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Test Bank For Olds Maternal-Newborn Nursing and Womens Health Across the Lifespan, 11th Edition (Davidson, 2020), Chapter 1-36 / 9780135206881 / All Chapters with Answers and Rationals$17.99
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Test Bank For Olds Maternal-Newborn Nursing and Womens
Health Across the Lifespan, 11th Edition (Davidson, 2020),
Chapter 1- / All Chapters with Answers
and Rationals
The nurse is admitting a client to the birthing unit. What question should the nurse ask to gain a
better understanding of the client's psychosocial status?
1. "How did you decide to have your baby at this hospital?"
2. "Who will be your labor support person?"
3. "Have you chosen names for your baby yet?"
4. "What feeding method will you use for your baby?" - ANSWER: Answer: 2
Explanation: 2. The expectant mother's partner or support person is an important member of the
birthing team, and assessments of the couple's coping, interactions, and teamwork are integral to the
nurse's knowledge base. The nurse's physical presence with the laboring woman provides the best
opportunity for ongoing assessment.
The nurse is admitting a client to the labor and delivery unit. Which aspect of the client's history
requires notifying the physician?
1. Blood pressure 120/88
2. Father a carrier of sickle-cell trait
3. Dark red vaginal bleeding
4. History of domestic abuse - ANSWER: Answer: 3
Explanation: 3. Third-trimester bleeding is caused by either placenta previa or abruptio placentae.
Dark red bleeding usually indicates abruptio placentae, which is life-threatening to both mother and
fetus.
The nurse is working with a pregnant adolescent. The client asks the nurse how the baby's condition is
determined during labor. The nurse's best response is that during labor, the nurse will do which of the
following?
1. Check the client's cervix by doing a pelvic exam every 2 hours.
2. Assess the fetus's heart rate with an electronic fetal monitor.
3. Look at the color and amount of bloody show that the client has.
4. Verify that the client's contractions are strong but not too close together. - ANSWER: Answer: 2
Explanation: 2. This statement best answers the question the client has asked.
During the initial intrapartal assessment of a client in early labor, the nurse performs a vaginal
examination. The client's partner asks why this pelvic exam needs to be done. The nurse should
explain that the purpose of the vaginal exam is to obtain information about which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Uterine contraction pattern
2. Fetal position
3. Presence of the mucous plug
4. Cervical dilation and effacement
5. Presenting part - ANSWER: Answer: 4, 5
Explanation: 4. The vaginal examination of a laboring client obtains information about the station of
the presenting part and the dilation and effacement of the cervix.
5. The vaginal examination of a laboring client obtains information about the fetal presenting part.
A client has just arrived in the birthing unit. What steps would be most important for the nurse to
perform to gain an understanding of the physical status of the client and her fetus?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
,1. Check for ruptured membranes and apply a fetal scalp electrode.
2. Auscultate the fetal heart rate between and during contractions.
3. Palpate contractions and resting uterine tone.
4. Assess the blood pressure, temperature, respiratory rate, and pulse rate.
5. Perform a vaginal exam for cervical dilation, and perform Leopold maneuvers. - ANSWER: Answer:
2, 3
Explanation: 2. Fetal heart rate auscultation gives information about the physical status of the fetus.
3. Contraction palpation provides information about the frequency, duration, and intensity of the
contractions.
The nurse is preparing to assess a laboring client who has just arrived in the labor and birth unit.
Which statement by the client indicates that additional education is needed?
1. "You are going to do a vaginal exam to see how dilated my cervix is."
2. "The reason for a pelvic exam is to determine how low in the pelvis my baby is."
3. "When you check my cervix, you will find out how thinned out it is."
4. "After you assess my pelvis, you will be able to tell when I will deliver." - ANSWER: Answer: 4
Explanation: 4. An experienced labor and birth nurse can estimate the time of delivery based on the
cervix, fetal position, station, and contraction pattern. However, during a pelvic exam, no information
is obtained about contractions. The nurse will not have enough information following the cervical
exam to estimate time of birth.
The client has been pushing for 3 hours, and the fetus is making a slow descent. The partner asks the
nurse whether pushing for this long is normal. How should the nurse respond?
1. "Your baby is taking a little longer than average, but is making progress."
2. "First babies take a long time to be born. The next baby will be easier."
3. "The birth would go faster if you had taken prenatal classes and practiced."
4. "Every baby is different; there really are no norms for labor and birth." - ANSWER: Answer: 1
Explanation: 1. Establishing rapport and a trusting relationship and providing information that is true
is best response.
During a maternal assessment, the nurse determines the fetus to be in a left occiput anterior (LOA)
position. Auscultation of the fetal heart rate should begin in what quadrant?
1. Right upper quadrant
2. Left upper quadrant
3. Right lower quadrant
4. Left lower quadrant - ANSWER: Answer: 4
Explanation: 4. The fetal heart rate (FHR) is heard most clearly at the fetal back. Thus, in a cephalic
presentation, the FHR is best heard in the lower quadrant of the maternal abdomen.
A laboring client asks the nurse, "Why does the physician want to use an intrauterine pressure
catheter (IUPC) during my labor?" The nurse would accurately explain that the best rationale for using
an IUPC is which of the following?
1. The IUPC can be used throughout the birth process.
2. A tocodynamometer is invasive.
3. The IUPC provides more accurate data than does the tocodynamometer.
4. The tocodynamometer can be used only after the cervix is dilated 2 cm. - ANSWER: Answer: 3
Explanation: 3. The IUPC has several benefits over an external tocotransducer or palpation. Because
the IUPC is inserted directly into the uterus, it provides near-exact pressure measurements for
contraction intensity and uterine resting tone. The increased sensitivity of the IUPC allows for very
accurate timing of uterine contractions (UCs).
The charge nurse is looking at the charts of laboring clients. Which client is in greatest need of further
intervention?
1. Woman at 7 cm, fetal heart tones auscultated every 90 minutes
2. Woman at 10 cm and pushing, external fetal monitor applied
3. Woman with meconium-stained fluid, internal fetal scalp electrode in use
4. Woman in preterm labor, external monitor in place - ANSWER: : 1
,Explanation: 1. During active labor, the fetal heart tones should be auscultated every 30 minutes;
every 90 minutes is not frequent enough.
The laboring client with meconium-stained amniotic fluid asks the nurse why the fetal monitor is
necessary, as she finds the belt uncomfortable. Which response by the nurse is most important?
1. "The monitor is necessary so we can see how your labor is progressing."
2. "The monitor will prevent complications from the meconium in your fluid."
3. "The monitor helps us to see how the baby is tolerating labor."
4. "The monitor can be removed, and oxygen given instead." - ANSWER: Answer: 3
Explanation: 3. Electronic fetal monitoring (EFM) provides a continuous tracing of the fetal heart rate
(FHR), allowing characteristics of the FHR to be observed and evaluated.
The nurse has just palpated contractions and compares the consistency to that of the forehead to
estimate the firmness of the fundus. What would the intensity of these contractions be identified as?
1. Mild
2. Moderate
3. Strong
4. Weak - ANSWER: Answer: 3
Explanation: 3. The consistency of strong contractions is similar to that of the forehead.
Before performing Leopold maneuvers, what would the nurse do?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Have the client empty her bladder.
2. Place the client in Trendelenburg position.
3. Have the client lie on her back with her feet on the bed and knees bent.
4. Turn the client to her left side.
5. Have the client lie flat with her ankles crossed. - ANSWER: Answer: 1, 3
Explanation: 1. The woman should have recently emptied her bladder before performing Leopold
maneuvers.
3. The woman should lie on her back with her abdomen uncovered. To aid in relaxation of the
abdominal wall, the shoulders should be raised slightly on a pillow and the knees drawn up a little.
The student nurse is to perform Leopold maneuvers on a laboring client. Which assessment requires
intervention by the staff nurse?
1. The client is assisted into supine position, and the position of the fetus is assessed.
2. The upper portion of the uterus is palpated, then the middle section.
3. After determining where the back is located, the cervix is assessed.
4. Following voiding, the client's abdomen is palpated from top to bottom. - ANSWER: Answer: 3
Explanation: 3. The cervical exam is not part of Leopold maneuvers. Abdominal palpation is the only
technique used for Leopold maneuvers.
The nurse is preparing to assess the fetus of a laboring client. Which assessment should the nurse
perform first?
1. Perform Leopold maneuvers to determine fetal position.
2. Count the fetal heart rate between, during, and for 30 seconds following a uterine contraction (UC).
3. Dry the maternal abdomen before using the Doppler.
4. The diaphragm should be cooled before using the Doppler. - ANSWER: Answer: 1
Explanation: 1. Performing Leopold maneuvers is the first step.
After several hours of labor, the electronic fetal monitor (EFM) shows repetitive variable
decelerations in the fetal heart rate. The nurse would interpret the decelerations to be consistent
with which of the following?
1. Breech presentation
2. Uteroplacental insufficiency
3. Compression of the fetal head
4. Umbilical cord compression - ANSWER: Answer: 4
, Explanation: 4. Variable decelerations occur when there is umbilical cord compression.
The nurse auscultates the FHR and determines a rate of 112 beats/min. Which action is appropriate?
1. Inform the maternal client that the rate is normal.
2. Reassess the FHR in 5 minutes because the rate is low.
3. Report the FHR to the doctor immediately.
4. Turn the maternal client on her side and administer oxygen. - ANSWER: Answer: 1
Explanation: 1. A fetal heart rate of 112 beats/min. falls within the normal range of 110-160
beats/min., so there is no need to inform the doctor.
Upon assessing the FHR tracing, the nurse determines that there is fetal tachycardia. The fetal
tachycardia would be caused by which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Early fetalhypoxia
2. Prolonged fetal stimulation
3. Fetal anemia
4. Fetal sleep cycle
5. Infection - ANSWER: Answer: 1, 2, 3, 5
Explanation: 1. Early fetal hypoxia can cause fetal tachycardia.
2. Prolonged fetal stimulation can cause fetal tachycardia.
3. Fetal anemia can cause fetal tachycardia.
5. Infection can cause fetal tachycardia.
Persistent early decelerations are noted. What would the nurse's first action be?
1. Turn the mother on her left side and give oxygen.
2. Check for prolapsed cord.
3. Do nothing. This is a benign pattern.
4. Prepare for immediate forceps or cesarean delivery. - ANSWER: Answer: 3
Explanation: 3. Early decelerations are considered benign, and do not require any intervention.
The laboring client's fetal heart rate baseline is 120 beats per minute. Accelerations are present to
135 beats/min. During contractions, the fetal heart rate gradually slows to 110, and is at 120 by the
end of the contraction. What nursing action is best?
1. Document the fetal heart rate.
2. Apply oxygen via mask at 10 liters.
3. Prepare for imminent delivery.
4. Assist the client into Fowler's position. - ANSWER: Answer: 1
Explanation: 1. The described fetal heart rate has a normal baseline; the presence of accelerations
indicates adequate fetal oxygenation, and early decelerations are normal. No intervention is
necessary.
The nurse is caring for a client who is having fetal tachycardia. The nurse knows that possible causes
include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Maternal dehydration
2. Maternal hyperthyroidism
3. Fetal hypoxia
4. Prematurity
5. Anesthesia or regional analgesia - ANSWER: Answer: 1, 2, 3, 4
Explanation: 1. Maternal dehydration can cause fetal tachycardia.
2. Maternal hyperthyroidism can cause fetal tachycardia.
3. Fetal tachycardia can indicate fetal hypoxia.
4. Prematurity can cause fetal tachycardia.
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