Test Bank for Maternity, Newborn, and Women's Health Nursing: A Case-Based Approach, 2nd Edition by Kate O'Meara
1. A woman in labor is to receive continuous internal electronic fetal monitoring. The
doctorreviews the woman's medical record to ensure which of the following as being
required?...
1 a woman in labor is to receive continuous internal electronic fetal monitoring the doctorreviews the womans medical record to ensure which of the following as being required aintact membrane
Maternity Final Exam Test – Bank1
Chapter 01: Perspectives on Maternal, Newborn, and Women’s HealthCare
1. A woman in labor is to receive continuous internal electronic fetal monitoring. The
doctorreviews the woman's medical record to ensure which of the following as being
required? A)Intact membranes
B) Cervical dilation of 2 cm or more
C) Floating presenting fetal part
D)A neonatologist to insert the
electrodeFeedback:
For continuous internal electronic fetal monitoring, four criteria must be met: ruptured
membranes,cervical dilation of at least 2 cm, fetal presenting part low enough to allow
placement of the electrode, and a skilled practitioner available to insert the electrode.
2. UNTILL assessing fetal heart rate, the doctor finds a heart rate of 175 bpm, accompanied
by adecrease in variability and late decelerations. Which of the following would the doctor
do next? A)Have the woman change her position.
B) Administer oxygen.
C) Notify the hospital provider.
D)Continue to monitor the pattern every 15
minutes.Feedback:
Fetal tachycardia as evidenced by a fetal heart rate greater than 160 bpm accompanied by a
decrease in variability and late decelerations is an ominous sign indicating the need for
promptintervention. The hospital provider should be notified immediately and then measures
should be instituted such as having the woman lie on her side and administering oxygen. In
this instance, monitoring should be continuous to detect any further changes and evaluate
the effectiveness ofinterventions.
10.A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which
statementby the woman would lead the doctor to suspect that the woman needs additional
tinstructing?
A) The warmth and buoyancy of the water has a nice relaxing effect.
B) I can stay in the bath for as long as I feel comfortable.
C) My cervix should be dilated more than 5 cm before I try using this method.
D) The temperature of the water should be at least 105
F.Feedback:
Hydrotherapy is an effective pain relief method. The water temperature should not exceed
bodytemperature. Therefore, a temperature of 105° F would be too warm. The warmth and
buoyancyhave a relaxing effect and women are encouraged to stay in the bath as long as
they feel comfortable. The woman should be in active labor with cervical dilation greater
than 5 cm.
11.A woman in labor received an opioid close to the time of birth. The doctor would
,assess thenewborn for which of the following?
A) Respiratory depression
B) Urinary retention
C) Abdominal distention
D) Hyperreflexi
aFeedback:
Opioids given close to the time of birth can cause central nervous system depression,
includingrespiratory depression, in the newborn, necessitating the administration of
naloxone. Urinary retention may occur in the woman who received neuraxial opioids.
Abdominal distention is notassociated with opioid administration. Hyporeflexia would
be more commonly associated withcentral nervous system depression due to opioids.
12. UNTILL applying the ultrasound transducers for continuous external electronic fetal
monitoring,at which location would the doctor place the transducer to record the FHR?
A) Over the uterine fundus where contractions are most intense
B) Above the umbilicus toward the right side of the diaphragm
C) Between the umbilicus and the symphysis pubis
D) Between the xiphoid process and
umbilicusFeedback:
The ultrasound transducer is positioned on the maternal abdomen in the midline
between the umbilicus and the symphysis pubis. The tocotransducer is placed over the
uterine fundus in thearea of greatest contractility.
13. After describing continuous internal electronic fetal monitoring to a laboring woman
and herpartner, which of the following would indicate the need for additional
tinstructing?
A) This type of monitoring is the most accurate method for our baby.
B) Unfortunately, I'm going to have to stay quite still in bed while it is in place.
C) This type of monitoring can only be used after my membranes rupture.
D) Youll be inserting a special electrode into my babys
scalp.Feedback:
With continuous internal electronic monitoring, maternal position changes and movement
do not interfere with the quality of the tracing. Continuous internal monitoring is considered
the most accurate method, but it can be used only if certain criteria are met, such as rupture
of membranes.A spiral electrode is inserted into the fetal presenting part, usually the head.
14. UNTILL planning the care of a woman in the active phase of labor, the doctor would
anticipateassessing the fetal heart rate at which interval?
A) Every 2 to 4 hours
B) Every 45 to 60 minutes
C) Every 15 to 30 minutes
D) Every 10 to 15
minutesFeedback:
During the active phase of labor, FHR is monitored every 15 to 30 minutes. FHR is assessed
every30 to 60 minutes during the latent phase of labor. The woman's temperature is
,typically assessedevery 4 hours during the first stage of labor and every 2 hours after
ruptured membranes. Bloodpressure, pulse, and respirations are assessed every hour
during the latent phase and every 30 minutes during the active and transition phases.
Contractions are assessed every 30 to 60 minutes
1. The United States ranks 50th in the world for maternal mortality and 41st among
industrializednations for infant mortality rate. UNTILL developing programs to assist in
decreasing these rates, which factor would most likely need to be addressed as having the
greatest impact?
A) Resolving all language and cultural differences
B) Assuring early and adequate prenatal care
C) Providing more extensive women's
shelters D)Encouraging all women to eat a
balanced diet
2. UNTILL integrating the principles of family-centered care, the doctor would include which
of thefollowing?
A) Childbirth is viewed as a procedural event
B) Families are unable to make informed choices
C) Childbirth results in changes in relationships
D) Families require little information to make appropriate decisions
3. UNTILL preparing a tinstructing plan for a group of first-time pregnant women, the
doctor expects to review how maternity care has changed over the years. Which of the
following wouldthe doctor include UNTILL discussing events of the 20th century?
A) Epidemics of puerperal fever
B) Performance of the first cesarean birth
C) Development of the x-ray to assess pelvic size
D) Creation of free-standing birth centers
4. After tinstructing a group of people about pregnancy-related mortality, the
instructordetermines that
additional tinstructing is needed UNTILL the people identify which condition as a leading
cause?A)Hemorrhage
B) Embolism
C) Obstructed
laborD)Infection
5. The doctor is working with a group of community health members to develop a plan to
address the special health needs of women. Which of the following conditions would the
group address asthe major problem?
A) Smoking
B) Heart disease
C) Diabete
sD)Cancer
6. UNTILL assessing a family for possible barriers to hospital, the doctor would consider
whichfactor to be most important?
, A) Language
B) Hospital workers attitudes
C) Transportation
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