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Safe Maternity and Pediatric Nursing Linnard-Palmer Coats Kyle Test Bank

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Safe Maternity and Pediatric Nursing Linnard-Palmer Coats Kyle Test Bank

ISBN-13: 978-0803624948

ISBN-10: 0803624948

 

Description

Safe Maternity and Pediatric Nursing Linnard-Palmer Coats Kyle Test Bank

ISBN-13: 978-0803624948

ISBN-10: 0803624948

 

 

 

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Free Nursing Test Questions:

Chapter 12: Birth-Related Procedures

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   Which patient does the nurse recognize as not an appropriate candidate for amniotomy?

1) The woman who is at 41 weeks’ gestation
2) The woman with a fetus in the breech presentation
3) The woman with a history of hypertension
4) The woman with a history of precipitous delivery

 

 

____     2.   Which assessment finding is most important for the nurse to report immediately after the performance of an amniotomy?

1) Temperature of 37.6°C
2) Clear, odorless amniotic fluid
3) Abnormal fetal heart rate (FHR) pattern
4) Leakage of clear fluid from the vagina

 

 

____     3.   Which patient does the nurse recognize as a candidate for an amnioinfusion?

1) The woman who is postterm
2) The woman with multiple gestations
3) The woman with oligohydramnios
4) The woman carrying a fetus with a neural tube defect

 

 

____     4.   After a successful external cephalic version, the patient says, “Oh good! Now I won’t have to worry about having a Cesarean section!” Which teaching should the nurse provide this patient in response to this comment?

1) The fetus can drift back into an abnormal presentation.
2) There is no reason to worry about having a Cesarean section.
3) Potential complications following the procedure
4) Need to drink plenty of fluids for the next 24 hours

 

 

____     5.   A patient is 39 weeks pregnant and is admitted for induction of labor. Her Bishop score is 2. Which teaching does the nurse prepare for this patient?

1) Explain the process of inducing labor
2) Describe the fetal monitoring equipment
3) Explain the importance of monitoring fetal activity
4) Explain the need for chemical or mechanical cervical ripening

 

 

____     6.   A patient’s cervix is 2 cm dilated and 40% effaced, the fetal head is in the 0 station, and the consistency of the cervix is medium and is in the midposition. On the basis of the calculated Bishop score, how does the nurse interpret these findings?

1) The patient’s cervix is ripe and ready for induction.
2) The patient’s cervix is ripening, but readiness for induction is questionable.
3) Induction could be attempted, but cervical ripening is questionable.
4) The patient’s cervix is not ripe, and induction should not be initiated at this time.

 

 

____     7.   Which method of cervical ripening and induction of labor does the nurse consider safest and least likely to result in complications?

1) Insertion of a transcervical Foley catheter
2) Application of prostaglandin gel
3) Administration of Prepidil Endocervical Gel
4) Infusion of oxytocin (Pitocin)

 

 

____     8.   Which outcome is most appropriate for a nursing diagnosis of Risk for Injury in a patient whose labor is induced?

1) Demonstrates and verbalizes reduced anxiety
2) Verbalizes understanding of the process of labor induction
3) Verbalizes readiness to become a mother
4) Maintains a good labor pattern with a reassuring FHR pattern

 

 

____     9.   During the induction process, a patient frequently asks, “What are you doing now?” or “What is that for?” Which nursing diagnosis is most appropriate for this patient?

1) Knowledge Deficit related to induction of labor
2) Fear/Anxiety
3) Risk for Injury
4) Altered Mental Status

 

 

____   10.   What will the nurse instruct the patient to do when the provider begins to apply traction to the vacuum extractor?

1) Hold her breath and count to 10
2) Push with the contraction
3) Turn to her left side
4) Pant to avoid pushing

 

 

____   11.   Which patient does the nurse identify as likely to require a Cesarean delivery?

1) Postterm
2) O-negative blood type
3) Active genital herpes
4) 35 weeks’ gestation

 

 

____   12.   Which patient does the nurse assess as most likely to be able to delivery vaginally rather than requiring a Cesarean delivery?

