Exam (elaborations)
intrapartum (1).
Exam of 5 pages for the course NUR 266 at NUR 266 (intrapartum (1).)
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intrapartumA client who is a primigravida is receiving magnesium sulfate for gestational hypertension. The
nurse is asked to monitor the client every 30 minutes. Which information should be of concern to
the nurse? - CORRECT ANSWER-Respirations of 10 breaths per minute
A woman who is 36 weeks pregnant arrives at the labor and delivery unit complaining of vaginal
bleeding. Which signs/symptoms would indicate that the client's bleeding is caused by placenta
previa? Select all that apply. - CORRECT ANSWER-2. Bright red vaginal bleeding
3. Lack of uterine contractions
A client who experienced abruptio placentae is at risk for disseminated intravascular coagulopathy
(DIC). The nurse should monitor this client for which symptom of this complication? - CORRECT
ANSWER-Oozing from injection sites
The nurse is collecting data from a client who has been diagnosed with placenta previa. Which
findings should the nurse expect to note? Select all that apply. - CORRECT ANSWER-4. Bright
red vaginal bleeding
5. Soft, relaxed, nontender uterus
The nurse assists the nurse-midwife in examining the client. The midwife documents the following
data: cervix 80% effaced and 3 cm dilated, vertex presentation minus (-) 2 station, membranes
ruptured. The nurse anticipates that the midwife will prescribe which activity for the client? -
CORRECT ANSWER-Complete bed rest
The nurse is caring for a client in labor. The fetal heart rate is 156 beats per minute and regular.
The client's contractions are occurring every 4 minutes with a duration of 42 seconds and
moderate intensity. The nurse should do which at this time? - CORRECT ANSWER-Continue
monitoring the client because the data reflect acceptable progress.
The nurse is caring for the nullipara woman in labor. The nurse understands that the health care
provider must be contacted if which condition becomes apparent? - CORRECT
ANSWER-Decreased periods of uterine relaxation between contractions
A mother experiencing dystocia looks alarmed and asks, "What's going on? Why are you all
poking and prodding? Is my baby okay?" Based on the client's questions, the nurse understands
that the client is experiencing which problem? - CORRECT ANSWER-Anxiety and fear
The nurse is assisting in caring for a client in labor. Which data collection finding by the nurse
would place the client at risk for uterine rupture? - CORRECT ANSWER-Shoulder dystocia
Before attempting to deliver the placenta after a precipitate delivery, the nurse waits for which sign
as an indication of placental separation? - CORRECT ANSWER-Change in uterine shape
the nurse is assisting in caring for a client with abruptio placentae and is monitoring the client for
disseminated intravascular coagulopathy (DIC). Which finding is least likely associated with DIC? -
CORRECT ANSWER-Swelling of the calf of one leg
A pregnant client with severe uterine bleeding is admitted to the labor and birthing department.
Which data should best alert the nurse to early signs of hypovolemic shock? - CORRECT
ANSWER-Restlessness and agitation
, The nurse in the delivery room is assisting with the delivery of a newborn. Which observation
would indicate that the placenta has separated from the uterine wall and is ready for delivery? -
CORRECT ANSWER-Changes in the shape of the uterus
the nurse tells a client she is now beginning the second stage of labor. The nurse realizes the
client understands the occurrences of this stage when the client makes which statement? -
CORRECT ANSWER-"My cervix is completely dilated."
The nurse is assigned to assist with caring for a client who is being admitted to the birthing center
in early labor. On admission, which action should the nurse take initially? - CORRECT
ANSWER-Determine the maternal and fetal vital signs.
The nurse is assigned to assist with caring for a client with abruptio placentae who is experiencing
vaginal bleeding. The nurse collects data from the client, knowing that abruptio placenta is
accompanied by which additional finding? - CORRECT ANSWER-Uterine tenderness on palpation
The nurse is preparing a client for a cesarean delivery. A urinary catheter is to be inserted into the
client's bladder, and the client asks the nurse why this is necessary. The nurse appropriately
replies by telling the client that which is the catheter's primary purpose? - CORRECT
ANSWER-Reduce the risk of injuring the bladder during the surgery.
The nurse has assisted in developing a plan of care for a client experiencing dystocia and includes
several nursing interventions in the plan of care. The nurse prioritizes the plan and selects which
nursing intervention as the highest priority? - CORRECT ANSWER-Monitoring fetal status
The nurse is caring for a woman in labor who is experiencing a precipitate delivery. Until help
arrives, the nurse places the client into which optimal position? - CORRECT ANSWER-Lateral
Sims'
The client is having moderate contractions that are occurring every 5 minutes and lasting 60
seconds. The fetal heart rate (FHR) is 150 beats per minute and regular. Based on these findings,
what is the appropriate nursing action? - CORRECT ANSWER-Continue to monitor the client.
A client in active labor with intact membranes is complaining of back discomfort. An analgesic was
administered 1 hour ago but has not relieved the discomfort. The nurse should avoid which
measure at this time to assist in relieving the back discomfort? - CORRECT ANSWER-Assist the
client to ambulate in the room.
A client was admitted to the maternity unit 12 hours ago and has been experiencing strong
contractions every 3 minutes, and the fetus is currently at station 0. The fetal heart rate on
admission was 140 beats per minute and regular. The fetal heart rate is decreasing and a
persistent nonreassuring fetal heart rate pattern is present. Which nursing action is appropriate? -
CORRECT ANSWER-Prepare the client for a cesarean delivery.
The nurse is assigned to assist with caring for a client who has been admitted to the labor unit.
The client is 9 cm dilated and is experiencing precipitous labor. Which is the priority nursing
action? - CORRECT ANSWER-Keep the client in a side-lying position.
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