Obstetrical Nursing – Intrapartum – NCLEX Quiz 3

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Questions: 10 | Attempts: 6,250 | Updated: Sep 15, 2023

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Obstetrical Nursing Intrapartum NCLEX Quiz 3 - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.

Questions and Answers

1.

A nurse is 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 of care and selects which of the following nursing interventions as the highest priority?
- A.
  
  Keeping the significant other informed of the progress of the labor
- B.
  
  Providing comfort measures
- C.
  
  Monitoring fetal heart rate
- D.
  
  Changing the client’s position frequently
Correct Answer
C. Monitoring fetal heart rate

Explanation
The priority is to monitor the fetal heart rate.

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2.

A maternity nurse is preparing to care for a pregnant client in labor who will be delivering twins. The nurse monitors the fetal heart rates by placing the external fetal monitor:
- A.
  
  Over the fetus that is most anterior to the mother’s abdomen
- B.
  
  Over the fetus that is most posterior to the mother’s abdomen
- C.
  
  So that each fetal heart rate is monitored separately
- D.
  
  So that one fetus is monitored for a 15-minute period followed by a 15 minute fetal monitoring period for the second fetus
Correct Answer
C. So that each fetal heart rate is monitored separately

Explanation
In a client with a multi-fetal pregnancy. each fetal heart rate is monitored separately.

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3.

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?
- A.
  
  Disseminated intravascular coagulation
- B.
  
  Chronic hypertension
- C.
  
  Infection
- D.
  
  Hemorrhage
Correct Answer
D. Hemorrhage

Explanation
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.

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4.

A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the newborn. the nurse assists in delivering the placenta. Which observation would indicate that the placenta has separated from the uterine wall and is ready for delivery?
- A.
  
  The umbilical cord shortens in length and changes in color
- B.
  
  A soft and boggy uterus
- C.
  
  Maternal complaints of severe uterine cramping
- D.
  
  Changes in the shape of the uterus
Correct Answer
D. Changes in the shape of the uterus

Explanation
Signs of placental separation include lengthening of the umbilical cord. a sudden gush of dark blood from the introitus (vaginal). a firmly contracted uterus. and the uterus changing from a discoid (like a disk) to a globular (like a globe) shape. The client may experience vaginal fullness. but not severe uterine cramping.

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5.

A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action?
- A.
  
  Place the client in Trendelenburg’s position
- B.
  
  Call the delivery room to notify the staff that the client will be transported immediately
- C.
  
  Gently push the cord into the vagina
- D.
  
  Find the closest telephone and stat page the physician
Correct Answer
A. Place the client in Trendelenburg’s position

Explanation
When cord prolapse occurs. prompt actions are taken to relieve cord compression and increase fetal oxygenation. The mother should be positioned with the hips higher than the head to shift the fetal presenting part toward the diaphragm. Oxygen at 8 to 10 L/min by face mask is delivered to the mother to increase fetal oxygenation.Options B and D: The nurse should push the call light to summon help. and other staff members should call the physician and notify the delivery room.Option C: No attempt should be made to replace the cord. The examiner. however. may place a gloved hand into the vagina and hold the presenting part off of the umbilical cord.

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6.

A maternity nurse is caring for a client with abruptio placenta and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation?
- A.
  
  Swelling of the calf in one leg
- B.
  
  Prolonged clotting times
- C.
  
  Decreased platelet count
- D.
  
  Petechiae. oozing from injection sites. and hematuria
Correct Answer
A. Swelling of the calf in one leg

Explanation
DIC is a state of diffuse clotting in which clotting factors are consumed. leading to widespread bleeding. Swelling and pain in the calf of one leg are more likely to be associated with thrombophlebitis.Options B. C. and D: Platelets are decreased because they are consumed by the process; coagulation studies show no clot formation (and are thus normal to prolong); and fibrin plugs may clog the microvasculature diffusely. rather than in an isolated area. The presence of petechiae. oozing from injection sites. and hematuria are signs associated with DIC.

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7.

A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present?
- A.
  
  Absence of abdominal pain
- B.
  
  A soft abdomen
- C.
  
  Uterine tenderness/pain
- D.
  
  Painless. bright red vaginal bleeding
Correct Answer
C. Uterine tenderness/pain

Explanation
In abruptio placentae. acute abdominal pain is present. Uterine tenderness and pain accompany placental abruption. especially with a central abruption and trapped blood behind the placenta. The abdomen will feel hard and board like on palpation as the blood penetrates the myometrium and causes uterine irritability. Observation of the fetal monitoring often reveals increased uterine resting tone. caused by failure of the uterus to relax in an attempt to constrict blood vessels and control bleeding.

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8.

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?
- A.
  
  Prepare the client for an ultrasound
- B.
  
  Obtain equipment for external electronic fetal heart monitoring
- C.
  
  Obtain equipment for a manual pelvic examination
- D.
  
  Prepare to draw a Hgb and Hct blood sample
Correct Answer
C. Obtain equipment for a manual pelvic examination

Explanation
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 can lead to maternal and fetal hemorrhage.Option A: A diagnosis of placenta previa is made by ultrasound.Option B: External fetal monitoring is crucial in evaluating the fetus that is at risk for severe hypoxia.Option D: The H/H levels are monitored. and external electronic fetal heart rate monitoring is initiated.

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9.

An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these findings. the nurse would prepare the client for:
- A.
  
  Complete bed rest for the remainder of the pregnancy
- B.
  
  Delivery of the fetus
- C.
  
  Strict monitoring of intake and output
- D.
  
  The need for weekly monitoring of coagulation studies until the time of delivery
Correct Answer
B. Delivery of the fetus

Explanation
The goal of management in abruptio placentae is to control the hemorrhage and deliver the fetus as soon as possible. Delivery is the treatment of choice if the fetus is at term gestation or if the bleeding is moderate to severe and the mother or fetus is in jeopardy.

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10.

A nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse would monitor the client closely for the risk of uterine rupture if which of the following occurred?
- A.
  
  Hypotonic contractions
- B.
  
  Forceps delivery
- C.
  
  Schultz delivery
- D.
  
  Weak bearing down efforts
Correct Answer
B. Forceps delivery

Explanation
Excessive fundal pressure. forceps delivery. violent bearing down efforts. tumultuous labor. and shoulder dystocia can place a woman at risk for traumatic uterine rupture. Hypotonic contractions and weak bearing down efforts do not alone add to the risk of rupture because they do not add to the stress on the uterine wall.

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Current Version
Sep 15, 2023

Quiz Edited by
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Sep 08, 2017

Quiz Created by
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Obstetrical Nursing – Intrapartum – NCLEX Quiz 3

A nurse is 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 of care and selects which of the following nursing interventions as the highest priority?

A maternity nurse is preparing to care for a pregnant client in labor who will be delivering twins. The nurse monitors the fetal heart rates by placing the external fetal monitor:

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?

A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the newborn. the nurse assists in delivering the placenta. Which observation would indicate that the placenta has separated from the uterine wall and is ready for delivery?

A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action?

A maternity nurse is caring for a client with abruptio placenta and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation?

A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present?

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?

An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these findings. the nurse would prepare the client for:

A nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse would monitor the client closely for the risk of uterine rupture if which of the following occurred?