Maternity Nursing Test II- Www.Rnpedia.Com

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1. As soon as the placenta is delivered, the nurse must do which of the following actions?

Explanation

The placenta must be inspected for completeness to include the membranes because an incomplete placenta could mean that there is retention of placental fragments which can lead to uterine atony. If the uterus does not contract adequately, hemorrhage can occur.

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Maternity Nursing Test II- Www.Rnpedia.Com - Quiz

Mark the letter of the letter of choice then click on the next button. Score will be posted as soon as the you are done with the quiz.... see moreYou got 60 minutes to finish the exam. Good luck! see less

2. The first thing that a nurse must ensure when the baby’s head comes out is

Explanation

The nurse should check right away for possible cord coil around the neck because if it is present, the baby can be strangulated by it and the fetal head will have difficulty being delivered.

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3. The normal umbilical cord is composed of:

Explanation

The umbilical cord is composed of 2 arteries and 1 vein.

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4.  To ensure that the baby will breath as soon as the head is delivered, the nurse’s priority action is to

Explanation

Suctioning the nose and mouth of the fetus as soon as the head is delivered will remove any obstruction that maybe present allowing for better breathing. Also, if mucus is in the nose and mouth, aspiration of the mucus is possible which can lead to aspiration pneumonia. (Remember that only the baby’s head has come out as given in the situation.)

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5. The drug usually given parentally to enhance uterine contraction is:

Explanation

The common oxytocin given to enhance uterine contraction is pitocin. This is also the drug given to induce labor.

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6. When the bag of waters ruptures, the nurse should check the characteristic of the amniotic fluid. The normal color of amniotic fluid is


Explanation

The normal color of amniotic fluid is clear like water. If it is yellowish, there is probably Rh incompatibility. If the color is greenish, it is probably meconium stained.

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7. The partograph is a tool used to monitor labor. The maternal parameters measured/monitored are the following EXCEPT:

Explanation

Partograph is a monitoring tool designed by the World Health Organization for use by health workers when attending to mothers in labor especially the high risk ones. For maternal parameters all of the above is placed in the partograph except the fluid intake since this is placed in a separate monitoring sheet.

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8. The following are common causes of dysfunctional labor. Which of these can a nurse, on her own manage?

Explanation

Full bladder can impede the descent of the fetal head. The nurse can readily manage this problem by doing a simple catheterization of the mother.

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9. The mechanisms involved in fetal delivery is


Explanation

The mechanism of fetal delivery begins with descent into the pelvic inlet which may occur several days before true labor sets in the primigravida. Flexion, internal rotation and extension are mechanisms that the fetus must perform as it accommodates through the passageway/birth canal. Eternal rotation is done after the head is delivered so that the shoulders will be easily delivered through the vaginal introitus.

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10. When the bag of waters ruptures spontaneously, the nurse should inspect the vaginal introitus for possible cord prolapse. If there is part of the cord that has prolapsed into the vaginal opening the correct nursing intervention is:

Explanation

The correct action of the nurse is to cover the cord with sterile gauze wet with sterile NSS. Observe strict asepsis in the care of the cord to prevent infection. The cord has to be kept moist to prevent it from drying. Don’t attempt to put back the cord into the vagina but relieve pressure on the cord by positioning the mother either on trendellenberg or sims position

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11. When the fetal head is at the level of the ischial spine, it is said that the station of the head is

Explanation

Station is defined as the relationship of the fetal head and the level of the ischial spine. At the level of the ischial spine, the station is “0”. Above the ischial spine it is considered (-) station and below the ischial spine it is (+) station.

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12. The basic delivery set for normal vaginal delivery includes the following instruments/articles EXCEPT:

Explanation

For normal vaginal delivery, the nurse needs only the instruments for cutting the umbilical cord such as: 2 clamps (straight or curve) and a pair of scissors as well as the kidney basin to receive the placenta. The retractor is not part of the basic set. In the hospital setting, needle holder and tissue forceps are added especially if the woman delivering the baby is a primigravida wherein episiotomy is generally done.

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13.  In a gravido-cardiac mother, the first 2 hours postpartum (4th stage of labor and delivery) particularly in a cesarean section is a critical period because at this stage

Explanation

During the pregnancy, there is an increase in maternal blood volume to accommodate the need of the fetus. When the baby and placenta have been delivered, there is a fluid shift back to the maternal circulation as part of physiologic adaptation during the postpartum period. In cesarean section, the fluid shift occurs faster because the placenta is taken out right after the baby is delivered giving it less time for the fluid shift to gradually occur.

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14. The second stage of labor begins with ___ and ends with __?

Explanation

Stage 2 of labor and delivery process begins with full dilatation of the cervix and ends with the delivery of baby. Stage 1 begins with true labor pains and ends with full dilatation and effacement of the cervix.

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15. When the shiny portion of the placenta comes out first, this is called the ___ mechanism.


Explanation

There are 2 mechanisms possible during the delivery of the placenta. If the shiny portion comes out first, it is called the Schultze mechanism; while if the meaty portion comes out first, it is called the Duncan mechanism.

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16. When the baby’s head is out, the immediate action of the nurse is

Explanation

he nurse should check if there is a cord coil because the baby will not be delivered safely if the cord is coiled around its neck. Wiping of the face should be done seconds after you have ensured that there is no cord coil but suctioning of the nose should be done after the mouth because the baby is a “nasal obligate” breather. If the nose is suctioned first before the mouth, the mucus plugging the mouth can be aspirated by the baby.

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17. When the nurse palpates the suprapubic area of the mother and found that the presenting part is still movable, the right term for this observation that the fetus is

Explanation

The term floating means the fetal presenting part has not entered/descended into the pelvic inlet. If the fetal head has entered the pelvic inlet, it is said to be engaged.

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18. The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by forceps under epidural anesthesia. The main rationale for this is:

Explanation

Forceps delivery under epidural anesthesia will make the delivery process less painful and require less effort to push for the mother. Pushing requires more effort which a compromised heart may not be able to endure.

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19. Upon assessment, the nurse got the following findings: 2 perineal pads highly saturated with blood within 2 hours post partum, PR= 80 bpm, fundus soft and boundaries not well defined. The appropriate nursing diagnosis is:

Explanation

All the signs in the stem of the question are signs of hemorrhage. If the fundus is soft and boundaries not well defined, the cause of the hemorrhage could be uterine atony.

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20. The following are correct statements about false labor EXCEPT

Explanation

In false labor, the contractions remain to be irregular in intensity and duration while in true labor, the contractions become stronger, longer and more frequent.

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21. The peak point of a uterine contraction is called the

Explanation

Acme is the technical term for the highest point of intensity of a uterine contraction.

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22. The placenta should be delivered normally within ___ minutes after the delivery of the baby.

Explanation

The placenta is delivered within 30 minutes from the delivery of the baby. If it takes longer, probably the placenta is abnormally adherent and there is a need to refer already to the obstetrician.

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23. When determining the duration of a uterine contraction the right technique is to time it from

Explanation

Duration of a uterine contraction refers to one contraction. Thus it is correctly measure from the beginning of one contraction to the end of the same contraction and not of another contraction.

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24.  In the Philippines, if a nurse performs abortion on the mother who wants it done and she gets paid for doing it, she will be held liable because

Explanation

Induced Abortion is illegal in the country as stated in our Penal Code and any person who performs the act for a fee commits a grave offense punishable by 10-12 years of imprisonment.

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25. To monitor the frequency of the uterine contraction during labor, the right technique is to time the contraction

Explanation

Frequency of the uterine contraction is defined as from the beginning of one contraction to the beginning of another contraction.

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26. At what stage of labor and delivery does a primigravida differ mainly from a multigravida?


Explanation

In stage 1 during a normal vaginal delivery of a vertex presentation, the multigravida may have about 8 hours labor while the primigravida may have up to 12 hours labor.

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27. The lower limit of viability for infants in terms of age of gestation is:


Explanation

Viability means the capability of the fetus to live/survive outside of the uterine environment. With the present technological and medical advances, 21 weeks AOG is considered as the minimum fetal age for viability.

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28. The following are signs that the placenta has detached EXCEPT:

Explanation

Placental detachment does not require the mother to bear down. A normal placenta will detach by itself without any effort from the mother.

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29.  The primary power involved in labor and delivery is

Explanation

Uterine contraction is the primary force that will expel the fetus out through the birth canal Maternal bearing down is considered the secondary power/force that will help push the fetus out.

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30. The fetal heart beat should be monitored every 15 minutes during the 2nd stage of labor. The characteristic of a normal fetal heart rate is

Explanation

The normal fetal heart rate will decelerate (go down) slightly during a contraction because of the compression on the fetal head. However, the heart rate should go back to the pre-contraction rate as soon as the contraction is over since the compression on the head has also ended.

