Chapter 23 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Chapter 23 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

The nurse is scheduling a patient for an external cephalic version (ECV). Which finding in the patient’s chart requires immediate intervention?

1. “Multip, transverse lie.”
2. “Primip, frank breech ballotable.”
3. “Multip, 32 weeks, complete breech.”
4. “Primip, failed ECV last week.”

Correct Answer: 3

Rationale 1: This patient has no contraindication to ECV.

Rationale 2: This patient has no contraindication to ECV.

Rationale 3: ECV is not attempted until 36 weeks. This patient is too early in her pregnancy for ECV.

Rationale 4: Although this patient is less likely to have a successful ECV this week if it was unsuccessful last week, there is no contraindication to attempting the procedure.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO01 – Explain the methods, purpose, criteria, and contraindications of external version in determining nursing care management.

Question 2

Type: MCSA

The clinical nurse coordinator is meeting with a group of nursing students in post conference to teach about caring for women who undergo artificial rupture of membranes (AROM) by way of amniotomy. Which nursing student’s statement indicates that the teaching has been effective?

1. “For women who undergo artificial rupture of membranes, vaginal examinations should be limited.”
2. “In most cases, it is appropriate to assess the fetal heart rate (FHR) right after the artificial rupture of membranes is performed.”
3. “Amniotomy is contraindicated for use in labor augmentation.”
4. “Women who undergo artificial rupture of membranes should be advised that they will experience a ‘dry birth.’”

Correct Answer: 1

Rationale 1: Following artificial rupture of membranes (AROM), because there is now an open pathway for organisms to ascend into the uterus, the number of vaginal exams must be kept to a minimum to reduce the chance of introducing an infection.

Rationale 2: In all cases, the fetal heart rate (FHR) is assessed just before and immediately after the amniotomy, and the two FHR assessments are compared.

Rationale 3: Amniotomy is an accepted method of labor augmentation.

Rationale 4: Women need to know that amniotic fluid is constantly produced because some women may worry that they will experience a “dry birth.”

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO03 – Describe the use of amniotomy and the nursing care management of the woman and fetus.

Question 3

Type: MCSA

Induction of labor is planned for a 31-year-old primip due to insulin-dependent diabetes. The patient is 39 weeks’ gestation. She reports that she feels as though her baby has “flipped” in her abdomen. Which nursing action is most important?

1. Evaluate fetal maturity.
2. Administer dinoprostone (Prepidil ) vaginal gel.
3. Implement continuous electronic fetal monitoring (EFM).
4. Notify the patient’s physician that the patient feels as though her baby has changed position.

Correct Answer: 4

Rationale 1: Malpresentation, such as breech, is a relative contraindication to induction of labor. Before proceeding with preparation for induction of labor, the patient will require additional evaluation by her physician before proceeding.

Rationale 2: Malpresentation, such as breech, is a relative contraindication to induction of labor. Before proceeding with preparation for induction of labor, the patient will require additional evaluation by her physician before proceeding.

Rationale 3: Malpresentation, such as breech, is a relative contraindication to induction of labor. Before proceeding with preparation for induction of labor, the patient will require additional evaluation by her physician before proceeding.

Rationale 4: Because malpresentation, such as breech, is a relative contraindication to induction of labor, the patient will require additional evaluation by her physician before proceeding.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO02 – Explain the indications, contraindications, labor readiness, and methods in determining the nursing care management for women during labor induction.

Question 4

Type: MCSA

The nurse is teaching childbirth education classes. Teaching has been successful if the primiparous patient states: “I can reduce the likelihood that I’ll tear or need an episiotomy if I:

1. “Push in a semi-sitting position.”
2. “Make sure I push long and hard.”
3. “Begin regular perineal massage.”
4. “Pull back on my legs when pushing.”

Correct Answer: 3

Rationale 1: Semi-sitting or lithotomy position increases the likelihood of perineal lacerations.

Rationale 2: Short pushes during the expulsion of the head decrease the likelihood of perineal lacerations.

Rationale 3: Perineal massage has been shown to decrease the need for episiotomy in primiparous patients.

Rationale 4: Pulling back on the legs while pushing tightens the perineal tissue, which in turn increases the likelihood of perineal lacerations.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO04 – Describe the indications for amnioinfusion and the nursing care of the woman during amnioinfusion.