Chapter 18 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 18 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 18_LO01_Q01

The nurse is admitting a client to the Labor and Delivery unit. Which aspect of the client’s history requires notifying the physician?

1. Blood pressure 120/88
2. Father is a carrier of sickle-cell trait.
3. Dark red vaginal bleeding
4. History of domestic abuse

Correct Answer: 3

Rationale:

1. Blood pressure 120/88. Although the diastolic reading is slightly elevated, this is not the top priority.
2. The infant also might have sickle trait, but sickle trait is not life-threatening at this time.
3. Third-trimester bleeding is caused by either placenta previa or abruptio placentae. Dark red bleeding usually indicates abruptio placentae, which is life-threatening to both mother and fetus.
4. This client is at risk for harm after delivery, but is not in a life-threatening situation at this time. This is not the highest priority for the client.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 18.1 Describe a maternal assessment of the laboring woman that includes the client history, high-risk screening, and physical and psychosociocultural factors.

Chapter 18_LO02 _Q02

The nurse is preparing to assess a laboring primiparous client who has just arrived in the Labor and Birth unit. Which statement indicates that additional education is needed?

1. “You are going to do a vaginal exam to see how far dilated my cervix is.”
2. “The reason for a pelvic exam is to determine how low in the pelvis my baby is.”
3. “When you check my cervix, you will find out how thinned out it is.”
4. “After you assess my pelvis, you will be able to tell when I will deliver.”

Correct Answer: 4

Rationale:

1. Cervical dilation is one aspect of the pelvic exam assessment.
2. Determining the station of the presenting part is one aspect of the pelvic exam assessment.
3. Cervical effacement, or the thinning of the cervix, is one aspect of the pelvic exam assessment.
4. An experienced Labor and Birth nurse can estimate the time of delivery based on the cervix, fetal position, station, and contraction pattern. However, during a pelvic exam, no information is obtained about the contractions. The nurse will not have enough information following the cervical exam to estimate time of birth.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Evaluation

Learning Outcome: 18.2 Evaluate the progress of labor by assessing the laboring woman’s contractions, cervical dilatation, and effacement.

Chapter 18_LO03 _Q03

The nurse is working with a pregnant adolescent. The client asks the nurse how the baby’s condition is determined during labor. Which statement indicates the client education was successful? “During labor, the nurse will:

1. “Check your cervix by doing a pelvic exam every two hours.”
2. “Assess the baby’s heart rate with an electronic fetal monitor.”
3. “Look at the color and amount of bloody show that you have.”
4. “Verify that your contractions are strong but not too close together.”

Correct Answer: 2

Rationale:

1. Although cervical exams are performed on a regular basis, the pelvic exam does not assess fetal status. The client has asked specifically about assessing fetal status in labor.
2. This option best answers the question the client has asked.
3. Although bloody show is monitored, doing so does not assess fetal status. The client has asked specifically about assessing fetal status in labor.
4. Although contraction strength is palpated abdominally, the client has asked about assessing fetal status in labor.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Planning

Learning Outcome: 18.3 Describe an intrapartal fetal assessment to determine fetal position and presentation, fetal heart rate, and fetal status.

Chapter 18_LO04_Q04

The nurse is preparing to assess the fetus of a laboring client. Which assessment should the nurse perform first?

1. Perform Leopold’s maneuver to determine fetal position.
2. Count the fetal heart rate for 30 seconds and multiply by two.
3. Dry the maternal abdomen before using the Doppler.
4. Place the client into a left lateral position.

Correct Answer: 1

Rationale:

1. This is the first step, so that the Doppler device can be placed directly over the heart, and multiple unsuccessful attempts to hear the heart rate are avoided.
2. Although this is how to auscultate the fetal heart rate, it is better to perform Leopold’s maneuver to determine fetal position, so that the Doppler device can be placed directly over the heart, and multiple unsuccessful attempts to hear the heart rate are avoided.
3. Prior to using the Doppler device, a water-based gel is applied to the skin.
4. The fetal heart tone assessment should be performed while the client is either supine with a lateral tilt or while in left lateral position. Leopold’s maneuver is performed first to determine where to listen for fetal heart tones.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 18.4 Describe the steps and frequency for performing auscultation of fetal heart rate.