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31. When doing perineal care in preparation for delivery, the nurse should observe the following EXCEPT

Explanation

Painting of the perineal area in preparation for delivery of the baby must always be done but the stroke should be from the perineum going outwards to the thighs. The perineal area is the one being prepared for the delivery and must be kept clean

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32. When delivering the baby’s head the nurse supports the mother’s perineum to prevent tear. This technique is called

Explanation

Ritgen’s technique is done to prevent perineal tear. This is done by the nurse by support the perineum with a sterile towel and pushing the perineum downard with one hand while the other hand is supporting the baby’s head as it goes out of the vaginal opening.

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33. In vaginal delivery done in the hospital setting, the doctor routinely orders an oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because:

Explanation

The action of oxytocin is to make the uterus contract as well make the cervix close. If it is given prior to placental delivery, the placenta will be trapped inside because the action of the drug is almost immediate if given parentally.

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34. Which of the following techniques during labor and delivery can lead to uterine inversion?

Explanation

When the placenta is still attached to the uterine wall, tugging on the cord while the uterus is relaxed can lead to inversion of the uterus. Light tugging on the cord when placenta has detached is alright in order to help deliver the placenta that is already detached.

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35. At what stage of labor is the mother is advised to bear down?

Explanation

The primary power of labor and delivery is the uterine contraction. This should be augmented by the mother’s bearing down during a contraction.

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36. The normal dilatation of the cervix during the first stage of labor in a nullipara is

Explanation

For nullipara the normal cervical dilatation should be 1.2 cm/hr. If it is less than that, it is considered a protracted active phase of the first stage. For multipara, the normal cervical dilatation is 1.5 cm/hr.

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37. Which of the following conditions will lead to a small-for-gestational age fetus due to less blood supply to the fetus?

Explanation

In general, when the heart is compromised such as in maternal cardiac condition, the condition can lead to less blood supply to the uterus consequently to the placenta which provides the fetus with the essential nutrients and oxygen. Thus if the blood supply is less, the baby will suffer from chronic hypoxia leading to a small-for-gestational age condition.

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38. The following are signs and symptoms of fetal distress EXCEPT:

Explanation

The normal range of FHR is 120-160 bpm, strong and regular. During a contraction, the FHR usually goes down but must return to its pre-contraction rate after the contraction ends.

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39. The following are types of breech presentation EXCEPT:

Explanation

Breech presentation means the buttocks of the fetus is the presenting part. If it is only the foot/feet, it is considered footling. If only the buttocks, it is frank breech. If both the feet and the buttocks are presenting it is called complete breech.

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40. The fetal heart rate is checked following rupture of the bag of waters in order to:


Explanation

After the rupture of the bag of waters, the cord may also go with the water because of the pressure of the rupture and flow. If the cord goes out of the cervical opening, before the head is delivered (cephalic presentation), the head can compress on the cord causing fetal distress. Fetal distress can be detected through the fetal heart tone. Thus, it is essential do check the FHB right after rupture of bag to ensure that the cord is not being compressed by the fetal head.

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41. During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the mother at the upper quadrant. The interpretation is that the position of the fetus is:


Explanation

The landmark used in determine fetal position is the posterior fontanel because this is the nearest to the occiput. So if the nurse palpated the occiput (O) at the left (L) side of the mother and at the upper/anterior (A) quadrant then the fetal position is LOA.

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42. If the labor period lasts only for 3 hours, the nurse should suspect that the following conditions may occur:
1.Laceration of cervix
2.Laceration of perineum
3.Cranial hematoma in the fetus
4.Fetal anoxia

Explanation

all the above conditions can occur following a precipitate labor and delivery of the fetus because there was little time for the baby to adapt to the passageway. If the presentation is cephalic, the fetal head serves as the main part of the fetus that pushes through the birth canal which can lead to cranial hematoma, and possible compression of cord may occur which can lead to less blood and oxygen to the fetus (hypoxia). Likewise the maternal passageway (cervix, vaginal canal and perineum) did not have enough time to stretch which can lead to laceration.

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43. When giving narcotic analgesics to mother in labor, the special consideration to follow is:

Explanation

Narcotic analgesics must be given when uterine contractions are already well established so that it will not cause stoppage of the contraction thus protracting labor. Also, it should be given when delivery of fetus is imminent or too close because the fetus may suffer respiratory depression as an effect of the drug that can pass through placental barrier.

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44. The proper technique to monitor the intensity of a uterine contraction is

Explanation

In monitoring the intensity of the contraction the best place is to place the fingertips at the fundal area. The fundus is the contractile part of the uterus and the fingertips are more sensitive than the palm of the hand.

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45. What are the important considerations that the nurse must remember after the placenta is delivered?
1.Check if the placenta is complete including the membranes
2.Check if the cord is long enough for the baby
3.Check if the umbilical cord has 3 blood vessels
4.Check if the cord has a meaty portion and a shiny portion

Explanation

The nurse after delivering the placenta must ensure that all the cotyledons and the membranes of the placenta are complete. Also, the nurse must check if the umbilical cord is normal which means it contains the 3 blood vessels, 2 veins and 1 artery.

