Exam (elaborations)
Chapter 19 Nursing Care during Obstetric Procedures
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Chapter 19 Nursing Care during Obstetric Procedures
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Chapter 19: Nursing Care during Obstetric ProceduresTest Bank
MULTIPLE CHOICE
1. The nurse knows that a urinary catheter is added to the instrument table if a forceps-assisted
birth is anticipated. What is the correct rationale for this intervention?
a. Spontaneous release of urine might contaminate the sterile field.
b. An empty bladder provides more room in the pelvis.
c. A sterile urine specimen is needed preoperatively.
d. A Foley catheter prevents the membranes from spontaneously rupturing.
ANS: B
Feedback
A Urine is sterile.
B Catheterization provides room for the application of the forceps blades and
limits bladder trauma.
C A clean-catch urinalysis is usually sufficient for preoperative treatment.
D The membranes must be ruptured and the cervix completely dilated for a
forceps-assisted birth.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 422
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
2. After a forceps-assisted birth, the mother is observed to have continuous bright red lochia but
a firm fundus. What other data indicates the presence of a potential vaginal wall hematoma?
a. Mild, intermittent perineal pain
b. Edema and discoloration of the labia and perineum
c. Lack of an episiotomy
d. Lack of pain in the perineal area
ANS: B
Feedback
A The pain with vaginal hematoma is severe and constant.
B The nurse should monitor for edema and discoloration. Using a cold application
to the labia and perineum reduces pain by numbing the area and limiting
bruising and edema for the first 12 hours.
C An episiotomy is performed as the fetal head distends the perineum.
D The pain associated with vaginal hematoma is severe.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 423
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. When positioning the Foley catheter before cesarean birth, the nurse knows that the catheter
drainage tube and catheter bag should be
, a. Positioned on top of the patient’s leg
b. Placed near the head of the table
c. Clamped during the cesarean section
d. Positioned at the foot of the surgeon under the sterile drapes
ANS: B
Feedback
A The drain tube of the catheter should be positioned under her leg to promote
drainage and to keep the catheter away from the operative area.
B The anesthesia clinician must monitor urine output during the surgery.
C Urinary output must be continuously monitored. An early sign of hypovolemia is
a decreasing urinary output.
D The surgeon might step on the drainage bag if the catheter was below the drapes,
and no one could monitor the urine output.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 428 | Box 19-2
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
4. To provide safe care for the woman, the nurse understands that which condition is a
contraindication for an amniotomy?
a. Dilation less than 3 cm
b. Cephalic presentation
c. –2 station
d. Right occiput posterior position
ANS: C
Feedback
A The dilation must be enough to determine labor.
B The presenting part should be cephalic. Amniotomy is deferred if the presenting
part is higher in the pelvis.
C A prolapsed cord can occur if the membranes artificially rupture when the
presenting part is not engaged.
D This indicates a cephalic presentation, which is appropriate for an amniotomy.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 413
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. Which patient status is an acceptable indication for serial oxytocin induction of labor?
a. Past 42 weeks’ gestation
b. Multiple fetuses
c. Polyhydramnios
d. History of long labors
ANS: A
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