front 1 the nurse is explaining the physiology of uterine contractions to a group of nursing students. which statement best explains the maternal-fetal exchange of oxygen and waste products during a contraction? | back 1 diminishes as the spiral arteries are compressed |
front 2 the nurse is directing an unlicensed assistive personnel to obtain maternal vital signs between contraction. which statement is the appropriate rationale for assessing maternal vital signs between contractions rather than at another interval? | back 2 maternal circulating blood volume increases temporarily during contractions. |
front 3 uncontrolled maternal hyperventilation during labor results in? | back 3 respiratory alkalosis |
front 4 which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet? | back 4 engagement |
front 5 the laboring patient asks the nurse how the labor contractions cause the cervix to dilate. the nurse responds that labor contractions facilitate cervical dilation by? | back 5 pulling the cervix over the fetus and amniotic sac |
front 6 pregnant patients can usually tolerate the normal blood loss associated with childbirth because of which physiological adaptation to pregnancy? | back 6 increased blood volume |
front 7 the nurse is assessing the duration of a patients labor contractions. which method does the nurse implement to assess the duration of labor contractions? | back 7 assess from the beginning to the end of each contraction |
front 8 which physiologic event is the key indicator of the commencement of true labor? | back 8 cervical dilation and effacement |
front 9 which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis? | back 9 flexion |
front 10 an increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of? | back 10 lightening |
front 11 a patient just delivered her baby via the vaginal route. the patient asks the nurse why the babys head is not round, but oval. which explanation should the nurse provide the patient? | back 11 this results from molding |
front 12 a patient whose cervix is dilated to 6 cm is considered to be in which phase of labor? | back 12 active phase |
front 13 the nurse is assessing a patient in the active phase of labor. what should the nurse expect during this phase? | back 13 the patient is requesting pain medication |
front 14 a laboring patient asks the nurse how she will know that the contraction is at its peak. the nurse explains that the contractions peaks during which stage of measurement? | back 14 the acme |
front 15 a patient in labor presents with a breech presentation. the nurse understands that a breech presentation is associated with? | back 15 umbilical cord compression |
front 16 the primary difference between the labor of a nullipara and that of a multipara is? | back 16 total duration of labor |
front 17 which maternal factor may inhibit fetal descent during labor? | back 17 a full bladder |
front 18 which assessment finding would cause a concern for a patient who had delivered vaginally? | back 18 patient complains of fingers tingling |
front 19 on admission to the labor and birth unit, a 38 year old female, gravida 4, para 3, at term in early labor is found to have a transverse lie on vaginal examination. what is the priority intervention at this time? | back 19 notify the health care provider |
front 20 which assessment finding indicates that cervical dilation and or effacement has occurred? | back 20 bloody mucus drainage from vagina |
front 21 if a notation on the patients health record states that the fetal position is LSP, this indicates that? | back 21 buttocks are in the left posterior quadrant of the pelvis |
front 22 to determine if the patient is in true labor, the nurse would assess for changes in? | back 22 cervical dilation |
front 23 the health care provider for a laboring patient makes the following entry into the patients record. 3/50%/+1. what instruction will the nurse implement with the patient? | back 23 breathe with me slowly, in through your nose and out through your mouth |
front 24 the examiner indicates to the labor nurse that the fetus is in the left occiput anterior (LOA) position. to facilitate the labor process, how will the nurse position the laboring patient? | back 24 on her left side |
front 25 the primiparous patient at 39 weeks gestation states to the nurse, "I can breathe easier now." what is the nurses most appropriate response? | back 25 that process is called lightening. do you have to urinate more frequently? |
front 26 the nurse assesses a laboring patients contraction pattern and notes the frequency at every 3 to 4 minutes, duration 50 to 60 seconds, and the intensity is moderate by palpation. what is the most accurate documentation for this contraction pattern? | back 26 stage 1, active phase |
front 27 a laboring patient states to the nurse, "I have to push!" what is the next nursing action? | back 27 examine the patients cervix for dilation |
front 28 after birth of the placenta the patient states, "All of a sudden I feel very cold," what is the most appropriate nursing action at this time? | back 28 place a warm blanket over the patient |
front 29 childbirth preparation can be considered successful if which of the following outcomes is achieved? | back 29 the patient rehearsed labor and practiced skills to master pain |
front 30 a woman with a known heroin habit is admitted in early labor. which drug is contraindicated with opiate-dependent patients? | back 30 nalpuphine (nubain) |
front 31 a patient is admitted to the labor and birth room in active labor, contractions are 4 to 5 minutes apart and last for 30 seconds. the nurse needs to perform a detailed assessment. when is the best time to ask questions or perform procedures? | back 31 after the contraction is over |
front 32 childbirth pain is different from other types of pain in that it is | back 32 associated with a physiologic process |
front 33 excessive anxiety during labor heightens the patients sensitivity to pain by increasing | back 33 muscle tension |
front 34 which fetal position may cause the laboring patient increased back discomfort? | back 34 left occiput posterior |
front 35 a major advantage of non-pharmacologic pain management is | back 35 there are no side effects or risks to the fetus |
front 36 the best time to teach non-pharmacologic pain management pain control methods to an unprepared laboring patient is during which stage? | back 36 latent phase |
front 37 the primary side effect of maternal narcotic analgesia in the newborn is | back 37 respiratory depression |
front 38 the nerve block used in labor that provides anesthesia to the lower vagina and perineum is referred to as a(n) | back 38 pudendal |
front 39 the nurse is teaching a childbirth education class. which information regarding excessive pain in labor should the nurse include in the session? | back 39 it may result in decreased placental perfusion |
front 40 which patient will most likely have increased anxiety and tension during labor? | back 40 gravida 2 who delivered a stillborn baby last year |
front 41 which method of pain management would be safest for a gravida 3, para 2, admitted at 8cm cervical dilation? | back 41 breathing and relaxation techniques |
front 42 a laboring patient who imagines who body opening to let the baby out is using a mental technique called | back 42 imagery |
front 43 when administering a narcotic to a laboring patient, which statement explains why the nurse should inject the medication at the beginning of a contraction? | back 43 less medication will be transferred to the fetus |
front 44 the method of anesthesia in labor that is considered the safest for the fetus is | back 44 local infiltration |
front 45 to improve placental blood flow immediately after the injection of an epidural anesthetic, the nurse should | back 45 place a wedge under the womans right hip |
front 46 which physiologic effect may occur in the presence of increased maternal pain perception during labor? | back 46 decreased perfusion to the placenta in response to catecholamine secretion |
front 47 which of the following factors would affect pain perception or tolerance for the laboring patient? | back 47 right occiput posterior fetal position during labor |
front 48 a patient in labor is approaching the transition stage and already has an epidural in place. An additional dose of medication has been prescribed and administered to the patient. which priority intervention should be performed in order to evaluate the clinical response to treatment? | back 48 document maternal blood pressure and fetal heart rates following medication administration and observe for any variations |
front 49 the process of labor places significant metabolic demands on the obstetric patient. which physiologic findings would be expected? | back 49 increased maternal demand for oxygen |
front 50 a labor patient, gravida 2, para 1, at term has received meperidine (demerol) for pain control during labor. her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. which medicaition does the nurse anticipate would be required in the birth room for administration? | back 50 naloxone (narcan) |
front 51 which statement is true with regard to the type of pain associated with childbirth experience? | back 51 pain associated with childbirth is self-limiting |
front 52 a patient in labor reports a feeling of burning pain during the second stage of labor. this type of pain is associated with | back 52 somatic pain |
front 53 a patient presents to the labor and birth area for emergent birth. vaginal exam reveals that the patient is fully dilated, vertex, +2 station, with ruptured membranes. the patient is extremely apprehensive because this is her first childbirth experience and asks for an epidural to be administered now. what is the priority nursing response based on this patient assessment? | back 53 assist the patient with non-pharmacologic methods of pain distraction during this time as you prepare for vaginal birth |
front 54 a labor patient has brought in a photograph of her two children and asks the nurse to place it on the wall so that she can look at it during labor contractions. this is an example of | back 54 focal point |
front 55 a pregnant woman in labor is quite anxious and has been breathing rapidly during contractions. she now complains of tingling sensation in her fingers. what is the priority nursing intervention at this time? | back 55 instruct the patient to breathe into her cupped hands |
front 56 a laboring patient has asked the nurse to assist her in utilizing a cutaneous stimulation strategy for pain management. the nurse would | back 56 apply a heat pack to lower back |
front 57 to relieve a mild postdural puncture headache, the nurse should encourage the intake of | back 57 tea or coffee |
front 58 which patient will be most receptive to teaching about non-pharmacologic pain control methods? | back 58 gravida 1, para 0, dilated 2 cm, 80% effaced |
front 59 the nurse is providing care to a patient in the active phase of the first stage of labor. the patient is crying out loudly with each contraction. what is the nurses most respectful approach for this patient? | back 59 ask the patients labor coach if this is a usual expression of pain for her |
front 60 a multiparas labor plan includes the use of jet hydrotherapy during the active phase of labor. what is the priority patient assessment prior to assisting the patient with this request? | back 60 maternal temperature |
front 61 a patient in active labor requests an epidural for pain management. what is the nurses most appropriate intervention at this juncture? | back 61 initiate an IV infusion of lactated Ringers solution at 2000 mL/hour over 30 minutes |