Chapter 08: Nursing Care of Women with
Complications During Labor and Birth
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A pulsating structure is felt during a vaginal examination of a woman in labor. How would the
nurse position the woman to prevent compression of a prolapsed cord?
a. On her right side with knees flexed
b. On her left side with a pillow placed between her legs
c. On her back with her head lower than the rest of her body
d. Supine with her legs elevated and bent at the knee
ANS: C
The Trendelenburg‘s (head down) position displaces the fetus upward to stop compression of
the prolapsed cord.
DIF: Cognitive Level: Application REF: p. 205 OBJ: 8
TOP: Emergencies During Childbirth—Prolapsed Umbilical Cord
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. Several hours after delivery, the nurse finds a woman crying. The woman says repeatedly, “My
baby is beautiful, but I was planning on a vaginal delivery. Instead I needed an emergency C-
section.” What is the most appropriate nursing diagnosis?
a. Anxiety related to the development of postpartum complications
b. Ineffective individual coping related to unfamiliarity with procedures
c. Risk for ineffective parenting related to emergency cesarean section
d. Grieving related to loss of expected birth experience
ANS: D
, Women who have cesarean births usually need greater support than those who have vaginal
births. They may feel grief, guilt, or anger, because the expected course of birth did not
occur.
DIF: Cognitive Level: Application REF: p. 203 OBJ: 8
TOP: Cesarean Section KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. A pregnant woman‘s membranes ruptured prematurely at 34 weeks. She will be discharged to her
home for the next few weeks. What would the nurse planning discharge instruction teach the
woman to do?
a. Report any increase in fetal activity.
b. Notify her obstetrician if she has a temperature above 37.8 C (100 F).
c. Massage her breasts to promote uterine relaxation.
d. Rest in a side-lying Trendelenburg‘s position with hips elevated.
ANS: B
For the woman with premature rupture of membranes (PROM) who is not having labor
induced right away, teaching combines information about infection and preterm labor. The
woman should monitor her temperature and report a temperature greater than 37.8C (100F).
DIF: Cognitive Level: Application REF: p. 186 OBJ: 6
TOP: Premature Rupture of Membranes KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
4. A woman who is 24 weeks pregnant is placed on an intravenous infusion of magnesium sulfate.
What side effect should the nurse inform the patient that she might experience?
a. Nausea and vomiting
b. Headache
c. Warm flush
d. Urinary frequency
ANS: C
Magnesium sulfate is the drug of choice for initiating therapy to stop labor. The patient will
notice a warm flush with the initiation of the drug.
Complications During Labor and Birth
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A pulsating structure is felt during a vaginal examination of a woman in labor. How would the
nurse position the woman to prevent compression of a prolapsed cord?
a. On her right side with knees flexed
b. On her left side with a pillow placed between her legs
c. On her back with her head lower than the rest of her body
d. Supine with her legs elevated and bent at the knee
ANS: C
The Trendelenburg‘s (head down) position displaces the fetus upward to stop compression of
the prolapsed cord.
DIF: Cognitive Level: Application REF: p. 205 OBJ: 8
TOP: Emergencies During Childbirth—Prolapsed Umbilical Cord
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. Several hours after delivery, the nurse finds a woman crying. The woman says repeatedly, “My
baby is beautiful, but I was planning on a vaginal delivery. Instead I needed an emergency C-
section.” What is the most appropriate nursing diagnosis?
a. Anxiety related to the development of postpartum complications
b. Ineffective individual coping related to unfamiliarity with procedures
c. Risk for ineffective parenting related to emergency cesarean section
d. Grieving related to loss of expected birth experience
ANS: D
, Women who have cesarean births usually need greater support than those who have vaginal
births. They may feel grief, guilt, or anger, because the expected course of birth did not
occur.
DIF: Cognitive Level: Application REF: p. 203 OBJ: 8
TOP: Cesarean Section KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. A pregnant woman‘s membranes ruptured prematurely at 34 weeks. She will be discharged to her
home for the next few weeks. What would the nurse planning discharge instruction teach the
woman to do?
a. Report any increase in fetal activity.
b. Notify her obstetrician if she has a temperature above 37.8 C (100 F).
c. Massage her breasts to promote uterine relaxation.
d. Rest in a side-lying Trendelenburg‘s position with hips elevated.
ANS: B
For the woman with premature rupture of membranes (PROM) who is not having labor
induced right away, teaching combines information about infection and preterm labor. The
woman should monitor her temperature and report a temperature greater than 37.8C (100F).
DIF: Cognitive Level: Application REF: p. 186 OBJ: 6
TOP: Premature Rupture of Membranes KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
4. A woman who is 24 weeks pregnant is placed on an intravenous infusion of magnesium sulfate.
What side effect should the nurse inform the patient that she might experience?
a. Nausea and vomiting
b. Headache
c. Warm flush
d. Urinary frequency
ANS: C
Magnesium sulfate is the drug of choice for initiating therapy to stop labor. The patient will
notice a warm flush with the initiation of the drug.
