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Which laboring patient should the nurse attend to first?
- A. 18-year-old primigravida with a fetal breech presentation
- B. 25-year-old multigravida with history of previous cesarean section
- C. 35-year-old multigravida with history of precipitate birth
- D. 16-year-old primigravida with a twin pregnancy
Correct Answer: C
Rationale: A precipitate birth is completed in less than 3 hours and can lead to complications like uterine rupture or cervical lacerations, requiring immediate attention.
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What would the nurse planning discharge instruction teach the woman to do?
- A. Report any increase in fetal activity.
- B. Notify her obstetrician if she has a temperature above 37.8?°C (100?°F).
- C. Massage her breasts to promote uterine relaxation.
- D. Rest in a side-lying Trendelenburg's position with hips elevated.
Correct Answer: B
Rationale: For the woman with premature rupture of membranes (PROM) who is not having labor induced right away, teaching combines information about infection and preterm labor. The woman should monitor her temperature and report a temperature greater than 37.8?°C (100?°F).
What position will the nurse promote to encourage fetal rotation and pain relief?
- A. Prone with legs supported and give her a back massage
- B. Supine with legs bent at the knee
- C. Standing with support
- D. Sitting up and leaning forward on the overbed table
Correct Answer: D
Rationale: A position that favors fetal rotation and descent and is helpful for the woman with back labor is to sit or kneel leaning forward on a support.
What are the rationales for labor induction?
- A. Placenta previa
- B. Prolapse of cord
- C. High station of fetus
- D. Maternal diabetes
- E. Placental insufficiency
Correct Answer: D,E
Rationale: Maternal diabetes and placental insufficiency are rationales for induction. Placenta previa, prolapse of cord, and high station of fetus are contraindications.
Which interventions could a nurse apply to help stimulate contractions?
- A. Encouraging the patient to sit upright
- B. Assisting the patient to ambulate
- C. Stimulating the nipples
- D. Offering emotional support
- E. Allowing the patient to vent frustration
Correct Answer: A,B,C
Rationale: Sitting upright, ambulating, and stimulating the nipples may encourage progression of labor.
What is the lowest Bishop score the patient should have prior to induction?
- A. 6
- B. 8
- C. 10
- D. 12
Correct Answer: A
Rationale: The Bishop score evaluates the suitability of the patient for a vaginal delivery. A minimum score of 6 is recommended by the American College of Obstetricians and Gynecologists (ACOG).