1) Active genital herpes
2) Fetal macrosomia
3) Multiple gestations
4) History of previous Cesarean section

 

 

____   13.   Which assessment data will the nurse obtain from a patient who is being prepared for a Cesarean section?

1) Cervical dilation and effacement
2) Obtain a signed consent form
3) Diet history for the past 8 hours
4) Insert an indwelling catheter

 

 

____   14.   Which medication is contraindicated immediately prior to performance of a Cesarean section?

1) Cefazolin 1 g IV
2) Famotidine 20 mg IV
3) Fentanyl 100 mcg IV
4) Citric acid-sodium citrate solution 30 mL PO

 

 

____   15.   When a patient is prepared for discharge post-Cesarean section, which teaching does the nurse provide?

1) Plan to be in the hospital for 3 to 5 days.
2) Arrange for help at home.
3) Keep hair on the lower abdomen and pubis clipped.
4) Avoid unnecessary activity for 2 weeks.

 

 

____   16.   Which teaching should the patient scheduled for a Cesarean birth receive during a routine visit with the provider 2 weeks prior to hospital admission?

1) Pack for 3 to 5 days in the hospital.
2) Obtain preoperative laboratory work.
3) Sign a consent for the operative procedure.
4) Maintain good hydration.

 

 

____   17.   The nurse assesses which patient as having the best chance of a successful vaginal birth after a Cesarean section?

1) The woman whose first and third children were born vaginally
2) The woman with well-controlled gestational diabetes
3) The woman whose last child is 12 months old and was born by Cesarean section
4) The woman requiring induction of labor 4 years after a Cesarean section

 

 

____   18.   When caring for a woman undergoing a trial of labor after Cesarean (TOLAC), the nurse most carefully observes for signs of what?

1) Macrosomia
2) Failure to progress
3) Anxiety
4) Uterine rupture

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____   19.   An immediate Cesarean section will need to be performed if the nurse assesses which signs or symptoms in a woman attempting vaginal birth after a prior Cesarean section? (Select all that apply.)

1) A popping sensation reported by the patient
2) Acute, continuous abdominal pain
3) Repetitive or prolonged fetal heart rate decelerations
4) Slow labor progression
5) Vaginal bleeding

 

 

____   20.   Prior to discharging a patient, following cephalic version, which teaching does the nurse provide? (Select all that apply.)

1) Teach the patient how to monitor for fetal activity and when to call the provider.
2) Teach the patient how to monitor the fetal heart rate and when to call the provider.
3) Teach the patient the signs of the rupture of membranes and when to return to the hospital.
4) Teach the patient the signs and symptoms of labor and when to return to the hospital.
5) Teach the patient the importance of receiving RhoGAM prior to delivery.

 

Chapter 12: Birth-Related Procedures

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  2

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Describe the amniotomy procedure and discuss nursing responsibilities.

Chapter page reference: 176

Heading: Amniotomy

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 A woman who is past her due date is a candidate for an amniotomy to promote labor.
2 The fetus in a breech position requires a Cesarean section if it cannot be repositioned; in addition, amniotomy could result in a prolapsed cordRemember, this patient is not a candidate for an amniotomy.
3 Hypertension is not a contraindication for amniotomy.
4 A history of precipitous delivery may make an amniotomy unnecessary, but it is not a contraindication.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Describe the amniotomy procedure and discuss nursing responsibilities.

Chapter page reference: 176

Heading: Amniotomy

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 A slight increase in temperature is expected during labor and does not need to be reported unless it exceeds 38°C.
2 Clear, odorless amniotic fluid is expected and does not need to be reported.
3 An abnormal FHR pattern can indicate a compressed umbilical cord and should be reported immediately.
4 Leakage of clear fluid from the vagina is expected and will continue because amniotic fluid continues to be produced.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Explain the purpose of an amnioinfusion.

Chapter page reference: 177

Heading: Amnioinfusion

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 A woman past her due date is not a candidate for amnioinfusion.
2 A woman carrying multiple gestations is not a candidate for amnioinfusion and would receive no benefit from the procedure.
3 The woman with oligohydramnios, or a reduction in amniotic fluid, is the best candidate for an amnioinfusion.
4 A woman carrying a fetus with a neural tube defect is not a candidate for amnioinfusion, and it is contraindicated for this woman.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Prepare patient teaching for the patient undergoing an external cephalic version.

Chapter page reference: 177

Heading: External Cephalic Version

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 It is important to explain that while the fetus has been repositioned, it is possible for fetal movement to cause repositioning to the breech position.
2 This is false reassurance and does not provide the most important information the woman needs.
3 Although the woman should be taught what to watch for and what to report, best response to her statement.
4 There is no need for the woman to increase fluid intake following this procedure.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Describe how a Bishop score is calculated and explain the significance of the score.

