Chapter 24 Childbirth at Risk, Labor-Related Complications
1) What would be a normal cervical dilatation rate in a first-time mother
(primip)?
1. 1.5 cm per hour
2. Less than 1 cm cervical dilatation per hour
3. 1 cm per hour
4. Less than 0.5 cm per hour
Answer: 1
Explanation: 1. Dilatation in a multip is about 1.5 cm per hour.
Page Ref: 596
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1 Discuss dysfunctional labor patterns.
MNL LO: 3.4.3 Discuss abnormalities of conditions associated with, and
management of labor dystocia.
2) Dystocia encompasses many problems in labor. What is the most
common?
1. Meconium-stained amniotic fluid
2. Dysfunctional uterine contractions
3. Cessation of contractions
4. Changes in the fetal heart rate
,Answer: 2
Explanation: 2. The most common problem is dysfunctional (or
uncoordinated) uterine contractions that result in a prolongation of labor.
Page Ref: 596
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1 Discuss dysfunctional labor patterns.
MNL LO: 3.4.3 Discuss abnormalities of conditions associated with, and
management of labor dystocia.
1
Copyright 2016 Pearson Education, Inc.
3) Risk factors for tachysystole include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Cocaine use
2. Placental abruption
3. Low-dose oxytocin titration regimens
4. Uterine rupture
5. Smoking
Answer: 1, 2, 4
Explanation: 1. Cocaine use is a risk factor for tachysystole.
2. Placental abruption is a risk factor for tachysystole.
4. Uterine rupture is a risk factor for tachysystole.
,Page Ref: 597
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 12. Create a safe environment that results
in high quality patient outcomes. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient
care. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1 Discuss dysfunctional labor patterns.
MNL LO: 3.4.3 Discuss abnormalities of conditions associated with, and
management of labor dystocia.
4) A woman has been having contractions since 4 a.m. At 8 a.m., her cervix
is dilated to 5 cm. Contractions are frequent, and mild to moderate in
intensity. Cephalopelvic disproportion (CPD) has been ruled out. After giving
the mother some sedation so she can rest, what would the nurse anticipate
preparing for?
1. Oxytocin induction of labor
2. Amnioinfusion
3. Increased intravenous infusion
4. Cesarean section
Answer: 1
Explanation: 1. Oxytocin is the drug of choice for labor augmentation or
labor induction and may be administered as needed for hypotonic labor patterns.
Page Ref: 598
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral
Therapies
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
, AACN Essentials Competencies: IX. 12. Create a safe environment that results
in high quality patient outcomes. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient
care. | Nursing/Integrated Concepts: Nursing Process: Planning
2
Copyright 2016 Pearson Education, Inc.
Learning Outcome: 2 Explain potential risk factors associated with oxytocin
induction of labor.
MNL LO: 3.5.1 Discuss methods of labor induction and augmentation
including implications for nursing care.
5) Nonreassuring fetal status often occurs with a tachysystole contraction
pattern. Intrauterine resuscitation measures may become warranted and can
include which of the following measures?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Position the woman on her right side.
2. Apply oxygen via face mask.
3. Call for anesthesia provider for support.
4. Increase intravenous fluids by at least 700 mL bolus.
5. Call the physician/CNM to the bedside.
Answer: 2, 3, 4
Explanation: 2. The nurse would apply oxygen via face mask.
3. The nurse would call for anesthesia provider for support.
4. The nurse would increase intravenous fluids by at least 500 mL bolus.
Page Ref: 598
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 12. Create a safe environment that
1) What would be a normal cervical dilatation rate in a first-time mother
(primip)?
1. 1.5 cm per hour
2. Less than 1 cm cervical dilatation per hour
3. 1 cm per hour
4. Less than 0.5 cm per hour
Answer: 1
Explanation: 1. Dilatation in a multip is about 1.5 cm per hour.
Page Ref: 596
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1 Discuss dysfunctional labor patterns.
MNL LO: 3.4.3 Discuss abnormalities of conditions associated with, and
management of labor dystocia.
2) Dystocia encompasses many problems in labor. What is the most
common?
1. Meconium-stained amniotic fluid
2. Dysfunctional uterine contractions
3. Cessation of contractions
4. Changes in the fetal heart rate
,Answer: 2
Explanation: 2. The most common problem is dysfunctional (or
uncoordinated) uterine contractions that result in a prolongation of labor.
Page Ref: 596
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1 Discuss dysfunctional labor patterns.
MNL LO: 3.4.3 Discuss abnormalities of conditions associated with, and
management of labor dystocia.
1
Copyright 2016 Pearson Education, Inc.
3) Risk factors for tachysystole include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Cocaine use
2. Placental abruption
3. Low-dose oxytocin titration regimens
4. Uterine rupture
5. Smoking
Answer: 1, 2, 4
Explanation: 1. Cocaine use is a risk factor for tachysystole.
2. Placental abruption is a risk factor for tachysystole.
4. Uterine rupture is a risk factor for tachysystole.
,Page Ref: 597
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 12. Create a safe environment that results
in high quality patient outcomes. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient
care. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1 Discuss dysfunctional labor patterns.
MNL LO: 3.4.3 Discuss abnormalities of conditions associated with, and
management of labor dystocia.
4) A woman has been having contractions since 4 a.m. At 8 a.m., her cervix
is dilated to 5 cm. Contractions are frequent, and mild to moderate in
intensity. Cephalopelvic disproportion (CPD) has been ruled out. After giving
the mother some sedation so she can rest, what would the nurse anticipate
preparing for?
1. Oxytocin induction of labor
2. Amnioinfusion
3. Increased intravenous infusion
4. Cesarean section
Answer: 1
Explanation: 1. Oxytocin is the drug of choice for labor augmentation or
labor induction and may be administered as needed for hypotonic labor patterns.
Page Ref: 598
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral
Therapies
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
, AACN Essentials Competencies: IX. 12. Create a safe environment that results
in high quality patient outcomes. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient
care. | Nursing/Integrated Concepts: Nursing Process: Planning
2
Copyright 2016 Pearson Education, Inc.
Learning Outcome: 2 Explain potential risk factors associated with oxytocin
induction of labor.
MNL LO: 3.5.1 Discuss methods of labor induction and augmentation
including implications for nursing care.
5) Nonreassuring fetal status often occurs with a tachysystole contraction
pattern. Intrauterine resuscitation measures may become warranted and can
include which of the following measures?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Position the woman on her right side.
2. Apply oxygen via face mask.
3. Call for anesthesia provider for support.
4. Increase intravenous fluids by at least 700 mL bolus.
5. Call the physician/CNM to the bedside.
Answer: 2, 3, 4
Explanation: 2. The nurse would apply oxygen via face mask.
3. The nurse would call for anesthesia provider for support.
4. The nurse would increase intravenous fluids by at least 500 mL bolus.
Page Ref: 598
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of
technology and standardized practices that support safety and quality. |
AACN Essentials Competencies: IX. 12. Create a safe environment that
