Homework answers / question archive / CHAPTER 14 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 includes: A)  Late decelerations B)  Absent variability C)  Variable decelerations D)  Early decelerations   2

CHAPTER 14 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 includes: A)  Late decelerations B)  Absent variability C)  Variable decelerations D)  Early decelerations   2

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CHAPTER 14

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 includes:

A)  Late decelerations

B)  Absent variability

C)  Variable decelerations

D)  Early decelerations

 

2.   The perinatal nurse notes a rapid decrease in the fetal heart rate that does not recover immediately following an amniotomy.  The most likely cause of this obstetrical emergency is:

A)  Prolapsed umbilical cord

B)  Vasa previa

C)  Oligohydramnios

D)  Placental abruption

 

3.   The perinatal nurse knows that an appropriate nursing assessment to rule out hypersensitivity in relation to Dinoprostone (Cervidil) insertion includes:

A)  Intake and output

B)  Blood pressure

C)  Maternal pulse

D)  Breath sounds

 

4.   During the postpartum assessment, the perinatal nurse notes that a patient who has just experienced a forceps-assisted birth now has a large quantity of bright red bleeding.  Her uterine fundus is firm.  The nurse's most appropriate action is to notify the physician/certified nurse midwife and describe a:

A)  Need for vaginal assessment and repair

B)  Requirement for an oxytocin infusion

C)  Need for further information for the woman/family about forceps

D)  Requirement for bladder assessment and catheterization

 

5.   According to agency policy, the perinatal nurse provides the following intrapartal nursing care for the patient with preeclampsia:

A)  Take the patient's blood pressure every six hours

B)  Encourage the patient to rest on her back

C)  Notify the physician of a urine output greater than 30 mL/hr

D)  Administer magnesium sulfate according to agency policy

 

6.   The perinatal nurse is providing care to Marilyn, a 25-year-old G1 TPAL 0000 woman hospitalized with severe hypertension at 33 weeks gestation.  The nurse is preparing to administer the second dose of b–methasone prescribed by the physician.  Marilyn asks: “What is this injection for again?”  The nurse's best response is:

A)  “This is to help your baby's lungs to mature”

B)  “This is to prepare your body to begin the labor process”

C)  “This is to help stabilize your blood pressure”

D)  “This is to help your baby grow and develop in preparation for birth”

 

7.   The perinatal nurse provides information to a laboring woman with twins that the second twin will normally be born within:

A)  5 minutes of the first twin

B)  15 minutes of the first twin

C)  30 minutes of the first twin

D)  60 minutes of the first twin

 

8.   The perinatal nurse providing care to a laboring woman recognizes a non-reassuring fetal heart rate tracing.  An appropriate initial action is to:

A)  Assist the laboring woman to a left lateral position

B)  Increase the intravenous solution

C)  Request that the physician/certified nurse-midwife apply a fetal scalp electrode

D)  Document the fetal heart rate and variability

 

9.   The perinatal nurse is providing care to Carol, a 28-year-old multiparous woman in labor.  Upon arrival to the birthing suite, Carol was 5 cm. dilated and experiencing contractions every 1–2 minutes that she describes as “strong”.  Carol states she labored for one hour at home. As the nurse assists Carol from the assessment area to her labor and birth room, Carol states that she is feeling some rectal pressure.  Carol is most likely experiencing:

A)  Hypertonic contractions

B)  Hypotonic contractions

C)  Precipitate labor

D)  Uterine hyperstimulation

 

10. The perinatal nurse determines by vaginal examination that Carol is fully dilated and the fetal presenting part is descending rapidly with Carol's pushing efforts.  The most appropriate nursing intervention at this time would be to:

A)  Assist Carol with breathing to slow down her pushing

B)  Leave the room to call the physician to come for the birth

C)  Provide information to Carol's partner about her stage of labor

D)  Document Carol's progress and coping abilities in labor

 

11. The perinatal nurse is providing care to Meghan, a 32-year-old G1 TPAL 0000 at 34 weeks gestation.  Her blood pressure is 170/100, reflexes are +3, urine is 2+ for protein and Meghan is complaining of a headache. An intravenous solution of Magnesium Sulfate is begun with an hourly dose of 2 grams. One of the parameters that the perinatal nurse is observing carefully in Meghan's blood work is:

A)  Hematocrit

B)  Neutrophil count

C)  Aspartate aminotransferase (AST)

D)  Gamma-glutamyl transpeptidase

 

12. The perinatal nurse, aware that Meghan's condition could deteriorate into HELLP syndrome, remains vigilant in patient assessment and observation.  HELLP stands for Hemolysis, Elevated Liver enzymes and:

A)  Low platelet count

B)  Lower pain threshold

C)  Lumbar pain

D)  Lessened patellar reflex

 

