Antepartum and intrapartum questions Exam Questions and Answers
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Antepartum and intrapartum
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Antepartum And Intrapartum
Antepartum and intrapartum Exam Questions and Answers
REMEMBER VEAL CHOP
A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatmen...
Antepartum and intrapartum questions Exam Questions and Answers REMEMBER VEAL CHOP A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition? 1.Medication that will provide sedation 2.Increased hydration 3.Oxytocin (Pitocin) infusion 4.Administration of a tocolytic medication - Answer -3. Therapeutic management for hypotonic uterine dysfunction includes oxytocin augmentation and amniotomy to stimulate a labor that slows. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa? 1.Disseminated intravascular coagulation 2.Chronic hypertension 3.Infection 4.Hemorrhage - Answer -4. Because the placenta is implanted in the lower uterine segment, which does not contain the same intertwining musculature as the fundus of the uterus, this site is more prone to bleeding. A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician's orders and would question which order? 1.Prepare the client for an ultrasound 2.Obtain equipment for external electronic fetal heart monitoring 3.Obtain equipment for a manual pelvic examination 4.Prepare to draw a Hgb and Hct blood sample - Answer -3. Manual pelvic examinations are contraindicated when vaginal bleeding is apparent in the 3rd trimester until a diagnosis is made and placental previa is ruled out. Digital examination of the cervix ca n lead to maternal and fetal hemorrhage. A diagnosis of placenta previa is made by ultrasound. The H/H levels are monitored, and external electronic fetal heart rate monitoring is initiated. External fetal monitoring is crucial in evaluating the fetus that is at risk for severe hypoxia A client is admitted to the birthing suite in early active labor. The priority nursing intervention on admission of this client would be: 1.Auscultating the fetal heart 2.Taking an obstetric history 3.Asking the client when she last ate 4.Ascertaining whether the membranes were ruptured - Answer -1. Determining the fetal well-being supersedes all other measures. If the FHR is absent or persistently decelerating, immediate intervention is required. A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus' head is: 1.Not yet engaged 2.Entering the pelvic inlet 3.Below the ischial spines 4.Visible at the vaginal opening - Answer -3. A station of +1 indicates that the fetal head is 1 cm below the ischial spines. The physician asks the nurse the frequency of a laboring client's contractions. The nurse assesses the client's contractions by timing from the beginning of one contraction: 1.Until the time it is completely over 2.To the end of a second contraction 3.To the beginning of the next contraction 4.Until the time that the uterus becomes very firm - Answer -3. This is the way to determine the frequency of the contractions The nurse observes the client's amniotic fluid and decides that it appears normal, because it is: 1.Clear and dark amber in color 2.Milky, greenish yellow, containing shreds of mucus 3.Clear, almost colorless, and containing little white specks 4.Cloudy, greenish -yellow, and containing little white specks - Answer -3. by 36 weeks' gestation, normal amniotic fluid is colorless with small particles of vernix caseosa present. GREEN=MECONIUM When examining the fetal monitor strip after rupture of the membranes in a laboring client, the nurse notes variable decelerations in the fetal heart rate. The nurse should: 1.Stop the oxytocin infusion 2.Change the client's position 3.Prepare for immediate delivery 4.Take the client's blood pressure - Answer -2. Variable decelerations usually are seen as a result of cord compression; a change of position will relieve pressure on the cord. When monitoring the fetal heart rate of a client in labor, the nurse identifies an elevation of 15 beats above the baseline rate of 135 beats per minute lasting for 15 seconds. This should be documented as: 1.An acceleration 2.An early elevation 3.A sonographic motion 4.A tachycardic heart rate - Answer -1. An acceleration is an abrupt elevation above the baseline of 15 beats per minute for 15 seconds; if the acceleration persists for more than 10 minutes it is considered a change in baseline rate. A tachycardic FHR is a bove 160 beats per minute A nurse is caring for a client in labor. The nurse determines that the client is beginning in the 2nd stage of labor when which of the following assessments is noted? A.The client begins to expel clear vaginal fluid B.The contractions are regular C.The membranes have ruptured D.The cervix is dilated completely - Answer -4. The second stage of labor begins when the cervix is dilated completely and ends with the birth of the neonate. A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to: 1.Place the mother in the supine position 2.Document the findings and continue to monitor the fetal patterns 3.Administer oxygen via face mask 4.Increase the rate of pitocin IV infusion - Answer -3. Late decelerations are due to uteroplacental insufficiency as the result of decreased blood flow and oxygen to the fetus during the uterine contractions. This causes hypoxemia; therefore oxygen is nece ssary. The supine position is avoided because it decreases uterine blood flow to the fetus. The client should be turned to her side to displace pressure of the gravid uterus on the inferior vena cava. An intravenous pitocin infusion is discontinued when a late deceleration is noted. A nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate a need to contact the physician?
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