labor and delivery nclex questions

labor and delivery nclex questions Related

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What effect will the presence of support people in labor most likely have?

  • A. improve the experience of the birthing person
  • B. improve the outcomes of the birthing person
  • C. improve the outcomes and experience of the birthing person
  • D. cause birth trauma and/or postpartum depression
Correct Answer: C

Rationale: The presence of support people during labor, such as a partner, family member, doula, or midwife, can have a positive impact on both the outcomes and experience of the birthing person. Studies have shown that having continuous support during labor can lead to shorter labor times, reduced need for medical interventions like cesarean sections or epidurals, increased satisfaction with the birth experience, and decreased likelihood of experiencing postpartum depression. Emotional support, physical comfort, and advocacy provided by support people can help the birthing person feel more empowered, confident, and less stressed during labor, ultimately leading to better outcomes and a more positive birth experience.

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A 24-year-old G4 T1 A2 L1 presents to obstetric triage with complaints of contractions every 3 minutes, accompanied by bright red vaginal bleeding. The woman is 29 weeks gestation with a twin pregnancy. She has had three urinary tract infections during this pregnancy and is currently taking Microbid daily as prophylaxis. Her last baby was born via cesarean section for breech malpresentation. She denies any other significant medical history. What risk factors for placenta previa does this patient have? Select all that apply.

  • A. Maternal age of 24
  • B. Twin gestation
  • C. Gestational age of 29 weeks
  • D. Previous delivery by cesarean section
Correct Answer: D

Rationale: The patient's age, history of cesarean section, and twin gestation all contribute to an increased risk of placenta previa. The most significant risk factor here is the previous cesarean section, which can cause scarring and increase the likelihood of abnormal placental implantation.

A woman has chosen a trial of labor after cesarean. Which findings indicate the best understanding of the nurse’s teaching by the patient?

  • A. "It is safer for me to be induced at 39 weeks so that my labor can be controlled and monitored carefully.”
  • B. "I will need to arrive to the hospital the night before my induction so that my cervix can be ripened with prostaglandins.”
  • C. "If I do not go into labor on my own, I will have to have a cesarean section since Pitocin is contraindicated for me.”
  • D. "A balloon catheter may be used to manually ripen my cervix, if necessary”
Correct Answer: D

Rationale: The correct understanding is that cervical ripening may be necessary before induction, and a balloon catheter can be used for this purpose. This is part of the education provided to patients who opt for a trial of labor after cesarean.

On admission to the labor unit, a primigravid woman at 38 weeks gestation states, “I need to urinate more now but at least I can breathe easier.” The nurse is aware that this is likely due to which physiological process?

  • A. Onset of labor
  • B. Effacement
  • C. Lightening
  • D. Rupture of membranes
Correct Answer: C

Rationale: Increased urination and easier breathing are signs of lightening, where the fetal head drops lower into the pelvis.

A nurse performs a vaginal examination on her patient in early labor and determines that the head is ballotable. What is this defined as?

  • A. Floating
  • B. Zero station
  • C. +1 station
  • D. -2 station
Correct Answer: A

Rationale: Ballotable means the fetal head is floating and can be pushed away from the cervix.

While attending the delivery of a patient with GODM, the nurse notices the retraction of the fetal head onto the perineum. What is the nurse’s next best action?

  • A. Apply fundal pressure
  • B. Assist the woman to left lateral position
  • C. Flex the mother to left lateral position
  • D. Assist the woman to hands-and-knees position
Correct Answer: D

Rationale: The retraction of the fetal head onto the perineum during labor can be indicative of shoulder dystocia or other obstructive complications, requiring immediate action. The best response is to assist the mother into hands-and-knees position, which can relieve pressure on the perineum and help with fetal descent.

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