Chapter 25 Birth-Related Procedures
1) The client is undergoing an emergency cesarean birth for fetal bradycardia.
The clients partner has not been allowed into the operating room. What can
the nurse do to alleviate the partners emotional distress?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Allow the partner to wheel the babys crib to the newborn nursery.
2. Allow the partner to be near the operating room where the newborns first
cry can be heard.
3. Have the partner wait in the clients postpartum room.
4. Encourage the partner to be in the nursery for the initial assessment.
5. Teach the partner how to take the clients blood pressure.
Answer: 1, 2, 4
Explanation: 1. Effective measures include allowing the partner to take the baby
to the nursery.
2. Effective measures include allowing the partner to be in a place near the
operating room, where the newborns first cry can be heard.
4. Effective measures include involving the partner in postpartum care in the
recovery room.
Page Ref: 646
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I. C. 13. Acknowledge the tension that may
exist between patient rights and the organizational responsibility for
professional, ethical care. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum,
across lifespan, and in all healthcare settings. | NLN Competencies:
Relationship-Centered Care: Promote and accept the patients emotions;
accept and respond to distress in patient and self; facilitate hope, trust, and faith.
| Nursing/Integrated Concepts: Nursing Process: Implementation
,Learning Outcome: 9 Explain the indications for cesarean birth, impact on the
family unit, preparation and teaching needs, and associated nursing
management.
MNL LO: 3.5.2 Explain the management of the childbearing family undergoing
a cesarean birth.
1
Copyright 2016 Pearson Education, Inc.
2) The client tells the nurse that she has come to the hospital so that her babys
position can be changed. The nurse would begin to organize the supplies needed
to perform which procedure?
1. A version
2. An amniotomy
3. Leopold maneuvers
,4. A ballottement
Answer: 1
Explanation: 1. Version, or turning the fetus, is a procedure used to change
the fetal presentation by abdominal or intrauterine manipulation.
Page Ref: 621
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
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: Planning
Learning Outcome: 2 Contrast the methods of external cephalic version and
internal version and the related nursing management.
MNL LO: 3.5.4 Describe external version, its indications, and associated
nursing considerations.
3) A woman has been admitted for an external version. She has completed an
ultrasound exam and is attached to the fetal monitor. Prior to the procedure,
why will terbutaline be administered?
1. To provide analgesia
2. To relax the uterus
3. To induce labor
4. To prevent hemorrhage
Answer: 2
Explanation: 2. Terbutaline is administered to achieve uterine relaxation.
Page Ref: 624
Cognitive Level: Understanding
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. 3. Implement holistic, patient-centered
care that reflects an understanding of human growth and development,
pathophysiology, pharmacology, medical management, and nursing
management across the health-illness continuum, across lifespan, and in all
healthcare settings. | NLN Competencies: Knowledge and Science:
Relationships between knowledge/science and quality and safe patient care |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2 Contrast the methods of external cephalic version and
internal version and the related nursing management.
MNL LO: 3.5.4 Describe external version, its indications, and associated
nursing considerations.
2
Copyright 2016 Pearson Education, Inc.
4) The nurse is scheduling a client for an external cephalic version (ECV).
Which finding in the clients chart requires immediate intervention?
1. Previous birth by cesarean
2. Frank breech ballotable
3. 37 weeks, complete breech
4. Failed ECV last week
Answer: 1
Explanation: 1. Any previous uterine scar is a contraindication to ECV. Prior
scarring of the uterus may increase the risk of uterine tearing or uterine rupture.
Page Ref: 623, 624
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of 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: Quality and Safety:
Communicate potential risk factors and actual errors. |
1) The client is undergoing an emergency cesarean birth for fetal bradycardia.
The clients partner has not been allowed into the operating room. What can
the nurse do to alleviate the partners emotional distress?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Allow the partner to wheel the babys crib to the newborn nursery.
2. Allow the partner to be near the operating room where the newborns first
cry can be heard.
3. Have the partner wait in the clients postpartum room.
4. Encourage the partner to be in the nursery for the initial assessment.
5. Teach the partner how to take the clients blood pressure.
Answer: 1, 2, 4
Explanation: 1. Effective measures include allowing the partner to take the baby
to the nursery.
2. Effective measures include allowing the partner to be in a place near the
operating room, where the newborns first cry can be heard.
4. Effective measures include involving the partner in postpartum care in the
recovery room.
Page Ref: 646
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I. C. 13. Acknowledge the tension that may
exist between patient rights and the organizational responsibility for
professional, ethical care. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum,
across lifespan, and in all healthcare settings. | NLN Competencies:
Relationship-Centered Care: Promote and accept the patients emotions;
accept and respond to distress in patient and self; facilitate hope, trust, and faith.
| Nursing/Integrated Concepts: Nursing Process: Implementation
,Learning Outcome: 9 Explain the indications for cesarean birth, impact on the
family unit, preparation and teaching needs, and associated nursing
management.
MNL LO: 3.5.2 Explain the management of the childbearing family undergoing
a cesarean birth.
1
Copyright 2016 Pearson Education, Inc.
2) The client tells the nurse that she has come to the hospital so that her babys
position can be changed. The nurse would begin to organize the supplies needed
to perform which procedure?
1. A version
2. An amniotomy
3. Leopold maneuvers
,4. A ballottement
Answer: 1
Explanation: 1. Version, or turning the fetus, is a procedure used to change
the fetal presentation by abdominal or intrauterine manipulation.
Page Ref: 621
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
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: Planning
Learning Outcome: 2 Contrast the methods of external cephalic version and
internal version and the related nursing management.
MNL LO: 3.5.4 Describe external version, its indications, and associated
nursing considerations.
3) A woman has been admitted for an external version. She has completed an
ultrasound exam and is attached to the fetal monitor. Prior to the procedure,
why will terbutaline be administered?
1. To provide analgesia
2. To relax the uterus
3. To induce labor
4. To prevent hemorrhage
Answer: 2
Explanation: 2. Terbutaline is administered to achieve uterine relaxation.
Page Ref: 624
Cognitive Level: Understanding
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. 3. Implement holistic, patient-centered
care that reflects an understanding of human growth and development,
pathophysiology, pharmacology, medical management, and nursing
management across the health-illness continuum, across lifespan, and in all
healthcare settings. | NLN Competencies: Knowledge and Science:
Relationships between knowledge/science and quality and safe patient care |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2 Contrast the methods of external cephalic version and
internal version and the related nursing management.
MNL LO: 3.5.4 Describe external version, its indications, and associated
nursing considerations.
2
Copyright 2016 Pearson Education, Inc.
4) The nurse is scheduling a client for an external cephalic version (ECV).
Which finding in the clients chart requires immediate intervention?
1. Previous birth by cesarean
2. Frank breech ballotable
3. 37 weeks, complete breech
4. Failed ECV last week
Answer: 1
Explanation: 1. Any previous uterine scar is a contraindication to ECV. Prior
scarring of the uterus may increase the risk of uterine tearing or uterine rupture.
Page Ref: 623, 624
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of 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: Quality and Safety:
Communicate potential risk factors and actual errors. |