Chapter page reference: 179

Heading: Care of the Woman Undergoing Induction/Augmentation of Labor

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Teaching on the process of induction is not required because the woman’s score is too low for induction.
2 Fetal monitoring equipment should be explained when it is applied.
3 This teaching will be provided when induction has begun.
4 A score less than 5 means the patient’s cervix is not adequately ripened, and she is not a candidate for induction until chemical or mechanical cervical ripening is conducted. Thus, it is important to teach the patient what to expect.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Describe how a Bishop score is calculated and explain the significance of the score.

Chapter page reference: 179

Heading: Care of the Woman Undergoing Induction/Augmentation of Labor

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The patient receives 1 point for cervical dilation, 1 point for effacement, 2 points for station, 1 point for consistency, and 1 point for cervical position; the total score is 6, meaning the cervix is ripe and ready for induction.
2 This statement is inaccurate on the basis of the calculated Bishop score.
3 Cervical ripening is not questionable on the basis of the calculated Bishop score.
4 This statement is inaccurate on the basis of the calculated Bishop score.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Discuss methods used to ripen a cervix and induce contractions.

Chapter page reference: 179

Heading: Cervical Ripening

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Use of a Foley rarely results in complications and is the safest method of ripening the cervix.
2 Application of prostaglandin gel is relatively safe, but medication complications of fever, nausea and vomiting, headache, diarrhea, tachysystole, and fetal decelerations in response to tachysystole are possible.
3 Prepidil Endocervical Gel is a brand-name prostaglandin gel and carries possible complications because it is a medication.
4 Oxytocin administration carries the greatest potential side effects and is not the safest method of ripening the cervix.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Prepare a nursing care plan for the patient undergoing labor induction or augmentation.

Chapter page reference: 182

Heading: Nursing Care Plan for Induction of Labor

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Reduced anxiety is an outcome for the nursing diagnosis of Fear or Anxiety.
2 Verbalizing understanding is an outcome for a diagnosis of Knowledge Deficit.
3 Verbalizing readiness to become a mother is not an outcome for Risk for Injury.
4 A good labor pattern and reassuring FHR are a good outcome for a patient with a diagnosis of Risk for Injury related to labor and delivery.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Prepare a nursing care plan for the patient undergoing labor induction or augmentation.

Chapter page reference: 182

Heading: Nursing Care Plan for Induction of Labor

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The patient is demonstrating a Knowledge Deficit related to induction of labor and requires teaching to explain the procedure.
2 Although the questions may be related to Fear or Anxiety, that is not the most appropriate diagnosis for this patient.
3 Risk for Injury is not indicated according to the information provided.
4 There is no reason to suspect an Altered Mental Status because the questions are appropriate and coherent.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Differentiate between vacuum extractor and forceps used for assisted vaginal delivery.

Chapter page reference: 181

Heading: Vacuum Extraction—Assisted Birth

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The woman should not be instructed to hold her breath because this results in fetal hypoxia.
2 The woman should be instructed to push with the contraction to assist in delivering the fetus.
3 The woman needs to remain supine so the provider has access to the fetal head to attach the vacuum extractor.
4 Panting to avoid pushing is incorrect information to teach the client.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: List common indications for a cesarean delivery.

Chapter page reference: 183

Heading: Cesarean Birth

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 Although being postterm increases the risk of macrosomia, it does not automatically mean a Cesarean is required because most postterm pregnancies are delivered vaginally.
2 O-negative blood type does not have any impact on how the delivery is performed.
3 Active genital herpes is an indication for a Cesarean section, to avoid infecting the baby.
4 A fetus of 35 weeks’ gestation is small and more likely to be delivered vaginally.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: List common indications for a Cesarean delivery.

Chapter page reference: 183

Heading: Cesarean Birth

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 A woman with active genital herpes will be encouraged to deliver via Cesarean section to avoid infecting the fetus.
2 Fetal macrosomia is an indicator for Cesarean section.
3 Multiple gestations are often delivered by Cesarean section because of the increased likelihood that at least one of the fetuses will be malpositioned for vaginal delivery.
4 Some patients who had a previous Cesarean may be able to deliver vaginally, but this requires careful assessment.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Discuss nursing responsibilities when preparing a patient for a Cesarean birth.

Chapter page reference: 184-185

Heading: The Procedure of a Cesarean Birth

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 A patient who has a planned Cesarean section does not experience laborRemember, dilation and effacement are not required assessment data.
2 A signed consent form is needed, but this does not represent assessment data.
3 It is important to know what the patient ate and drank over the last 8 hours, because a Cesarean procedure is surgery and has risks of nausea and vomiting.
4 An indwelling catheter is inserted to keep the bladder empty, but this is an intervention and not assessment data.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Discuss nursing responsibilities when preparing a patient for a Cesarean birth.

Chapter page reference: 186

Heading: Drug Facts: Preoperative Medications

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Cefazolin (Ancef®) or other antibiotics are often administered prophylactically to avoid postoperative wound infection.
2 Famotidine (Pepcid®) is usually administered to reduce nausea and vomiting.
3 Fentanyl is a narcotic that causes respiratory depression in the neonateRemember, it is normally avoided preoperatively.
4 Citric acid-sodium citrate solution (Bicitra®) is an optional drug that may be given to reduce or prevent nausea and vomiting.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Plan patient teaching for a Cesarean birth.

Chapter page reference: 184

Heading: Health Promotion: Preparing for a Scheduled Cesarean Birth

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 If the patient is preparing for discharge, it is too late to tell her to prepare for 3 to 5 days.
2 The patient should be advised to seek help while she recovers, especially if she has small children at home.
3 There is no need for the hair to be clipped once the baby has been born.
4 Activity should be “as tolerated” and should be gradually increasedRemember, it is inaccurate to tell her to avoid unnecessary activity.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Plan patient teaching for a Cesarean birth.

Chapter page reference: 184

Heading: The Procedure of a Cesarean Birth

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The woman should be warned that she is likely to spend at least 3 to 5 days in the hospital after a Cesarean birth.
2 Preoperative laboratory work will be obtained within 72 hours of the scheduled procedureRemember, it is too soon to obtain it now.
3 The consent form will be signed on admission.
4 Good hydration should be maintained at all times, and this instruction is not needed at this time.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Identify the factors that indicate a patient is a good candidate for a vaginal birth after Cesarean (VBAC).

Chapter page reference: 186

Heading: Vaginal Birth After Cesarean

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 Having delivered a child vaginally in the past is a positive indicator of successful vaginal delivery after a Cesarean section.
2 Women with gestational diabetes, even when well controlled, are at increased risk for macrosomia, requiring a Cesarean section.
3 A recent Cesarean section is a poor indicator for vaginal birth.
4 The need for induction increases the risk of injury when attempting vaginal delivery following a Cesarean section.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Plan nursing care for the patient undergoing a trial of labor after Cesarean (TOLAC).

Chapter page reference: 186

Heading: Vaginal Birth After Cesarean

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Macrosomia should be ruled out before allowing the woman to attempt vaginal delivery.
2 Failure to progress is an ominous sign but not the most carefully observed sign.
3 Anxiety is not a negative sign, and some anxiety is expected.
4 Uterine rupture is the greatest risk of women delivering vaginally after a prior Cesarean sectionRemember, the nurse must observe the woman carefully for any signs of this potentially fatal complication.

 

 

PTS:   1                    CON:  Pregnancy

 

MULTIPLE RESPONSE

 

  1. ANS:  1, 2, 3, 5

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Plan nursing care for the patient undergoing a trial of labor after Cesarean (TOLAC).

Chapter page reference: 186

Heading: Vaginal Birth After Cesarean

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1. A popping sensation is a sign of uterine rupture and indicates the need for a Cesarean section.
2. Acute, continuous abdominal pain is a sign of uterine rupture and indicates the need for a Cesarean section.
3. Repetitive or prolonged fetal heart rate decelerations indicate fetal distress and may be an indication of uterine rupture, indicating the need for a Cesarean section.
4. Slow labor progression is not a sign of uterine rupture, and a Cesarean section is not required unless progression is excessively slow.
5. Vaginal bleeding must be assessed to determine if it is an indicator of uterine rupture, requiring an immediate Cesarean section.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1, 3, 4

Chapter number and title: 12: Birth-Related Procedures

Chapter learning objective: Prepare patient teaching for the patient undergoing an external cephalic version.

Chapter page reference: 177

Heading: External Cephalic Version

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1. It is important for the mother to monitor fetal movement and contact the provider if movement stops or declines.
2. The mother will have no way to monitor fetal heart rateRemember, this is not a required teaching.
3. The mother should be taught the signs of membrane rupture, a potential complication following cephalic version.
4. Cephalic version can induce laborRemember, the woman should be aware of the signs and symptoms of labor and when to return to the hospital.
5. RhoGAM administration is related to the mother’s blood type, not a cephalic version.

 

 

PTS:   1                    CON:  Pregnancy

 

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