Obstetrical Nursing – Intrapartum – NCLEX Quiz 4

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Questions: 10 | Attempts: 19,566 | Updated: Aug 16, 2023

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Obstetrical Nursing Intrapartum NCLEX Quiz 4 - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.

Questions and Answers

1.

A client is admitted to the birthing suite in early active labor. The priority nursing intervention on the admission of this client would be:
- A.
  
  Auscultating the fetal heart
- B.
  
  Taking an obstetric history
- C.
  
  Asking the client when she last ate
- D.
  
  Ascertaining whether the membranes were ruptured
Correct Answer
A. Auscultating the fetal heart

Explanation
Determining the fetal well-being supersedes all other measures. If the FHR is absent or persistently decelerating. immediate intervention is required.

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2.

A client who is gravida 1. para 0 is admitted in labor. Her cervix is 100% effaced. and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus’ head is:
- A.
  
  Not yet engaged
- B.
  
  Entering the pelvic inlet
- C.
  
  Below the ischial spines
- D.
  
  Visible at the vaginal opening
Correct Answer
C. Below the ischial spines

Explanation
A station of +1 indicates that the fetal head is 1 cm below the ischial spines.

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3.

After doing Leopold’s maneuvers. the nurse determines that the fetus is in the ROP position. To best auscultate the fetal heart tones. the Doppler is placed:
- A.
  
  Above the umbilicus at the midline
- B.
  
  Above the umbilicus on the left side
- C.
  
  Below the umbilicus on the right side
- D.
  
  Below the umbilicus near the left groin
Correct Answer
C. Below the umbilicus on the right side

Explanation
Fetal heart tones are best auscultated through the fetal back; because the position is ROP (right occiput presenting). the back would be below the umbilicus and on the right side.

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4.

The physician asks the nurse the frequency of a laboring client’s contractions. The nurse assesses the client’s contractions by timing from the beginning of one contraction:
- A.
  
  Until the time it is completely over
- B.
  
  To the end of a second contraction
- C.
  
  To the beginning of the next contraction
- D.
  
  Until the time that the uterus becomes very firm
Correct Answer
C. To the beginning of the next contraction

Explanation
This is the way to determine the frequency of the contractions

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5.

The nurse observes the client’s amniotic fluid and decides that it appears normal. because it is:
- A.
  
  Clear and dark amber in color
- B.
  
  Milky. greenish yellow. containing shreds of mucus
- C.
  
  Clear. almost colorless. and containing little white specks
- D.
  
  Cloudy. greenish-yellow. and containing little white specks
Correct Answer
C. Clear. almost colorless. and containing little white specks

Explanation
By 36 weeks gestation. normal amniotic fluid is colorless with small particles of vernix caseosa present.

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6.

At 38 weeks gestation. a client is having late decelerations. The fetal pulse oximeter shows 75% to 85%. The nurse should:
- A.
  
  Discontinue the catheter. if the reading is not above 80%
- B.
  
  Discontinue the catheter. if the reading does not go below 30%
- C.
  
  Advance the catheter until the reading is above 90% and continue monitoring
- D.
  
  Reposition the catheter. recheck the reading. and if it is 55%. keep monitoring
Correct Answer
D. Reposition the catheter. recheck the reading. and if it is 55%. keep monitoring

Explanation
Adjusting the catheter would be indicated. Normal fetal pulse oximetry should be between 30% and 70%. 75% to 85% would indicate maternal readings.

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7.

When examining the fetal monitor strip after the rupture of the membranes in a laboring client. the nurse notes variable decelerations in the fetal heart rate. The nurse should:
- A.
  
  Stop the oxytocin infusion
- B.
  
  Change the client’s position
- C.
  
  Prepare for immediate delivery
- D.
  
  Take the client’s blood pressure
Correct Answer
B. Change the client’s position

Explanation
Variable decelerations usually are seen as a result of cord compression; a change of position will relieve pressure on the cord.

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8.

When monitoring the fetal heart rate of a client in labor. the nurse identifies an elevation of 15 beats above the baseline rate of 135 beats per minute lasting for 15 seconds. This should be documented as:
- A.
  
  An acceleration
- B.
  
  An early elevation
- C.
  
  A sonographic motion
- D.
  
  A tachycardic heart rate
Correct Answer
A. An acceleration

Explanation
An acceleration is an abrupt elevation above the baseline of 15 beats per minute for 15 seconds; if the acceleration persists for more than 10 minutes it is considered a change in baseline rate. A tachycardic FHR is above 160 beats per minute.

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9.

A laboring client complains of low back pain. The nurse replies that this pain occurs most when the position of the fetus is:
- A.
  
  Breech
- B.
  
  Transverse
- C.
  
  Occiput anterior
- D.
  
  Occiput posterior
Correct Answer
D. Occiput posterior

Explanation
A persistent occiput posterior position causes intense back pain because of fetal compression of the sacral nerves. Occiput anterior is the most common fetal position and does not cause back pain.

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10.

The breathing technique that the mother should be instructed to use as the fetus’ head is crowning is:
- A.
  
  Blowing
- B.
  
  Slow chest
- C.
  
  Shallow
- D.
  
  Accelerated-decelerated
Correct Answer
A. Blowing

Explanation
Blowing forcefully through the mouth controls the strong urge to push and allows for a more controlled birth of the head.

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Current Version
Aug 16, 2023

Quiz Edited by
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Sep 08, 2017

Quiz Created by
Santepro

Obstetrical Nursing – Intrapartum – NCLEX Quiz 4

A client is admitted to the birthing suite in early active labor. The priority nursing intervention on the admission of this client would be:

A client who is gravida 1. para 0 is admitted in labor. Her cervix is 100% effaced. and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus’ head is:

After doing Leopold’s maneuvers. the nurse determines that the fetus is in the ROP position. To best auscultate the fetal heart tones. the Doppler is placed:

The physician asks the nurse the frequency of a laboring client’s contractions. The nurse assesses the client’s contractions by timing from the beginning of one contraction:

The nurse observes the client’s amniotic fluid and decides that it appears normal. because it is:

At 38 weeks gestation. a client is having late decelerations. The fetal pulse oximeter shows 75% to 85%. The nurse should:

When examining the fetal monitor strip after the rupture of the membranes in a laboring client. the nurse notes variable decelerations in the fetal heart rate. The nurse should:

When monitoring the fetal heart rate of a client in labor. the nurse identifies an elevation of 15 beats above the baseline rate of 135 beats per minute lasting for 15 seconds. This should be documented as:

A laboring client complains of low back pain. The nurse replies that this pain occurs most when the position of the fetus is:

The breathing technique that the mother should be instructed to use as the fetus’ head is crowning is: