Chapter 21 Quiz – Nursing Management of Labor and Birth at Risk

A laboring patient is diagnosed with shoulder dystocia. What is the nurse’s priority action?

• Apply fundal pressure

• Encourage the patient to push harder

• Assist with McRoberts maneuver and suprapubic pressure

• Prepare the patient for cesarean section

A nurse is caring for a patient receiving oxytocin. The contractions are occurring every 90 seconds and last over 90 seconds with non-reassuring FHR. What should the nurse do first?

• Reposition the patient

• Administer oxygen

• Discontinue oxytocin infusion

• Notify the provider

What is the most serious risk associated with premature rupture of membranes (PROM)?

• Precipitous delivery

• Fetal macrosomia

• Umbilical cord prolapse

• Polyhydramnios

A patient in preterm labor is receiving magnesium sulfate. Which assessment finding should be reported immediately?

• Mild flushing

• Urine output of 80 mL in 4 hours

• Respiratory rate of 10 breaths per minute

• Absent deep tendon reflexes

A nurse is educating a patient with a history of precipitous labor. What should the nurse emphasize?

• Avoid exercise during pregnancy

• Call the provider when contractions are 10 minutes apart

• Go to the hospital as soon as contractions begin

• Plan for a scheduled induction at 42 weeks

A nurse is assessing a patient suspected of having an amniotic fluid embolism. Which symptom is most concerning?

• Leg cramps

• Restlessness and shortness of breath

• Mild abdominal cramping

• Blood pressure of 130/84

Which finding is most concerning during induction with oxytocin?

• Contractions every 2–3 minutes lasting 60 seconds

• Fetal heart rate baseline 130 bpm with moderate variability

• Contractions every minute with uterine resting tone 35 mmHg

• Uterine resting tone of 10 mmHg between contractions

What is the priority nursing intervention for a patient experiencing a uterine rupture?

• Increase the rate of oxytocin

• Prepare for emergency cesarean delivery

• Administer misoprostol

• Encourage the patient to ambulate

A nurse is educating a patient about to undergo a vacuum-assisted delivery. Which statement indicates understanding?

• I might need an episiotomy during the procedure.

• This is only done if I’m not fully dilated.

• It guarantees that I won’t need a cesarean section.

• There is no risk of injury to my baby.

Which of the following are risk factors for preterm labor? (Select all that apply)

• History of cervical insufficiency
  

• Multiple gestation
  

• Gestational diabetes
  

• Urinary tract infection
  

• Maternal age over 40