OB Questions with Answer III

61. After the woman receives epidural block anesthesia, the nurse should immediately:

1. Assess the FHR

B.    Assess the woman’s BP, pulse, and respirations

3. Administer oxygen via face mask
4. Place the woman in semi-Fowler’s position

62. Assessment findings on a woman in labor include cervical dilation of 4 cm, 100% effaced, station 0, contractions every 5 to 6 minutes lasting 50 to 60seconds, membranes intact, FHR 140 to 150 BPM loudest in the upper left quadrant, and hard round mass palpable at the level of the fundus. Assessment findings indicate that the fetus is in

A.    Breech presentation

2. Cephalic presentation
3. Posterior position
4. Transverse lie

63. Assessment findings on a woman in labor include cervical dilation of 4 cm, 100% effaced, station 0, contractions every 5 to 6 minutes lasting 50 to 60seconds, membranes intact, FHR 140 to 150 BPM loudest in the upper left quadrant, and hard round mass palpable at the level of the fundus. While monitoring the FHR membranes rupture spontaneously revealing meconium-stained amniotic fluid. The nurse’s initial action should be to:

1. Prepare the woman for CS delivery because of fetal distress
2. Notify the physician

C.    Determine the FHR

4. Place the woman in left side lying position because amniotic fluid indicates fetal distress

64. Assessment reveals cervical dilation of 5 cm cervical effacement 80%, station +3 frequency of contractions 5 to 8 minutes, duration of contractions 40-50 seconds, membranes ruptured spontaneously 1 hour prior to admission, vertex presentation, LOA position. The woman asks the nurse if it is all right for her to get up and walk around. The nurse’s best response should be

1. “You should stay in bed; walking may interfere with proper uterine contractions”
2. “I can’t make a decision on that, you will have to ask the doctor.”
3. “You will have to stay in bed; otherwise your contractions cannot be timed and no one can listen to the FHR”
4. “It’s quite all right for you to be up and about as long as you feel comfortable and your membranes are intact”

65. A woman in labor progresses to 7 to 8 cm dilated and the vertex is low in the midpelvis. To alleviate discomfort during contractions, the nurse should instruct the woman to

1. Pant during contractions

B.    Abdominal breathe

3. Chest breathe
4. Pant between contractions

66. If labor is progressing satisfactorily, when would it be appropriate to administer medication such as Demerol?

1. 3 cm dilation
2. 4 cm dilation
3. 5 cm dilation

D.    7 cm dilation

67. Demerol 50 mg and Phenergan 50 mg are ordered to be administered IM. This medication would:

1. Induce sleep until the time of delivery

B.    Increase pain threshold, resulting I relaxation

3. Act as amnesic drug
4. Act as a preliminary anesthesia

68. The beginning of the second stage of labor can be recognized by the client’s desire to:

1. Relax during contractions

B.    Push during contractions

3. Pant during contractions
4. Blow during contractions

69. A woman is positioned on the delivery table; both legs should be placed simultaneously in the stirrups to prevent:

1. Excessive pull on the fascia
2. Pressure on the perineum

C.    Trauma to the uterine ligaments

4. Venous stasis in the legs

70. A G3P2 is in labor and is progressing rapidly. When should she be moved into the delivery room?

1. Cervix is dilated 2-4 cm

B.    Cervix is dilated 7-8 cm

3. Cervix is dilated 10 cm
4. At the onset of labor

71. Which of the following is observed first when placenta begins to separate?

1. Lengthening of the cord
2. Sudden gush of blood

C.    Abdomen becomes globular and firm

4. Sudden rise of the fundus

72. The placenta should be delivered within the period of time following delivery?

1. 1-2 minutes

B.    3-10 minutes

3. 15-20 minutes
4. 20-30 minutes

73. Ten minutes after the delivery, the placenta is still intact. What action does the nurse take?

1. Gently pull on the cord to initiate separation
2. Call the physician back to the delivery room
3. Push gently, but firmly on the fundus

D.    Allow the infant to suck the breast

74. About 15 minutes after delivery, the woman begins to complain about chills. The most appropriate action by the nurse would be to:  

A.      Notify the physician of the problem

B.      Cover with a blanket

C.      Administer acetaminophen as ordered

D.     Increase the IV infusion rate

75. The nurse assesses the postpartum mother during the fourth stage of labor for:

1. Level of maternal love

B.    Distention of the bladder

3. Ability to relax
4. Knowledge of the newborn behavior

76. The nurse notes bright red bleeding in a patient who delivered 26 hours ago. What is the probable cause of bleeding?

A.    Uterine atony

2. Normal bleeding
3. Perineal laceration
4. Placental fragments

77. The nurse is aware that the nursing action that would be best promote parent-infant attachment behaviors would be:

1. Encouraging rooming-in, with parental infant care

B.    Keeping the new family together immediately postpartum

3. Restricting visitation on the postpartum unit
4. Supporting the parents’ choice of breastfeeding

78. The nurse is aware that during the taking-in phase of the postpartum period the area of health teaching that the mother will be most responsive to is:

1. Family Planning
2. Infant feeding
3. Infant hygiene

D.    Perineal care

79. A woman’s labor does not progress and a cesarean delivery is performed. Afterwards she tells the nurse

      that she is a “natural childbirth flunkie.” The postpartal phase of adjustment that the statement most closely typifies is:

1. Taking hold
2. Working through

C.    Taking in

4. Letting go

80. A mother chooses to bottle feed her newborn because this will cause the least interference with full resumption of her teaching practice. Before discharge the nurse should teach her that if breast engorgement occurs, she should

1. Take 2 aspirins every 4 hours
2. Apply hot compresses to the breasts

C.    Wear a tightly fitted brassiere

4. Cease drinking milk for 2 weeks