NR327 Exam 2 Review Questions #6 Pain Management during Childbirth

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2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 1/9 (6) ✅ NR327 Exam 2 Re... view Questions #6 Pain Management during Childbirth (13) * Required 1. Email address * 2. 1. The nurse is preparing to perform Leopold's maneuvers. Why are Leopold's maneuvers used by practitioners? * Mark only one oval. a. To determine the status of the membranes b. To determine cervical dilation and effacement c. To determine the best location to assess the fetal heart rate d. To determine whether the fetus is in the posterior position 3. 2. Which comfort measure should a nurse use to assist a laboring woman to relax? * Mark only one oval. a. Recommend frequent position changes. b. Palpate her filling bladder every 15 minutes. c. Offer warm wet cloths to use on the client's face and neck. d. Keep the room lights lit so the client and her coach can see everything. 4. 3. Which assessment finding could indicate hemorrhage in the postpartum patient? * Mark only one oval. a. Elevated pulse rate b. Elevated blood pressure c. Firm fundus at the midline d. Saturation of two perineal pads in 4 hours 5. 4. Which is an essential part of nursing care for a laboring client? * Mark only one oval. a. Helping the woman manage the pain b. Eliminating the pain associated with labor c. Feeling comfortable with the predictable nature of intrapartal care d. Sharing personal experiences regarding labor and birth to decrease her anxiety https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 2/9 6. 5. A client at 40 weeks' gestation should be instructed to go to a hospital or birth center for evaluation when she experiences: * Mark only one oval. a. fetal movement. b. irregular contractions for 1 hour. c. a trickle of fluid from the vagina. d. thick pink or dark red vaginal mucus. 7. 6. Which client at term should go to the hospital or birth center the soonest after labor begins? * Mark only one oval. a. Gravida 2, para 1, who lives 10 minutes away b. Gravida 1, para 0, who lives 40 minutes away c. Gravida 2, para 1, whose first labor lasted 16 hours d. Gravida 3, para 2, whose longest previous labor was 4 hours 8. 7. A woman who is gravida 3, para 2, enters the intrapartum unit. The most important nursing assessments are: * Mark only one oval. a. contraction pattern, amount of discomfort, and pregnancy history. b. fetal heart rate, maternal vital signs, and the woman's nearness to birth. c. last food intake, when labor began, and cultural practices the couple desires. d. identification of ruptured membranes, the woman's gravida and para, and her support person. 9. 8. A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the client to be: * Mark only one oval. a. discharged home with a sedative. b. admitted for extended observation. c. admitted and prepared for a cesarean birth. d. discharged home to await the onset of true labor. 10. 9. The nurse auscultates the fetal heart rate and determines a rate of 152 bpm. Which nursing intervention is appropriate? * Mark only one oval. a. Inform the mother that the rate is normal. b. Reassess the fetal heart rate in 5 minutes because the rate is too high. c. Report the fetal heart rate to the physician or nurse-midwife immediately. d. Tell the mother that she is going to have a boy because the heart rate is fast https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 3/9 11. 10. Which should the nurse recognize as being associated with fetal compromise? * Mark only one oval. a. Active fetal movements b. Fetal heart rate in the 140s c. Contractions lasting 90 seconds d. Meconium-stained amniotic fluid 12. 11. The nurse is caring for a low-risk client in the active phase of labor. At which interval should the nurse assess the fetal heart rate? * Mark only one oval. a. Every 15 minutes b. Every 30 minutes c. Every 45 minutes d. Every 1 hour 13. 12. Which nursing assessment indicates that a woman who is in the second stage of labor is almost ready to give birth? * Mark only one oval. a. Bloody mucous discharge increases. b. The vulva bulges and encircles the fetal head. c. The membranes rupture during a contraction. d. The fetal head is felt at 0 station during the vaginal examination. 14. 13. During labor a vaginal examination should be performed only when necessary because of the risk of: * Mark only one oval. a. infection. b. fetal injury. c. discomfort. d. perineal trauma. 15. 14. A 25-year-old primigravida client is in the first stage of labor. She and her husband have been holding hands and breathing together through each contraction. Suddenly, the client pushes her husband's hand away and shouts, "Don't touch me!" This behavior is most likely: * Mark only one oval. a. abnormal labor. b. a sign that she needs analgesia. c. normal and related to hyperventilation. d. common during the transition phase of labor. https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 4/9 16. 15. At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is 110 bpm, and the infant is crying vigorously with the limbs flexed. The infant's trunk is pink, but the hands and feet are blue. The Apgar score for this infant is: * Mark only one oval. a. 7. b. 8. c. 9. d. 10. 17. 16. If a woman's fundus is soft 30 minutes after birth, the nurse's first response should be to: * Mark only one oval. a. massage the fundus. b. take the blood pressure. c. notify the physician or nurse-midwife. d. place the woman in Trendelenburg position. 