Chapter 14: CarŤng for the Search …
Woman ExperŤencŤng
ComplŤcatŤons DurŤng
Labor and BŤrth NursŤng
School Test Banks
Chapter 14: Caring for the Woman Experiencing
Complications During Labor and Birth
MULTIPLE CHOICE
1. The perinatal nurse explains to a nursing student that
the most appropriate patient for an amnioinfusion is a
woman who has a fetal heart rate tracing that exhibits
which pattern?
A. Absent variability
B. Early decelerations
1/40
,C. Late decelerations
D. Variable decelerations
ANS: D
Pregnancy outcome in patients experiencing variable fetal
heart rate decelerations caused by cord compression is
improved through the use of amnioinfusion, which is the
instillation of normal saline or lactated Ringers solution
into the uterine cavity.
Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy
PTS: 1
2. The perinatal nurse notes a rapid decrease in the fetal
heart rate (FHR) that does not recover immediately
following an amniotomy. What action should the nurse
perform first?
A. Administer oxygen at 100%.
B. Assess the maternal temperature.
C. Perform a vaginal examination.
D. Recheck the FHR in 30 minutes.
ANS: C
The nurse needs to assess the fetal heart rate immediately
before and after the artificial rupture of the membranes.
Changes such as transient fetal tachycardia may occur and
are common. However, other fetal heart rate patterns, such
as bradycardia and variable decelerations, may be indicative
of cord compression or prolapse. The nurse should
perform a vaginal examination to assess for cord prolapse.
Administering oxygen may or may not be needed. Maternal
temperature is assessed every 2 hours after artificial
rupture of membranes but is not related to this situation.
The nurse should not wait 30 minutes prior to doing
anything.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment:
2/40
,Management of Care
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate
PTS: 1
3. The perinatal nurse has administered a dose of
dinoprostone (Cervidil) to a woman prior to a labor
induction with oxytocin (Pitocin). The nurse then notices
that the admission database is incomplete. What conditions
should the nurse quickly question the patient about?
A. Asthma
B. Gallbladder disease
C. IV drug use
D. Penicillin allergy
ANS: A
Dinoprostone is a prostaglandin E2 preparation for
cervical ripening. It should be used cautiously in women
with a history of asthma, glaucoma, and renal, hepatic, or
cardiovascular disorders. Once the missing information is
noticed, the nurse should assess for contraindications to
using the medication, then for conditions that make it
riskier. The other conditions are not related.
Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological
and Parenteral Therapies
Integrated Process: Nursing Process: Assessment
Difficulty: Difficult
PTS: 1
4. During the postpartum assessment, the perinatal nurse
notes that a patient who has just experienced a forceps-
assisted birth now has a large amount of bright red vaginal
bleeding. Her uterine fundus is firm. The most appropriate
action by the nurse is to collaborate with the health-care
provider in which activity?
A. Bladder assessment and catheterization
B. Preparing the woman for a hysterectomy
C. Uterine massage and oxytocin infusion
D. Vaginal assessment and repair
3/40
, ANS: D
A forceps-assisted birth is one in which a steel instrument
with two curved blades is used to facilitate the birth of the
infants head. Perineal trauma is one of the major
complications associated with the use of forceps. Because
hemorrhage (bright red bleeding) may result from cervical
lacerations and vaginal tearing, the woman requires close
observation during the postpartum period. If this occurs,
the care provider should be notified regarding a potential
vaginal repair. The other actions are not warranted.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate
PTS: 1
5. The perinatal nurse is caring for a patient with
preeclampsia. What intervention does the nurse include on
this patients care plan?
A. Administer magnesium sulfate per agency policy.
B. Assess the patients blood pressure every 6 hours.
C. Encourage the patient to rest on her back.
D. Notify the physician of urine output greater than 30
mL/hr.
