Select the correct answer for each question.
What position is least effective when gravity is desired to assist in fetal descent?

Lithotomy
Kneeling
Sitting
Walking

The nurse recognizes that a woman is in true labor when she states which of the following?“I passed some thick, pink mucus when I urinated this morning.”
“My bag of waters just broke.”
“The contractions in my uterus are getting stronger and closer together.”
“My baby dropped, and I have to urinate more frequently now.”

An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The woman states, “My contractions are so strong, I don’t know what to do.” The nurse shouldassess for fetal well-being
encourage the woman to lie on her side
disturb the woman as little as possible
recognize that pain is personalized for each individual

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman’s IV fluid for a preprocedural bolus. Prior to initiation of the epidural the woman should be informed regarding the disadvantages of an epidural block. They include all EXCEPTability to move freely is limited
orthostatic hypotension and dizziness
gastric emptying is not delayed
higher rate of fever

Your client is in early labor, and you are discussing the pain relief options she is considering. She states that she wants an epidural “no matter what!” What is your best response? “I’ll make sure you get your epidural.”
“You may only have an epidural if your doctor allows it.”
“You may only have any epidural if you are going to deliver vaginally.”
“The type of analgesia or anesthesia used is determined in part by the stage of your labor and the method of birth.”

A first-time mother is concerned about the type of medications she will receive during labor. She is in a fair amount of pain and is nauseated. Additionally she appears to be very anxious. You explain that opioid analgesics often are used with sedatives because of what reason?
“The two together work the best for you and your baby.”
“Sedatives help the opioid work better, and they will help relax you and relieve your nausea.”
“They work better together so you can sleep until you have the baby.”
“This is what the doctor has ordered for you.”

According to professional standards (AWHONN, 2007) the nonanesthetist registered nurse caring for a woman with an epidural is permitted to perform all actions EXCEPTmonitor the status of the woman and fetus
initiate epidural anesthesia
replace empty infusion bags with the same medication and concentrate
stop the infusion and initiate emergency measures

During anesthetic management of the morbidly obese woman in labor, the nurse must remain alert for complications specific to this type of client. Which is not a concern for the L&D nurse? Failed epidural placement
Accidental dural puncture
Inadequate pain relief
Difficult intubation

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The nurse’s first priority is to
change the woman’s position
notify the health care provider
assist with amnioinfusion
insert a scalp electrode

Which fetal heart rate (FHR) finding concerns the nurse during labor?Accelerations with fetal movement
Early decelerations
An average FHR of 126 beats/min
Late decelerations

What three measures should the nurse implement to provide intrauterine resuscitation? Select the best response that indicates the priority of actions that should be taken, starting with the most important. Call the provider, reposition the mother, and perform a vaginal exam.
Provide oxygen via face mask, reposition the mother, and increase IV fluid.
Administer oxygen to the mother, increase IV fluid, and notify the health care provider.
Perform a vaginal examination, reposition the mother, and provide oxygen via face mask.

According to the National Institute of Child Health and Human Development (NICHD) Three-Tier System of Fetal Heart Rate Classification, category III tracings include all fetal heart rate tracings not categorized as category I or II. Which characteristics of the fetal heart rate belong in category III? (choose all that apply):
Baseline rate of 110 to 160 beats/min
Tachycardia
Absent baseline variability not accompanied by recurrent decelerations
Variable decelerations with other characteristics such as shoulders or overshoots
Absent baseline variability with recurrent variable decelerations
Bradycardia

Five essential components of any fetal heart rate (FHR) tracing must be evaluated regularly. These include (choose all that apply): Baseline rate
Baseline variability
Accelerations
Decelerations
Changes or trends over time
Frequency of contractions

Which action is correct when palpation is used to assess the characteristics and pattern of uterine contractions?
Place the hand on the abdomen below the umbilicus and palpate uterine tone with the fingertips.
Determine the frequency by timing from the end of one contraction to the end of the next contraction.
Evaluate the intensity by pressing the fingertips into the uterine fundus.
Assess uterine contractions every 30 minutes throughout the first stage of labor.

The woman in labor should be encouraged to use the Valsalva maneuver (holding one’s breath and tightening abdominal muscles) for pushing during the second stage.

True

False