L E CT U R E \ P OW E R P O I NT

[MIDTERMS] QUIZ 1 & 2: GESTATIONAL CONCERNS & HIGH RISK: LABOR AND DELIVERY

QUIZ 1 MIDTERMS - GESTATIONAL CONCERNS ANSWER: SEVERE NAUSEA AND VOMITING LEADING TO
ELECTROLYTE, METABOLIC, AND NUTRITIONAL IMBALANCES
1. Occurs before 12 weeks gestation because of some IN THE ABSENCE OF OTHER MEDICAL PROBLEMS
maternal illness or genetic effect
ANSWER: SPONTANEOUS ABORTION 15. A client with hyperemesis gravidarum is at risk for having a
(an)...
2. Uterine bleeding prior to 20 weeks gestation, without any ANSWER: INFANT WHO IS GROWTH RETARDED
cervical dilation or effacement
ANSWER: THREATENED ABORTION 16. Magnesium sulfate is given to pregnant clients with
preeclampsia to prevent which of the following conditions?
3. Passage of some fetal or placental tissue, but not all ANSWER: SEIZURES
ANSWER: INCOMPLETE ABORTION
17. Which is the common sign of preeclampsia?
4. Uterine bleeding prior to 20 weeks gestation with cervical ANSWER: PROTEINURIA / HYPERTENSION
dilation but no expulsion of fetal or placental tissue
ANSWER: INEVITABLE ABORTION 18. A pregnant client who reports painless vaginal bleeding at
28 week’s gestation is diagnosed with placenta previa. The
5. Fetus loss in 3 or more pregnancies, caused by cervical placental edge reaches the internal os. This type of
insufficiency placenta previa is known as:
ANSWER: HABITUAL ABORTION ANSWER: MARGINAL PLACENTA PREVIA

6. Abortion artificually induced may be therapeutic or illegal 19. Which of the following assessments would indicate that the
ANSWER: INDUCED ABORTION patient has developed abruptio placenta?
ANSWER: SHARP FUNDAL PAIN WITHOUT RELAXATION
7. Performed without legal constraints and control not done by BETWEEN CONTRACTIONS
physician
ANSWER: ILLEGAL ABORTION 20. Which of the following best describes Amniotic fluid
embolism?
8. Fetus born dead after 20 weeks gestation ANSWER: IS A RARE EVENT WITH EXTREMELY HIGH
ANSWER: STILLBIRTH MATERNAL-FETAL MORTALITY

9. All the products of conception are expelled from the uterus
ANSWER: COMPLETE ABORTION
10. Fetus dies but is retained
ANSWER: MISSED ABORTION
11. if a patient experiences a ruptured ectopic pregnancy, an
expected sign or symptom would be
ANSWER: SUDDEN EXCRUCIATING PAIN IN LOWER ABDOMEN
12. A 30-year-old woman is admitted to the emergency room.
She is complaining of pain in her right pelvic area that has
been present for the past four days. The tentative diagnosis
is ectopic pregnancy. Nurse Joan knows that an ectopic
pregnancy occurs:
ANSWER: OUTSIDE OF THE UTERINE CAVITY
21. Which of the following signs and symptoms indicates
amniotic fluid embolism?
ANSWER: SUDDEN ONSET OF RESPIRATORY DISTRESS, CHEST
PAIN, BP 90/60 MMHG, RR 26/MIN, PR 98BPM
22. What would be the nurse priority action if the membranes
have ruptured?
ANSWER: COUNT THE FETAL HEART RATE
23. Which of the following would be the management of
H-mole patient?
ANSWER: DILATATION AND CURETTAGE
24. Which of the following discharge teaching plan of the
patient would the nurse include?
ANSWER: AVOID BEING PREGNANT FOR AT LEAST ONE YEAR

13. Which of the following best describes gestational 25. A multigravida patient on her third trimester, comes to the
trophoblastic disease? hospital with a complaint of vaginal bleeding, She states
ANSWER: AN ALTERATION OF EARLY EMBRYONIC GROWTH, that she snorted cocaine approximately 1 hour earlier.
CAUSING PLACENTAL DISRUPTION, RAPID PROLIFERATION OF Which of the following complications is most likely causing
ABNORMAL CELLS, DESTRUCTION OF THE EMBRYO the patient’s complaint of vaginal bleeding?
ANSWER: ABRUPTIO PLACENTAE
14. Which of the following statements best describes
hyperemesis gravidarum? QUIZ 2 MIDTERMS - HIGH RISK: LABOR AND DELIVERY
 [MIDTERM] QUIZ 1 & 2: GESTATIONAL CONCERNS & HIGH RISK: LABOR AND DELIVERY
1. Pitocin drug is used to induce and increase the strength and
duration of labor contractions. Which of the following is
contraindicated to pitocin stimulation?
ANSWER: FETAL DISTRESS
2. The patient is having a prolonged labor and there is no
progress past a dilation of 8 cm. Her physician decides to do
a cesarean delivery. The new mother and her partner
express their disappointment that they will not have a
natural childbirth. The best response is to say:
ANSWER: “MOST COUPLES WHO HAVE AN UNPLANNED
CESAREAN BIRTH FEEL CHEATED AND DISAPPOINTED”
3. When assessing the fetal heart rate of a female in the last
stage of labor, the nurse known that an early indication of
fetal distress is when:
ANSWER: FETAL HEART TONES ARE BELOW 120 OR ABOVE 160
BEATS/MINUTE
4. Which of the following factors would the nurse suspect as
predisposing a client to placenta previa?
ANSWER: MULTIPLE GESTATION
5. Which technique is least effective for the woman with
persistent occipito posterior position?
ANSWER: LIE SUPINE AND RELAX
6. During the first stage of labor, a pregnant patient complains
of having severe back pain. What would the nurse infer
about the patient’s clinical condition from the observation?
ANSWER: OCCIPITOPOSTERIOR POSITION OF THE FETUS
7. Which one of the following problems may lead to
inadequate fetal descent?
ANSWER: SHORT CORD
8. An assisted birth using forceps or a vacuum extractor may
be performed for ineffective pushing, for large infants, to
shorten the second stage of labor, or for a malpresentation.
The nurse who is caring for the mother following an assisted
birth should keep which of the following in mind?
ANSWER: A VACUUM EXTRACTOR IS SAFER THAN FORCEPS
BECAUSE IT CAUSES LESS TRAUMA TO THE BABY AND THE
MOTHER’S PERINEUM
9. A nurse is developing a plan of care for another client
experiencing dystocia and includes several nursing
interventions in the plan of care. Which of the following
nursing interventions is considered as the highest priority?
ANSWER: MONITORING FETAL HEART RATE
10. The patient delivered a 9 pound, 10 ounce inant assisted by
vacuum. When the nurse performs the second 15-minute
assessment, the client complains of increasing perineal pain
and a lot of pressure. What action should the nurse take?
ANSWER: CHECK THE PERINEUM FOR A HEMATOMA
11. The woman has shoulder dystocia when giving birth. The
nurse should expect:
ANSWER: THE APPLICATION OF SUPRAPUBIC PRESSURE
12. An infant weighing 8 pounds, 10 ounces is vaginally born.
Shoulder dystocia occurred at birth. Because of this
problem, the nurse should assess the infant for:
ANSWER: CREAKING SENSATION WHEN THE CLAVICLES ARE
PALPATED
13. The medical record of a client reveals a condition which the
fetus cannot pass through the maternal pelvis
ANSWER: CEPHALOPELVIC DISPROPORTION
14. Which of the following factors is the underlying cause of
dystocia?
ANSWER: MECHANICAL
15. A G2P1 woman is in labor attempting a VBAC, when she
suddenly complains of light-headedness and dizziness. An
increase in pulse and decrease in blood pressure is noted as
a change from the vital signs obtained 15 minutes prior. The
nurse should investigate further for additional signs or
symptoms of which complication?
ANSWER: UTERINE RUPTURE
16. A client is experiencing shoulder dystocia during birth. The
nurse woulds place priority on performing which assessment
post birth?
ANSWER: BRACHIAL PLEXUS ASSESSMENT
17. A client is giving birth when shoulder dystocia occurs in the
fetus. The nurse recognizes that which condition in the client
is likely to increase the risk for shoulder dystocia?
ANSWER: DIABETES
18. The first sign of shoulder dystocia is referred to as:
ANSWER: TURTLE SIGN
19. Which of the following women is the best candidate for
VBAC?
ANSWER: CLIENT WHO HAD A BREECH PRESENTATION IN HER
LAST PREGNANCY, THE PREGNANCY IS A VERTEX
PRESENTATION
20. Which of the following would be the benefits of VBACs?
ANSWER: SHORTER RECOVERY TIME, FEWER INFECTIONS,
DECREASED FETAL BLOOD LOSS
21. Primary power of labor
ANSWER: UTERINE CONTRACTION
22. Uterus turns inside out with birth of fetus
ANSWER: UTERINE INVERSION
23. Uterus then descends into the vaginal canal
ANSWER: UTERINE PROLAPSE
24. Strength of the uterine contraction
ANSWER: POWER
25. Prolongation in the duration of labor
ANSWER: DYSFUNCTIONAL
26. Contractions cease, diagnose as false labor
ANSWER: PROLONGED LATENT PHASE
 [MIDTERM] QUIZ 1 & 2: GESTATIONAL CONCERNS & HIGH RISK: LABOR AND DELIVERY

