Labor Pain Quiz

35 Questions | Total Attempts: 1461

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Labor Pain Quiz - Quiz


Questions and Answers
  • 1. 
    On completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, –1. What is a correct interpretation of the data?
    • A. 

      A. The fetal presenting part is 1 cm above the ischial spines

    • B. 

      B. Effacement is 4 cm from completion.

    • C. 

      C. Dilation is 50% completed.

    • D. 

      D. The fetus has achieved passage through the ischial spines.

  • 2. 
    A woman is in active labor with her first child when her membranes rupture. She voices a concern to the nurse that she is afraid of having a “dry labor.” Which of the following responses by the nurse would be MOST appropriate?  THIS MAY NOT BE ON THE EXAM
    • A. 

      . “The amniotic fluid provides only minimal lubrication for the labor process.”

    • B. 

      “The amniotic sac may impede the progress of labor and is often ruptured artificially.”

    • C. 

      “Labor is only slightly more difficult with early rupture of the amniotic sac.”

    • D. 

      “Because there is limited amniotic fluid, additional fluids will be supplied.”

  • 3. 
    A primipara is admitted in early labor, and her membranes rupture. Which of the following assessments by the nurse is MOST important?
    • A. 

      Determine the pH of the amniotic fluid.

    • B. 

      Evaluate the mother’s blood pressure.

    • C. 

      Check the monitor for decelerations.

    • D. 

      Assess for a prolapsed cord.

  • 4. 
    During the fourth stage of labor, the nurse should palpate the fundus? 
    • A. 

      Three cm below the umbilicus.

    • B. 

      At the umbilicus.

    • C. 

      Two cm above the umbilicus.

    • D. 

      to the right of the umbilicus.

  • 5. 
    The nurse is caring for a 22-year-old woman who is completing the first stage of labor. The woman’s husband is at her side and has been coaching her according to exercises they learned at natural childbirth classes. Suddenly the woman begins to shake and screams, “I can't stand this anymore!” The nurse should encourage the husband to?  MAY NOT BE ON TEST 
    • A. 

      Instruct his wife to use shallow respirations during the contractions.

    • B. 

      Offer his wife ice chips or sips of water to distract her from the pain.

    • C. 

      Stroke his wife’s abdomen between contractions.

    • D. 

      Review with his wife the breathing pattern needed at each stage of labor.

  • 6. 
    A 28-year-old woman at 39-weeks gestation in active labor screams, “I have to push, I have topush.” The nurse notes that the client is 8 cm dilated. The nurse should?  MAY NOT BE ON TEST 
    • A. 

      Instruct the client to take a deep breath and bear down.

    • B. 

      Apply gentle but firm fundal pressure to the client’s abdomen.

    • C. 

      Coach the client in relaxation techniques.

    • D. 

      Tell the client to pant with pursed lips.

  • 7. 
    The nurse discusses symptoms of the onset of labor with a 26-year-old primipara. Which of the following statements, if made by the client to the nurse, indicates a need for further teaching? THIS MAY NOT BE ON THE EXAM
    • A. 

      “I will note an increase in fetal movement.”

    • B. 

      “I may feel a gush of fluid run down my legs.”

    • C. 

      “I may see some blood in my vaginal discharge.”

    • D. 

      “I may experience a low backache.”

  • 8. 
    The nurse assesses a prolonged deceleration of the fetal heart rate while the client is receiving oxytocin IV to stimulate labor. The priority nursing intervention would be to
    • A. 

      Discontinue the infusion.

    • B. 

      Turn client to the left side.

    • C. 

      Change the fluids to LR.

    • D. 

      Increase the IV flow rate.

  • 9. 
    During a nonstress test (NST), the nurse observes several late decelerations. Which of the following nursing actions is MOST appropriate? THIS MAY NOT BE ON THE EXAM
    • A. 

      Reposition the client on her right side.

    • B. 

      Notify the physician for further evaluation.

    • C. 

      Document these results in the nurses notes.

    • D. 

      Stop the oxytocin (Pitocin) immediately.

  • 10. 
    The newborn infant of an HIV-positive mother is admitted to the nursery. Which of the following would the nurse include in the plan of care?
    • A. 

      Standard precautions.

    • B. 

      . Testing for HIV.

    • C. 

      Transfer to an acute care nursery facility.

    • D. 

      Request AZT from the pharmacy.

  • 11. 
    At 1 minute following birth, the newborn exhibited the following: heart rate of 155; loud, vigorous crying with active movement of all extremities; sneezing when nose is stimulated with a catheter; hands and feet bluish and cool to the touch. The Apgar score of this newborn should be recorded as? 
    • A. 

      5

    • B. 

      7

    • C. 

      9

    • D. 

      10

  • 12. 
    Which of the following rationales best explains why a pregnant client should lie on her left side when resting or sleeping in the later stages of pregnancy?
    • A. 

      To facilitate digestion

    • B. 

      To facilitate bladder emptying

    • C. 

      To prevent compression of vena cava

    • D. 

