NURS 326 - Maternity Exam 2 Questions With Complete
Solutions
A graduate nurse is taking care of a patient. The patient is a 25
yr old, G1P0, 39 wk gestation, who's in true labor. She's 10
cm/100%/-2. What statement made by the nurse to the patient
warrants more education?
A. "I need to assess the strength of your contractions by
touching your abdomen."
B. "I need to assess the FHT of your baby."
C. "I need to check the position of your baby via ultrasound."
D. "You're going to begin pushing in a few minutes." Correct
Answers D. "You're going to begin pushing in a few minutes."
WE NEVER START PUSHING AT A NEGATIVE
STATION!!
A nurse is treating a pregnant patient with a baby whose growth
scan measures 10lbs. How can the nurse be proactive in order to
decrease risk of shoulder dystocia? Correct Answers Ask if the
patient has been consulted for a C-section and explain the risks
of vaginal birth. If they haven't been consulted, have the
physician come consult them for a c-section
A patient comes into the hospital and says they don't feel their
baby moving. The nurse begins to do a NST. What result would
be reassuring to the nurse? Correct Answers An "A": a
Reactive fetal heart strip (2 accelerations that go up by 15 beats
for 15 seconds in a 15-20-minute period)
,A patient is on a Pitocin drip and is starting to have contractions
that last 3 minutes. What is happening to the mom and what
nursing interventions would the nurse take? Correct Answers
This is Uterine Tetany:
• Turn off Pitocin
• Turn patient to side lying position
• Fetal surveillance
• Administer 02 via mask.
• Turn regular IV fluid open
• Check urine output: should be at least 60- 80ml/hr
Aside from our nursing interventions, what medication should
we have at bedside in the case of a patient having hypotension
caused by an epidural? Correct Answers Ephedrine
(Adrenergic antagonist)
For a physician to offer the use of forceps to a mom in labor,
what needs to be confirmed first? Correct Answers Mom must
be fully dilated
How are external or internal continuous monitoring displayed?
Correct Answers Via monitor paper or computer screen
How are placenta previa's diagnosed? Correct Answers
ULTRASOUND!!
How can the nurse educate the patient to prevent premature
labor and birth? Correct Answers • Prevent dehydration
(promote water intake, use large bore IV to give fluids if
dehydrated and contracting)
,• Prevent infection (UTI, STI)
• Pelvic rest (Nothing in the vagina!! - no douching, no sex, no
tampons)
• Decreased activity (don't go to the gym, excessive exercise)
How can the nurse make sure that the pain is managed
appropriately? Correct Answers - Make realistic pain
management goals with the patient (Mom can't have an epidural
during 1st phase of labor)
- Decrease the adverse psychologic effects that pain can cause so
it doesn't interfere with maternal-fetal bonding
How can the nurse prepare the patient for a preterm infant?
Correct Answers Be supportive and have the mom/partner meet
the NICU team
How can the nurse use medical interventions to prevent
premature labor in a hospital setting? Correct Answers •
Tocolytics (meds to stop preterm labor -- contractions):
Magnesium sulfate
• IV hydration
How do the soft tissues of the maternal passage help with
progression of labor and birth? Correct Answers Cervix must
efface/dilate, vagina must expand, and pelvic floor muscles must
help to rotate the baby/move them downwards towards the exit
, How do we classify a FHT strip with accelerations? Correct
Answers - Reassuring: accelerations of any size or shape (It
reassures us that the baby is getting all the oxygenated blood it
needs).
- Reactive: in a 15-minute period, the FHR went up twice by 15
bpm for 15 seconds (2 accelerations by 15 beats for 15 seconds
during a 15-minute period)
How do we compare a non-progressing cervix to one that's
completely dilated for birth? Correct Answers We measure
dilation of the cervix by putting our fingers in there and estimate
how wide the opening is.
- 1 cm = 1 finger
- 2 cm dilated = 2 fingers overlapped
- 3 cm dilated = 2 fingers opened slightly
- 10 cm dilated: No cervix (can feel the baby's head)
How do we compare a normal cervix to one that's completely
effaced for birth? Correct Answers We measure the length of
the cervix with our fingers.