27. Abnormally slow cervical dilation or fetal descent during 42. In planning for home care of a woman with pre
active labor ANSWER: PROLONGED BED REST MAY CAUSE NEGATIVE
ANSWER: PROTRACTED LABOR PHYSIOLOGIC EFFECTS

28. Progress in dilation slows after 8 cm and uterine contractions
become dysfunctional
ANSWER: PROLONGED DECELERATION PHASE
29. No change in cervical dilation for 2 hours
ANSWER: SECONDARY ARREST OF DILATION
30. Rate of descent is < 1.0cm/hr in a nullipara or 2.0cm/hr in a
multipara
ANSWER: PROLONGED DESCENT
31. No descent in 2nd stage of labor
ANSWER: ARREST OF DESCENT
32. Pathological retraction ring
ANSWER: BANDL’S RING
43. Evaluating the effectiveness of magnesium sulfate for the
treatment of preterm labor, what finding would alert the
nurse to possible side effects?
ANSWER: SERUM MAGNESIUM LEVEL OF 10MG/DL
44. Which of the following would alert the post anesthesia care
unit (PACU) nurse to the possibility of uterine inversion?
ANSWER: DRAMATIC INCREASE IN VAGINAL BLEEDING
45. The nurse is caring for a client who is in labor and
experiencing incomplete uterine relaxation between
hypertonic contractions. The nurse recognizes the adverse
effect of the contraction pattern is
ANSWER: REDUCED FETAL OXYGEN SUPPLY

33. Labor that occurs after 20 weeks

ANSWER: ACTIVE LABOR

34. Labor lasts less than 3 hours

ANSWER: PRECIPITATE LABOR

35. Administration of drug helpful in uncoordinated labor

ANSWER: SYNTOCINON

36. What is the effect of precipitate labor in a fetus?

ANSWER: SUBDURAL HEMORRHAGE

37. A multiparous woman arrived 2 hours ago in active labor

with 4cm of cervical dilation and states that she has a
strong urge to push. Which answer most likely describes
what is occurring?
ANSWER: SHE IS HAVING A PRECIPITOUS DELIVERY

38. The woman is having hypotonic labor and is very frustrated

because this is her third trip to the birth center. What nursing
measure is most appropriate for her?
ANSWER: OFFER HER A WARM SHOWER OR BATH

39. The woman is receiving magnesium sulfate to stop preterm

labor. The essential nursing assessment related to this drug is:
ANSWER: HOURLY VITAL SIGNS, HEART SOUNDS, AND LUNG
SOUNDS

40. The nurse in a labor room is monitoring a client with

dysfunctional labor signs of fetal or maternal compromise.
Which assessment finding would alert the nurse to a
compromise?
ANSWER: PERSISTENT NONREASSURING FETAL HEART RATE

41. After a precipitous delivery, the nurse notes that the new
mother is passive and only touches her newborn infant
briefly with her fingertips. What should the nurse do to help
the woman process the delivery?
ANSWER: SUPPORT THE MOTHER IN HER REACTION TO THE
NEWBORN INFANT
[MIDTERM] QUIZ 1 & 2: GESTATIONAL CONCERNS & HIGH RISK: LABOR AND DELIVERY