Chapter 16: Nursing Care During Obstetric Procedures

Chapter 16: Nursing Care During Obstetric Procedures

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse knows that a urinary catheter is added to the instrument table if a forceps-assisted birth is anticipated. The correct rationale for this intervention is that:

ANS:  B

Catheterization provides room for the application of the forceps blades and limits bladder trauma. A clean-catch urinalysis is usually sufficient for preoperative treatment. Urine is sterile. The membranes must be ruptured and the cervix completely dilated for a forceps-assisted birth.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   314

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

2. After a forceps-assisted birth, the client is observed to have continuous bright red lochia but a firm fundus. Which other data would indicate the presence of a potential vaginal wall hematoma?

ANS:  D

The nurse should monitor for edema and discoloration. Using a cold application to the labia and perineum reduces pain by numbing the area and limiting bruising and edema for the first 12 hours. An episiotomy is performed as the fetal head distends the perineum. The pain with vaginal hematoma is severe and constant. The pain associated with vaginal hematoma is severe.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   314

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

3. The nurse is positioning the Foley catheter prior to a cesarean birth. Which position should the nurse use to place the catheter drainage tubing and catheter bag?

ANS:  A

The drain tube of the catheter should be positioned under the client’s to promote drainage and to keep the catheter away from the operative area. Urinary output must be continuously monitored. An early sign of hypovolemia is decreasing urinary output. The anesthesia clinician must monitor urine output during the surgery so it should not be clamped. The surgeon might step on the drainage bag if the catheter were below the drapes, and no one could monitor the urine output.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   322

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Safe and Effective Care Environment

4. Which condition is a contraindication for an amniotomy?

ANS:  A

A prolapsed cord can occur if the membranes artificially rupture when the presenting part is not engaged. The presenting part should be cephalic. The dilation must be enough to determine labor. Right occiput posterior is a cephalic presentation appropriate for an amniotomy.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   305

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

5. Which client status is an acceptable indication for serial oxytocin induction of labor?

ANS:  D

Continuing a pregnancy past the normal gestational period is likely to be detrimental to fetal health. Multiple fetuses overdistend the uterus, making induction of labor high risk. Polyhydramnios overdistends the uterus, making induction of labor high risk. A history of rapid labors is a reason for induction of labor because of the possibility that the baby would otherwise be born in uncontrolled circumstances.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   308

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity