LABOR & DELIVERY EXAM GUIDE WITH
LATEST UPDATE QUESTIONS AND
CORRECT ANSWERS
What data indicates to the nurse that placental detachment is occurring?
a) An abrupt lengthening of the cord
b) Decreased vaginal bleeding
c) A decrease in the number of contractions
d) Relaxation of the uterus - Answer-A
When caring for a client with preeclampsia, which action is a priority?
1. Monitoring the client's labor carefully and preparing for a fast delivery
2. Continually assessing the fetal tracing for signs of fetal distress
3. Checking vital signs every 15 minutes to watch for increasing blood pressure
4. Reducing visual and auditory stimulation - Answer-Answer: 4
RATIONALES: A client with preeclampsia is at risk for seizure activity because her
neurologic system is overstimulated. Therefore, in addition to administering
pharmacologic interventions to reduce the possibility of seizures, the nurse should
lessen auditory and visual stimulation. Although the other actions are important, they're
of a lesser priority.
While performing continuous electronic monitoring of a client in labor, the nurse should
document which information about the contractions?
A) Duration, frequency, and intensity
B) Duration, dilation,, frequency
C) Frequency, duration maternal position
D) Duration, effacement, position - Answer-a) Duration, frequency & intensity
What interval should the nurse use when assessing the frequency of contractions of a
multiparous client in active labor admitted to the birthing area?
a)beginning of one contraction to the beginning of the next contraction
b) end of one contraction to the end of the next contraction
c ) beginning of one contraction to the end of the next contraction
,d) acme of one contraction to the beginning of the next contraction - Answer-a)
beginning of one contraction to the beginning of the next contraction
For a primigravid client with the fetal presenting part at -1 station, what would be the
nurse's priority immediately after a spontaneous rupture of the membranes? - Answer-
check the fetal HR
A client hospitalized for preterm labor tells the nurse her mother in law blames her for
"overdoing it" and causing the preterm labor. Which of the following is the most
appropriate response from the nurse?
"Your mother in law was wrong. You didn't do anything to cause this." "Let's talk about
how preterm labor occurs, so as to help you understand what causes it." "It is natural to
blame one another when things become difficult." "Did you think that you did anything
you shouldn't have?" - Answer-"Let's talk about how preterm labor occurs, so as to
help you understand what causes it."
Explanation:
The nurse needs to explore the client's feelings to assist her in understanding what
happened and to disperse the blame she is feeling. The other responses do not explore
feelings experienced by the client and may stop the dialogue with the nurse from
continuing.
The nurse who is assessing the position, presentation, and lie of the fetus of a 9-month-
pregnant woman performs which of the following actions? - Answer-Leopold's
maneuvers
A client in labor is attached to an electronic fetal monitor (EFM). Which finding by an
EFM indicates adequate uteroplacental and fetal perfusion?
Late decelerations
Persistent fetal bradycardia
Variable decelerations and sinusoidal pattern
Fetal heart rate variability within 5 to 10 beats/minute - Answer-Fetal heart rate
variability within 5 to 10 beats/minute
A client in the first stage of labor enters the labor and delivery area. She seems anxious
and tells the nurse that she hasn't attended childbirth education classes. Her partner,
who accompanies her, is also unprepared for childbirth. Which nursing intervention
would be most effective for the couple at this time?
Teach the client and her partner about pain transmission.
Teach the client progressive muscle relaxation.
Instruct the partner on touch, massage, and breathing patterns.
, Use hypnosis on the client and her partner. - Answer-Instruct the partner on touch,
massage, and breathing patterns.
A client with intrauterine growth restriction is admitted to the labor and birth unit and
started on an I.V. infusion of oxytocin. Which aspect of the client's care plan should the
nurse revise?
Monitoring vital signs, including assessment of fetal well-being, every 15 to 30 minutes
Allowing the client to ambulate as tolerated
Helping the client use breathing exercises to manage her contractions
Carefully titrating the oxytocin based on the client's pattern of labor - Answer-Allowing
the client to ambulate as tolerated
Initial client assessment information includes: blood pressure 160/110 mm Hg, pulse 88
beats/minute, respiratory rate 22 breaths/minute, reflexes +3/+4 with 2 beat clonus.
Urine specimen reveals +3 protein, negative sugar and ketones. Based on these
findings, a nurse should expect the client to have which complaints?
Headache, blurred vision, and facial and extremity swelling
Abdominal pain, urinary frequency, and pedal edema
Diaphoresis, nystagmus, and dizziness
Lethargy, chest pain, and shortness of breath - Answer-Headache, blurred vision, and
facial and extremity swelling
A physician placed a direct fetal scalp electrode on the fetus. What information should a
nurse include when documenting direct fetal scalp electrode placement?
The maternal and fetal body movements identified by the direct fetal scalp electrode,
time of fetal scalp electrode placement, and FHR
Time of fetal scalp electrode placement, name of the physician who placed the
electrode, and frequency of uterine contractions
The name of the physician who applied the electrode, Doppler transducer placement,
and FHR
Time of fetal scalp electrode placement, name of the physician who applied the
electrode, and the fetal heart rate (FHR) - Answer-Time of fetal scalp electrode
LATEST UPDATE QUESTIONS AND
CORRECT ANSWERS
What data indicates to the nurse that placental detachment is occurring?
a) An abrupt lengthening of the cord
b) Decreased vaginal bleeding
c) A decrease in the number of contractions
d) Relaxation of the uterus - Answer-A
When caring for a client with preeclampsia, which action is a priority?