- normal cervix = about 3in
- at time of delivery = no inches (fully effaced/completely
disappears
How do we determine a normal kick count? Correct Answers
Based on the regular movement pattern noted by mom
Solutions
A graduate nurse is taking care of a patient. The patient is a 25
yr old, G1P0, 39 wk gestation, who's in true labor. She's 10
cm/100%/-2. What statement made by the nurse to the patient
warrants more education?
A. "I need to assess the strength of your contractions by
touching your abdomen."
B. "I need to assess the FHT of your baby."
C. "I need to check the position of your baby via ultrasound."
D. "You're going to begin pushing in a few minutes." Correct
Answers D. "You're going to begin pushing in a few minutes."
WE NEVER START PUSHING AT A NEGATIVE
STATION!!
A nurse is treating a pregnant patient with a baby whose growth
scan measures 10lbs. How can the nurse be proactive in order to
decrease risk of shoulder dystocia? Correct Answers Ask if the
patient has been consulted for a C-section and explain the risks
of vaginal birth. If they haven't been consulted, have the
physician come consult them for a c-section
A patient comes into the hospital and says they don't feel their
baby moving. The nurse begins to do a NST. What result would
be reassuring to the nurse? Correct Answers An "A": a
Reactive fetal heart strip (2 accelerations that go up by 15 beats
for 15 seconds in a 15-20-minute period)
,A patient is on a Pitocin drip and is starting to have contractions
that last 3 minutes. What is happening to the mom and what
nursing interventions would the nurse take? Correct Answers
This is Uterine Tetany:
• Turn off Pitocin
• Turn patient to side lying position
• Fetal surveillance
• Administer 02 via mask.
• Turn regular IV fluid open
• Check urine output: should be at least 60- 80ml/hr
Aside from our nursing interventions, what medication should
we have at bedside in the case of a patient having hypotension
caused by an epidural? Correct Answers Ephedrine
(Adrenergic antagonist)
For a physician to offer the use of forceps to a mom in labor,
what needs to be confirmed first? Correct Answers Mom must
be fully dilated
How are external or internal continuous monitoring displayed?
Correct Answers Via monitor paper or computer screen
How are placenta previa's diagnosed? Correct Answers
ULTRASOUND!!
How can the nurse educate the patient to prevent premature
labor and birth? Correct Answers • Prevent dehydration
(promote water intake, use large bore IV to give fluids if
dehydrated and contracting)
,• Prevent infection (UTI, STI)
• Pelvic rest (Nothing in the vagina!! - no douching, no sex, no
tampons)
• Decreased activity (don't go to the gym, excessive exercise)
How can the nurse make sure that the pain is managed
appropriately? Correct Answers - Make realistic pain
management goals with the patient (Mom can't have an epidural
during 1st phase of labor)
- Decrease the adverse psychologic effects that pain can cause so
it doesn't interfere with maternal-fetal bonding
How can the nurse prepare the patient for a preterm infant?
Correct Answers Be supportive and have the mom/partner meet
the NICU team
How can the nurse use medical interventions to prevent
premature labor in a hospital setting? Correct Answers •
Tocolytics (meds to stop preterm labor -- contractions):
Magnesium sulfate
• IV hydration
How do the soft tissues of the maternal passage help with
progression of labor and birth? Correct Answers Cervix must
efface/dilate, vagina must expand, and pelvic floor muscles must
help to rotate the baby/move them downwards towards the exit
, How do we classify a FHT strip with accelerations? Correct
Answers - Reassuring: accelerations of any size or shape (It
reassures us that the baby is getting all the oxygenated blood it
needs).
- Reactive: in a 15-minute period, the FHR went up twice by 15
bpm for 15 seconds (2 accelerations by 15 beats for 15 seconds
during a 15-minute period)
How do we compare a non-progressing cervix to one that's
completely dilated for birth? Correct Answers We measure
dilation of the cervix by putting our fingers in there and estimate
how wide the opening is.
- 1 cm = 1 finger
- 2 cm dilated = 2 fingers overlapped
- 3 cm dilated = 2 fingers opened slightly
- 10 cm dilated: No cervix (can feel the baby's head)
How do we compare a normal cervix to one that's completely
effaced for birth? Correct Answers We measure the length of
the cervix with our fingers.
- normal cervix = about 3in
- at time of delivery = no inches (fully effaced/completely
disappears
How do we determine a normal kick count? Correct Answers
Based on the regular movement pattern noted by mom