18. 17. The nurse thoroughly dries the infant immediately after birth primarily to: * Mark only one oval. a. reduce heat loss from evaporation. b. stimulate crying and lung expansion. c. increase blood supply to the hands and feet. d. remove maternal blood from the skin surface. 19. 18. The nurse notes that a client who has given birth 1 hour ago is touching her infant with her fingertips and talking to him softly in high-pitched tones. Based on this observation, which action should the nurse take? * Mark only one oval. a. Request a social service consult for psychosocial support. b. Observe for other signs that the mother may not be accepting of the infant. c. Document this evidence of normal early maternal-infant attachment behavior. d. Determine whether the mother is too fatigued to interact normally with her infant. 20. 19. Which nursing diagnosis would take priority in the care of a primipara client with no visible support person in attendance who has entered the second stage of labor after a first stage of labor lasting 4 hours? * Mark only one oval. a. Fluid volume deficit (FVD) related to fluid loss during labor and birth process b. Fatigue related to length of labor requiring increased energy expenditure c. Acute pain related to increased intensity of contractions d. Anxiety related to imminent birth process https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 5/9 21. 20. Which of the following behaviors would be applicable to a nursing diagnosis of risk for injury in a client who is in labor? * Mark only one oval. a. Length of second-stage labor is 2 hours. b. Client has received an epidural for pain control during the labor process. c. Client is using breathing techniques during contractions to maximize pain relief. d. Client is receiving parenteral fluids during the course of labor to maintain hydration. 22. 21. A gravida 1, para 0, 38 weeks' gestation is in the transition phase of labor with SROM and is very anxious. Vaginal exam, 8 cm, 100% effaced, -1 station vertex presentation. She wants the nurse to keep checking her by performing repeated vaginal exams because she is sure that she is progressing rapidly. What is the best response that the nurse can provide to this client at this time? * Mark only one oval. a. Performing more frequent vaginal exams will not make the labor go any quicker. b. Even though she is in transition, frequent vaginal exams must be limited because of the potential for infection. c. Tell the client that she will check every 30 minutes. d. Medicate the client as needed for anxiety so that the labor can progress. 23. 22. When using the second Leopold's maneuver in fetal assessment, the nurse would palpate (the): * Mark only one oval. a. both sides of the maternal abdomen. b. lower abdomen above the symphysis pubis. c. both upper quadrants of the maternal abdomen . d. lower abdomen for flexion of the presenting part. 24. 23. A nursing priority during admission of a laboring client who has not had prenatal care is: * Mark only one oval. a. obtaining admission labs. b. identifying labor risk factors. c. discussing her birth plan choices. d. explaining importance of prenatal care. 25. 24. The nurse has given the newborn an Apgar score of 5. She should then: * Mark only one oval. a. begin ventilation and compressions. b. do nothing except place the infant under a radiant warmer. c. observe the infant and recheck the score after 10 minutes. d. gently stimulate by rubbing the infant's back while administering O2. https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 6/9 26. 25. The client in labor experiences a spontaneous rupture of membranes. What information related to this event must the nurse include in the client's record? * Mark only one oval. a. Fetal heart rate b. Pain level c. Test results ensuring that the fluid is not urine d. The client's understanding of the event 27. 26. At 5 minutes after birth, the nurse assesses that the neonate's heart rate is 96 bpm, respirations are spontaneous, with a strong cry, body posture is flexed with vigorous movement, reflexes are brisk, and there is cyanosis of the hands and feet. What Apgar score will the nurse assign? * Mark only one oval. a. 7 b. 8 c. 9 d. 10 28. 27. The gynecologist performs an amniotomy. What will the nurse's role include immediately following the procedure? * Mark only one oval. a. Assessing for ballottement b. Conducting a pH and/or fern test c. Labeling of specimens for chromosomal analysis d. Recording the character and amount of amniotic fluid 29. 28. The nurse assesses the amniotic fluid. Which characteristic presents the lowest risk of fetal complications? * Mark only one oval. a. Bloody b. Clear with bits of vernix caseosa c. Green and thick d. Yellow and cloudy with foul odor 30. 29. The nurse assists the midwife during a vaginal examination of the client in labor. What does the nurse recognize as the primary reason that a vaginal exam is done at this time? * Mark only one oval. a. To apply internal monitoring electrodes b. To assess for Goodell's sign c. To determine cervical dilation and effacement d. To determine strength of contractions https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 7/9 31. 30. A woman arrives to the labor and birth unit at term. She is greeted by a staff nurse and a nursing student. The student reviews the initial intake assessment with the staff nurse. Which action will the staff nurse have to correct? * Mark only one oval. a. Obtain a fetal heart rate. b. Determine the estimated due date. c. Auscultate anterior and posterior breath sounds. d. Ask the client when she last had something to eat. 32. 31. The health care provider has asked the nurse to prepare for an amniotomy. What is the nurse's priority action with this procedure? * Mark only one oval. a. Perform Leopold's maneuvers. b. Determine the color of the amniotic fluid. c. Assess the fetal heart rate immediately after the procedure. d. Prepare the patient for a change in her pain level after the procedure. 33. 32. The nurse is preparing to initiate intravenous (IV) access on a patient in the active phase of labor. Which size IV cannula is best for this patient? * Mark only one oval. a. 18-gauge b. 20-gauge c. 22-gauge d. 24-gauge 34. 33. The nurse notes a concerning fetal heart rate pattern for a patient in active labor. The health care provider has prescribed the placement of a Foley catheter. What priority nursing action will the nurse implement when placing the catheter? * Mark only one oval. a. Place the catheter as quickly as possible. b. Place a small pillow under the patient's left hip. c. Omit the use of a cleansing agent, such as Betadine. d. Set up the catheter tray before positioning the patient. 35. 34. The nurse examines a primipara's cervix at 8-9/100%/+2; it is tight against the fetal head. The patient reports a strong urge to bear down. What is the nurse's priority action? * Mark only one oval. a. Palpate her bladder for fullness. b. Assess the frequency and duration of her contractions. c. Determine who will stay with the patient for the birth. d. Encourage the patient to exhale in short breaths with contractions. https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 8/9 36. 35. The labor nurse is reviewing the cardinal maneuvers with a group of nursing students. Which maneuver will immediately follow the birth of the baby's head? * Mark only one oval. a. Expulsion b. Restitution c. Internal rotation d. External rotation 37. 36. The nurse is performing Leopold's maneuvers on a client. Which figure depicts the Leopold's maneuver that determines whether the fetal presenting part is engaged in the maternal pelvis. Refer to Figures a to d. * Mark only one oval. a. b. c. d. 38. 37. A laboring client is 10 cm dilated but does not feel the urge to push. The nurse understands that according to laboring down, the advantages of waiting until an urge to push are which of the following? (Select all that apply.) * Check all that apply. a. Less maternal fatigue b. Less birth canal injuries c. Decreased pushing time d. Faster descent of the fetus e. An increase in frequency of contractions 39. 38. Which interventions should be performed in the birth room to facilitate thermoregulation of the newborn? (Select all that apply.) * Check all that apply. a. Place the infant covered with blankets in the radiant warmer. b. Dry the infant off with sterile towels. c. Place stockinette cap on infant's head. d. Bathe the newborn within 30 minutes of birth. e. Remove wet linen as needed. 40. 39. When taking care of a client in labor who is not considered to be at risk, which assessments should be included in the plan of care? (Select all that apply.) * Check all that apply. a. Check the DTR each shift. b. Monitor and record vital signs frequently during the course of labor. c. Document the FHR pattern, noting baseline and response to contraction patterns. d. Indicate on the EFM tracing when maternal position changes are done. e. Provide food, as tolerated, during the course of labor. https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com2/5/2019 (6) ✅ NR327 Exam 2 Review Questions #6 Pain Management during Childbirth (13) https://docs.google.com/forms/d/1eBA83QIizjZiyGPCXR18wbU7BrdbpNZC7kJ5v4I_4bs/edit 9/9 Powered by 41. 40. Which interventions are required following an amniotomy procedure? (Select all that apply.) * Check all that apply. a. Notation related to amount of fluid expelled b. Color and consistency of fluid c. Fetal heart rate d. Maternal blood pressure e. Maternal heart rate 42. 41. The nurse is monitoring a client in the active stage of labor. Which conditions associated with fetal compromise should the nurse monitor? (Select all that apply.) * Check all that apply. a. Maternal hypotension b. Fetal heart rate of 140 to 150 bpm c. Meconium-stained amniotic fluid d. Maternal fever—38° C (100.4° F) or higher e. Complete uterine relaxation of more than 30 seconds between contractions 43. 42. The nurse is caring for a client in the fourth stage of labor. Which assessment findings should the nurse identify as a potential complication? (Select all that apply.) * Check all that apply. a. Soft boggy uterus b. Maternal temperature of 99° F c. High uterine fundus displaced to the right d. Intense vaginal pain unrelieved by analgesics e. Half of a lochia pad saturated in the first hour after birth 44. 43. The nurse in the birth room receives an order to give a newborn 0.3 mg of naloxone (Narcan) intramuscularly. The medication vial reads naloxone (Narcan), 0.4 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Fill in the blank and record your answer using two decimal places. _____ mL. Use a leading zero if necessary. * Send me a copy of my responses. https://www.coursehero.com/file/37570029/6-NR327-Exam-2-Review-Questions-6-Pain-Management-during-Childbirth-13pdf/ This study resource was shared via CourseHero.com Powered by TCPDF (www.tcpdf.org) [Show More]

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