1. Monitoring the client's labor carefully and preparing for a fast delivery
2. Continually assessing the fetal tracing for signs of fetal distress
3. Checking vital signs every 15 minutes to watch for increasing blood pressure
4. Reducing visual and auditory stimulation - Answer-Answer: 4
RATIONALES: A client with preeclampsia is at risk for seizure activity because her
neurologic system is overstimulated. Therefore, in addition to administering
pharmacologic interventions to reduce the possibility of seizures, the nurse should
lessen auditory and visual stimulation. Although the other actions are important, they're
of a lesser priority.
While performing continuous electronic monitoring of a client in labor, the nurse should
document which information about the contractions?
A) Duration, frequency, and intensity
B) Duration, dilation,, frequency
C) Frequency, duration maternal position
D) Duration, effacement, position - Answer-a) Duration, frequency & intensity
What interval should the nurse use when assessing the frequency of contractions of a
multiparous client in active labor admitted to the birthing area?
a)beginning of one contraction to the beginning of the next contraction
b) end of one contraction to the end of the next contraction
c ) beginning of one contraction to the end of the next contraction
,d) acme of one contraction to the beginning of the next contraction - Answer-a)
beginning of one contraction to the beginning of the next contraction
For a primigravid client with the fetal presenting part at -1 station, what would be the
nurse's priority immediately after a spontaneous rupture of the membranes? - Answer-
check the fetal HR
A client hospitalized for preterm labor tells the nurse her mother in law blames her for
"overdoing it" and causing the preterm labor. Which of the following is the most
appropriate response from the nurse?
"Your mother in law was wrong. You didn't do anything to cause this." "Let's talk about
how preterm labor occurs, so as to help you understand what causes it." "It is natural to
blame one another when things become difficult." "Did you think that you did anything
you shouldn't have?" - Answer-"Let's talk about how preterm labor occurs, so as to
help you understand what causes it."
Explanation:
The nurse needs to explore the client's feelings to assist her in understanding what
happened and to disperse the blame she is feeling. The other responses do not explore
feelings experienced by the client and may stop the dialogue with the nurse from
continuing.
The nurse who is assessing the position, presentation, and lie of the fetus of a 9-month-
pregnant woman performs which of the following actions? - Answer-Leopold's
maneuvers
A client in labor is attached to an electronic fetal monitor (EFM). Which finding by an
EFM indicates adequate uteroplacental and fetal perfusion?
Late decelerations
Persistent fetal bradycardia
Variable decelerations and sinusoidal pattern
Fetal heart rate variability within 5 to 10 beats/minute - Answer-Fetal heart rate
variability within 5 to 10 beats/minute
A client in the first stage of labor enters the labor and delivery area. She seems anxious
and tells the nurse that she hasn't attended childbirth education classes. Her partner,
who accompanies her, is also unprepared for childbirth. Which nursing intervention
would be most effective for the couple at this time?
Teach the client and her partner about pain transmission.
Teach the client progressive muscle relaxation.
Instruct the partner on touch, massage, and breathing patterns.
, Use hypnosis on the client and her partner. - Answer-Instruct the partner on touch,
massage, and breathing patterns.
A client with intrauterine growth restriction is admitted to the labor and birth unit and
started on an I.V. infusion of oxytocin. Which aspect of the client's care plan should the
nurse revise?
Monitoring vital signs, including assessment of fetal well-being, every 15 to 30 minutes
Allowing the client to ambulate as tolerated
Helping the client use breathing exercises to manage her contractions
Carefully titrating the oxytocin based on the client's pattern of labor - Answer-Allowing
the client to ambulate as tolerated
Initial client assessment information includes: blood pressure 160/110 mm Hg, pulse 88
beats/minute, respiratory rate 22 breaths/minute, reflexes +3/+4 with 2 beat clonus.
Urine specimen reveals +3 protein, negative sugar and ketones. Based on these
findings, a nurse should expect the client to have which complaints?
Headache, blurred vision, and facial and extremity swelling
Abdominal pain, urinary frequency, and pedal edema
Diaphoresis, nystagmus, and dizziness
Lethargy, chest pain, and shortness of breath - Answer-Headache, blurred vision, and
facial and extremity swelling
A physician placed a direct fetal scalp electrode on the fetus. What information should a
nurse include when documenting direct fetal scalp electrode placement?
The maternal and fetal body movements identified by the direct fetal scalp electrode,
time of fetal scalp electrode placement, and FHR
Time of fetal scalp electrode placement, name of the physician who placed the
electrode, and frequency of uterine contractions
The name of the physician who applied the electrode, Doppler transducer placement,
and FHR
Time of fetal scalp electrode placement, name of the physician who applied the
electrode, and the fetal heart rate (FHR) - Answer-Time of fetal scalp electrode