      . to avoid fetal anomalies

  • 13. 
    A woman with a term, uncomplicated pregnancy comes into L&D in early labor saying that she thinks her water broke. Which action should the nurse take?
    • A. 

      Prep the woman for delivery

    • B. 

      Note color, amt and odor of fluid

    • C. 

      Immediately contact doctor

    • D. 

      Collect sample of fluid for microbial analysis

  • 14. 
    A client at 42 weeks gest is 3cm dilated, 30% effaced, with membranes intact and the fetus at +2 station. FHR is at 140-150 bpm. After 2 hours, the nurse notes on the EFM that, for the past 10 min, the FHR ranged from 160-190bpm. The client states that her baby has been extremely active. UCs are strong, occurring every 3-4 min. and lasting 40-60 sec. Which of the following findings would indicate fetal hypoxia?
    • A. 

      Abnormally long UCs

    • B. 

      Abnormally strong uterine intensity

    • C. 

      Excessively frequent contractions with rapid fetal movement

    • D. 

      Excessive fetal activity and fetal tachycardia

  • 15. 
    The cervix of a 26 year old primigravida in labor is 5cm dilated and 75% effaced, and the fetus is at 0 station. The doctor prescribes an epidural regional block. Into which of the following positions should the nurse place the client when the epidural is admin?
    • A. 

      Lithotomy

    • B. 

      Supine

    • C. 

      Prone

    • D. 

      Lateral

  • 16. 
    Which of the following terms is used to describe the thinning and shortening of the cervix that occurs just before and during labor?
    • A. 

      Ballottement

    • B. 

      Dilation

    • C. 

      Effacement

    • D. 

      Muliparous

  • 17. 
    Which of the following fetal positions is most favorable for birth?
    • A. 

      Vertex (Cephalic,Longitudinal Lie)

    • B. 

      Transverse lie

    • C. 

      Frank breech presentation

  • 18. 
    Which of the following nursing actions is required before a client in labor receives an epidural?
    • A. 

      Give a fluid bolus of 500 ml

    • B. 

      Check for maternal pupil dilation

    • C. 

      assess maternal reflexes

    • D. 

      Assess maternal gait

  • 19. 
    When assessing a fetal heart rate (FHR) tracing, the nurse notes a decrease in the baseline rate from 155 to 110. The rate of 110 persists for more than 10 minutes. The nurse could attribute this decrease in baseline to:
    • A. 

      Maternal hyperthyroidism.

    • B. 

      Initiation of epidural anesthesia that resulted in maternal hypotension

    • C. 

      Maternal infection accompanied by fever.

    • D. 

      Alteration in maternal position from semirecumbent to lateral.

  • 20. 
    On review of a fetal monitor tracing, the nurse notes that for several contractions the fetal heart rate decelerates as a contraction begins and returns to baseline just before it ends. The nurse should:
    • A. 

      Describe the finding in the nurse's notes.

    • B. 

      Reposition the woman onto her side.

    • C. 

      Call the physician for instructions.

    • D. 

      Administer oxygen at 8 to 10 L/min with a tight face mask.

  • 21. 
    Which finding meets the criteria of a reassuring fetal heart rate (FHR) pattern? THIS MAY NOT BE ON THE EXAM
    • A. 

      FHR does not change as a result of fetal activity.

    • B. 

      Average baseline rate ranges between 100 and 140 beats/min.

    • C. 

      Mild late deceleration patterns occur with some contractions

    • D. 

      Variability averages between 6 to 10 beats/min.

  • 22. 
    Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position, and her vital signs are stable and fall within a normal range. Contractions are intense, last 90 seconds, and occur every 1½ to 2 minutes. The nurse's immediate action would be to:
    • A. 

      Change the woman's position.

    • B. 

      Stop the Pitocin.

    • C. 

      Elevate the woman's legs.

    • D. 

      Administer oxygen via a tight mask at 8 to 10 L/min.

  • 23. 
    As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is 1 day postpartum. An expected finding would be:
    • A. 

      Presence of soft, nontender colostrum

    • B. 

      Leakage of milk at let-down.

    • C. 

      Swollen, warm, and tender on palpation.

    • D. 

      A few blisters and a bruise on each areola.

  • 24. 
    When palpating the fundus of a woman 18 hours after birth, the nurse notes that it is firm, 2 fingerbreadths above the umbilicus, and deviated to the left of midline. The nurse should:
    • A. 

      Massage the fundus.

    • B. 

      Administer Methergine, 0.2 mg PO, that has been ordered prn.

    • C. 

      Assist the woman to empty her bladder.

    • D. 

      Recognize this as an expected finding during the first 24 hours following birth.

  • 25. 
    Which finding would be a source of concern if noted during the assessment of a woman who is 12 hours’ postpartum?  
    • A. 

      Postural hypotension

    • B. 

      Temperature of 100.4° F

    • C. 

      Bradycardia—pulse rate of 55 beats/min

    • D. 

      Pain in left calf with dorsiflexion of left foot

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