Submit
46. The passageway in labor and deliver of the fetus include the following EXCEPT

Explanation

The pelvis is a bony structure that is part of the passageway but is not flexible. The lower uterine segment including the cervix as well as the vaginal canal and introitus are all part of the passageway in the delivery of the fetus.

Submit
47. The following are natural childbirth procedures EXCEPT:

Explanation

Ritgen’s method is used to prevent perineal tear/laceration during the delivery of the fetal head. Lamaze method is also known as psychoprophylactic method and Dick-Read method are commonly known natural childbirth procedures which advocate the use of non-pharmacologic measures to relieve labor pain.

Submit
48. Which provision of our 1987 constitution guarantees the right of the unborn child to life from conception is

Explanation

The Philippine Constitution of 1987 guarantees the right of the unborn child from conception equal to the mother as stated in Article II State Policies, Section 12.

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49. The cervical dilatation taken at 8:00 A.M. in a G1P0 patient was 6 cm. A repeat I.E. done at 10 A.M. showed that cervical dilation was 7 cm. The correct interpretation of this result is:

Explanation

The active phase of Stage I starts from 4cm cervical dilatation and is expected that the uterus will dilate by 1cm every hour. Since the time lapsed is already 2 hours, the dilatation is expected to be already 8 cm. Hence, the active phase is protracted.

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50. When shaving a woman in preparation for cesarean section, the area to be shaved should be from ___ to ___

Explanation

Shaving is done to prevent infection and the area usually shaved should sufficiently cover the area for surgery, cesarean section. The pubic hair is definitely to be included in the shaving

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As soon as the placenta is delivered, the nurse must do which of the...
The first thing that a nurse must ensure when the baby’s head comes...
The normal umbilical cord is composed of:
 To ensure that the baby will breath as soon as the head is...
The drug usually given parentally to enhance uterine contraction is:
When the bag of waters ruptures, the nurse should check the ...
The partograph is a tool used to monitor labor. The maternal...
The following are common causes of dysfunctional labor. Which of these...
The mechanisms involved in fetal delivery is
When the bag of waters ruptures spontaneously, the nurse should ...
When the fetal head is at the level of the ischial spine, it is said...
The basic delivery set for normal vaginal delivery includes the...
 In a gravido-cardiac mother, the first 2 hours postpartum (4th ...
The second stage of labor begins with ___ and ends with __?
When the shiny portion of the placenta comes out first, this is called...
When the baby’s head is out, the immediate action of the nurse is
When the nurse palpates the suprapubic area of the mother and found ...
The preferred manner of delivering the baby in a gravido-cardiac is ...
Upon assessment, the nurse got the following findings: 2 perineal ...
The following are correct statements about false labor EXCEPT
The peak point of a uterine contraction is called the
The placenta should be delivered normally within ___ minutes after the...
When determining the duration of a uterine contraction the right...
 In the Philippines, if a nurse performs abortion on the mother...
To monitor the frequency of the uterine contraction during labor, the...
At what stage of labor and delivery does a primigravida differ mainly...
The lower limit of viability for infants in terms of age of gestation...
The following are signs that the placenta has detached EXCEPT:
 The primary power involved in labor and delivery is
The fetal heart beat should be monitored every 15 minutes during ...
When doing perineal care in preparation for delivery, the nurse should...
When delivering the baby’s head the nurse supports the mother’s...
In vaginal delivery done in the hospital setting, the doctor ...
Which of the following techniques during labor and delivery can lead...
At what stage of labor is the mother is advised to bear down?
The normal dilatation of the cervix during the first stage of labor in...
Which of the following conditions will lead to a small-for-gestational...
The following are signs and symptoms of fetal distress EXCEPT:
The following are types of breech presentation EXCEPT:
The fetal heart rate is checked following rupture of the bag of waters...
During an internal examination, the nurse palpated the ...
If the labor period lasts only for 3 hours, the nurse should suspect...
When giving narcotic analgesics to mother in labor, the special...
The proper technique to monitor the intensity of a uterine contraction...
What are the important considerations that the nurse must remember...
The passageway in labor and deliver of the fetus include the following...
The following are natural childbirth procedures EXCEPT:
Which provision of our 1987 constitution guarantees the right of the...
The cervical dilatation taken at 8:00 A.M. in a G1P0 patient was 6 ...
When shaving a woman in preparation for cesarean section, the area to...
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