ANS: A
The nurse is the manager of care for the woman with
preeclampsia during the intrapartal period. Careful
assessments are critical. The nurse administers
medications as ordered and should adhere to hospital
protocol for a magnesium sulfate infusion. Vital signs
should be assessed more often than every 6 hours. The
patient should be encouraged to maintain a left side-lying
position. A urine output of greater than 30 mL/hour is
normal.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
4/40
Woman ExperŤencŤng
ComplŤcatŤons DurŤng
Labor and BŤrth NursŤng
School Test Banks
Chapter 14: Caring for the Woman Experiencing
Complications During Labor and Birth
MULTIPLE CHOICE
1. The perinatal nurse explains to a nursing student that
the most appropriate patient for an amnioinfusion is a
woman who has a fetal heart rate tracing that exhibits
which pattern?
A. Absent variability
B. Early decelerations
1/40
,C. Late decelerations
D. Variable decelerations
ANS: D
Pregnancy outcome in patients experiencing variable fetal
heart rate decelerations caused by cord compression is
improved through the use of amnioinfusion, which is the
instillation of normal saline or lactated Ringers solution
into the uterine cavity.
Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy
PTS: 1
2. The perinatal nurse notes a rapid decrease in the fetal
heart rate (FHR) that does not recover immediately
following an amniotomy. What action should the nurse
perform first?
A. Administer oxygen at 100%.
B. Assess the maternal temperature.
C. Perform a vaginal examination.
D. Recheck the FHR in 30 minutes.
ANS: C
The nurse needs to assess the fetal heart rate immediately
before and after the artificial rupture of the membranes.
Changes such as transient fetal tachycardia may occur and
are common. However, other fetal heart rate patterns, such
as bradycardia and variable decelerations, may be indicative
of cord compression or prolapse. The nurse should
perform a vaginal examination to assess for cord prolapse.
Administering oxygen may or may not be needed. Maternal
temperature is assessed every 2 hours after artificial
rupture of membranes but is not related to this situation.
The nurse should not wait 30 minutes prior to doing
anything.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment:
2/40
,Management of Care
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate
PTS: 1
3. The perinatal nurse has administered a dose of
dinoprostone (Cervidil) to a woman prior to a labor
induction with oxytocin (Pitocin). The nurse then notices
that the admission database is incomplete. What conditions
should the nurse quickly question the patient about?
A. Asthma
B. Gallbladder disease
C. IV drug use
D. Penicillin allergy
ANS: A
Dinoprostone is a prostaglandin E2 preparation for
cervical ripening. It should be used cautiously in women
with a history of asthma, glaucoma, and renal, hepatic, or
cardiovascular disorders. Once the missing information is
noticed, the nurse should assess for contraindications to
using the medication, then for conditions that make it
riskier. The other conditions are not related.
Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological
and Parenteral Therapies
Integrated Process: Nursing Process: Assessment
Difficulty: Difficult
PTS: 1
4. During the postpartum assessment, the perinatal nurse
notes that a patient who has just experienced a forceps-
assisted birth now has a large amount of bright red vaginal
bleeding. Her uterine fundus is firm. The most appropriate
action by the nurse is to collaborate with the health-care
provider in which activity?
A. Bladder assessment and catheterization
B. Preparing the woman for a hysterectomy
C. Uterine massage and oxytocin infusion
D. Vaginal assessment and repair
3/40
, ANS: D
A forceps-assisted birth is one in which a steel instrument
with two curved blades is used to facilitate the birth of the
infants head. Perineal trauma is one of the major
complications associated with the use of forceps. Because
hemorrhage (bright red bleeding) may result from cervical
lacerations and vaginal tearing, the woman requires close
observation during the postpartum period. If this occurs,
the care provider should be notified regarding a potential
vaginal repair. The other actions are not warranted.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate
PTS: 1
5. The perinatal nurse is caring for a patient with
preeclampsia. What intervention does the nurse include on
this patients care plan?
A. Administer magnesium sulfate per agency policy.
B. Assess the patients blood pressure every 6 hours.
C. Encourage the patient to rest on her back.
D. Notify the physician of urine output greater than 30
mL/hr.
ANS: A
The nurse is the manager of care for the woman with
preeclampsia during the intrapartal period. Careful
assessments are critical. The nurse administers
medications as ordered and should adhere to hospital
protocol for a magnesium sulfate infusion. Vital signs
should be assessed more often than every 6 hours. The
patient should be encouraged to maintain a left side-lying
position. A urine output of greater than 30 mL/hour is
normal.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
4/40