13. The perinatal nurse is asked to assess Julie, a 35-year-old woman, G1 TPAL 0000 at 34 weeks gestation with a twin gestation.  Julie complains of regular contractions with low abdominal pain that moves into the lumbar section of her back.  Julie is very concerned about her babies' health as her twins are the result of advanced reproductive technology methods.  The perinatal nurse's most appropriate initial nursing action is to:

A)  Initiate continuous fetal monitoring

B)  Assess the frequency, strength and duration of Julie's contractions

C)  Reassure Julie that everything will be done for her and her babies

D)  Review Julie's birth plan to understand her wishes for labor and birth

 

14. The perinatal nurse has assessed Neela, who has a twin pregnancy, and made the following determinations: blood pressure = 136/80; pulse rate = 84; fetal heart rates (FHRs) are between 138–146 bpm and 132–138 bpm; uterine contractions occur every 5–6 minutes, duration = 45 seconds, moderate strength.  Neela's birth plan describes her wish to be involved in all decision-making throughout her labor and birth as well as her partner's wish to say a prayer in each infant's ear as soon after birth as possible (he is a Muslim).  The perinatal nurse's appropriate actions would include a discussion with Neela and her partner about:

A)  The need for Neela to have an intravenous infusion administered throughout labor

B)  The emergent care the infants will require after birth that will not allow the time to pray

C)  The need for epidural analgesia during labor because of Neela's multiple gestation

D)  The gestational abilities of the twins at birth, the progress of Neela's labor and the nurse's ability to advocate for prayers if possible

 

15. The perinatal nurse is providing care to Carolyn, a 17-year-old woman, G2 TPAL 0010, who has been admitted because of an antenatal hemorrhage.  An ultrasound examination confirms that she is experiencing an abruptio placentae.  Carolyn's vital signs include the following: blood pressure = 110/66, Pulse = 92; respirations = 18 breaths/minute.  The fetal heart rate is 156 bpm and is being continuously monitored.  An additional element of nursing care would be:

A)  Hourly assessment of vital signs

B)  Assessment of the perineum every 15 minutes for evidence of bleeding

C)  Assessment of intake and output every 8 hours

D)  Blood work that includes a complete blood count (CBC), prothrombin time, and serum electrolytes

 

16. The perinatal nurse knows that one of the most severe complications for Carolyn with her diagnosis of abruptio placentae is:

A)  Couvelaire uterus

B)  Decreased circulatory blood volume

C)  Shock related to hemorrhage

D)  Hydrops fetalis

 

17. The perinatal nurse includes the following when explaining the physiology of artificial rupture of membranes to the student nurse: rupture of membranes causes a release of arachidonic acid, which converts to prostaglandins, substances known to stimulate oxytocin in the pregnant uterus.

A)  True

B)  False

 

18. The perinatal nurse describes asynclitism to students as a presentation that occurs when the fetal head is turned toward the maternal sacrum or symphysis at an oblique angle.

A)  True

B)  False

 

19. The perinatal nurse explains to the student nurse that the most frequent fetal risk associated with the use of forceps is cord compression.

A)  True

B)  False

 

20. A patient with hypertension who is receiving intravenous magnesium sulfate therapy has requested an epidural anesthetic.  The perinatal nurse should first review the patient's complete blood count results for evidence of a decreased platelet count.

A)  True

B)  False

 

21. The perinatal nurse knows that the laboring diabetic patient's blood glucose level should always be less than 120 mg/dL.

A)  True

B)  False

 

22. The perinatal nurse explains to the student nurses that as a result of the Term Breech Trial, a trial of labor is the standard of care for a woman whose fetus is in a breech presentation.

A)  True

B)  False

 

23. The perinatal nurse prepares for two potential complications that may accompany a precipitous labor and birth: postpartum ______________ and a need for neonatal ________________.

 

 

24. The perinatal nurse assists the nursing student who is preparing the patient with oligohydramnios for a fluid infusion into the uterine cavity.  This procedure is described as a(n) ________________.

 

 

25. Nursing documentation that the perinatal nurse must include following an amnioinfusion is the infusion _____________ and the presence of any ____________________.

 

 

26. The perinatal nurse understands that the most appropriate nursing action following an amniotomy is an assessment of the ___________________ as well as the ________ and ________ of the amniotic fluid.

 

 

27. The perinatal nurse is aware that the use of nipple stimulation in labor may increase the frequency and strength of _________________ and rarely causes _____________.

 

 

28. The perinatal nurse caring for a laboring woman who is receiving an oxytocin infusion documents the following information:  rate of __________, frequency and strength of ___________, fetal ___________________ and cervical ___________ and ________.

 

 

29. The perinatal nurse recognizes that the laboring multiparous patient who is attempting a vaginal birth following a previous Cesarean birth needs frequent assessments to ensure that there is ________ during her labor.