia. CORRECT ANSWER: C (C14, #5) 11. The nurse should be aware that an effective plan to achieve adequate pain relief without maternal risk is most effective if: a. The mother gives birth without any analgesic or anesthetic. b. The mother and family’s priorities and preferences are incorporated into the plan. c. The primary health care provider decides the best pain relief for the mother and family. d. The nurse informs the family of all alternative methods of pain relief available in the hospital setting. CORRECT ANSWER: B (C14, #6) A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure would be to use: a. Counterpressure against the sacrum. b. Pant-blow (breaths and puffs) breathing techniques. c. Effleurage. d. Conscious relaxation or guided imagery. CORRECT ANSWER: A (C14, #8) 12. Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help clients. Nurses should know that women may be stoic until late in labor, when they may become vocal and request pain relief. a. Chinese c. Hispanic b. Arab or Middle Eastern d. African-American CORRECT ANSWER: C (C14, #15) 13. With regard to a pregnant woman’s anxiety and pain experience, nurses should be aware that: a. Even mild anxiety must be treated. b. Severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety, and so on. c. Anxiety may increase the perception of pain, but it does not affect the mechanism of labor. d. Women who have had a painful labor will have learned from the experience and have less anxiety the second time because of increased familiarity. CORRECT ANSWER: B (C14, #16) 14. In the current practice of childbirth preparation, emphasis is placed on: a. The Dick-Read (natural) childbirth method. b. The Lamaze (psychoprophylactic) method. c. The Bradley (husband-coached) method. d. Having expectant parents attend childbirth preparation in any or no specific method. CORRECT ANSWER: D (C14, #18) 15. With regard to spinal and epidural (block) anesthesia, nurses should know that: a. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births. b. A high incidence of after-birth headache is seen with spinal blocks. c. Epidural blocks allow the woman to move freely. d. Spinal and epidural blocks are never used together. CORRECT ANSWER: B (C14, #23) 16. After change-of-shift report the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is: a. Visceral. c. Somatic. b. Referred. d. Afterpain. CORRECT ANSWER: B (C14, #26) 17. The nerve block used in labor that provides anesthesia to the lower vagina and perineum is called: a. An epidural. c. A local. b. A pudendal. d. A spinal block. CORRECT ANSWER: B (C14, #29) 18. To assist the woman after delivery of the infant, the nurse knows that the blood patch is used after spinal anesthesia to relieve: a. Hypotension. c. Neonatal respiratory depression. b. Headache. d. Loss of movement. CORRECT ANSWER: B (C14, #33) 19. The nurse caring for the woman in labor should understand that maternal hypotension can result in: a. Early decelerations. c. Uteroplacental insufficiency. b. Fetal dysrhythmias. d. Spontaneous rupture of membranes. CORRECT ANSWER: C (C15, #8) 20. The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by: a. Change in position.