Comfort Measures During Labor

HESI RN · Comfort Measures During Labor

Question 1 of 83

What indicates progression to the second stage of labor?

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HESI RN · Comfort Measures During Labor

Question 2 of 83

What is the primary rationale for teaching breathing and relaxation exercises in childbirth classes?

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HESI RN · Comfort Measures During Labor

Question 3 of 83

What can amniotomy cause?

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HESI RN · Comfort Measures During Labor

Question 4 of 83

What should the nurse do during the next contraction for a woman at 10 cm dilation, 100% effacement, and +3 station?

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HESI RN · Comfort Measures During Labor

Question 5 of 83

What type of monitor can measure the strength of a contraction?

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HESI RN · Comfort Measures During Labor

Question 6 of 83

What is the appropriate action for a primigravida at 2 cm dilation, contracting q 12 minutes, with a reassuring fetal heart rate?

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HESI RN · Comfort Measures During Labor

Question 7 of 83

How can a nurse support the patient during the fourth stage of labor?

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HESI RN · Comfort Measures During Labor

Question 8 of 83

What is the primary purpose of assessing the perineum after birth?

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HESI RN · Comfort Measures During Labor

Question 9 of 83

What helps relieve back labor pain?

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HESI RN · Comfort Measures During Labor

Question 10 of 83

What type of FHR decelerations are a sign of possible fetal descent?

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HESI RN · Comfort Measures During Labor

Question 11 of 83

During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to:

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HESI RN · Comfort Measures During Labor

Question 12 of 83

What is a direct influence on cervical dilation? Select all that apply.

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HESI RN · Comfort Measures During Labor

Question 13 of 83

What is the expected effect of pudendal anesthesia?

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HESI RN · Comfort Measures During Labor

Question 14 of 83

What is the primary risk associated with a retained placenta?

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HESI RN · Comfort Measures During Labor

Question 15 of 83

What should the nurse do first if a client feels the need to move her bowels late in labor?

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HESI RN · Comfort Measures During Labor

Question 16 of 83

What should the nurse do first if a client reports seeing blood-tinged mucus?

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HESI RN · Comfort Measures During Labor

Question 17 of 83

What anticipatory guidance should the nurse provide for new parents regarding sociologic changes?

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HESI RN · Comfort Measures During Labor

Question 18 of 83

What person is at high risk for labor dystocia?

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HESI RN · Comfort Measures During Labor

Question 19 of 83

What must the nurse assess when noting fetal heart decelerations?

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HESI RN · Comfort Measures During Labor

Question 20 of 83

What should the nurse encourage a woman in active labor to do?

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HESI RN · Comfort Measures During Labor

Question 21 of 83

Which deceleration pattern is related to cord compression?

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HESI RN · Comfort Measures During Labor

Question 22 of 83

What is a fetal complication of vacuum extractor use?

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HESI RN · Comfort Measures During Labor

Question 23 of 83

What complications can cocaine and methamphetamine use cause?

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HESI RN · Comfort Measures During Labor

Question 24 of 83

A woman is admitted in active labor. Her leukocyte count is 14,500/mm3. Based on this information, the nurse should:

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HESI RN · Comfort Measures During Labor

Question 25 of 83

What is a risk of prolonged second stage labor?

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HESI RN · Comfort Measures During Labor

Question 26 of 83

Where should the nurse place the fetoscope to hear the fetal heartbeat for LOA positioning?

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HESI RN · Comfort Measures During Labor

Question 27 of 83

Which fetal attitude corresponds to a chin-on-chest position?

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HESI RN · Comfort Measures During Labor

Question 28 of 83

A client is in the third stage of labor. Which of the following assessments should the nurse make/observe for?

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HESI RN · Comfort Measures During Labor

Question 29 of 83

What would the nurse administer if the newborn has decreased or no respiratory effort?

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HESI RN · Comfort Measures During Labor

Question 30 of 83

What position may encourage the fetus to find the occiput anterior position?

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HESI RN · Comfort Measures During Labor

Question 31 of 83

What is a sign of intrauterine fetal demise?

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HESI RN · Comfort Measures During Labor

Question 32 of 83

What characteristic does a Category II tracing have?

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HESI RN · Comfort Measures During Labor

Question 33 of 83

Before proceeding with a physical assessment, what should the nurse check in the prenatal record?

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HESI RN · Comfort Measures During Labor

Question 34 of 83

An ultrasound report of a fetus' heart states that 'normal fetal circulation is noted.' Which statement is consistent with the finding?

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HESI RN · Comfort Measures During Labor

Question 35 of 83

What statement indicates a woman is probably in labor and should proceed to the hospital?

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HESI RN · Comfort Measures During Labor

Question 36 of 83

Calculate the drip rate for 150 cc over 1 hour with a drop factor of 10.

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HESI RN · Comfort Measures During Labor

Question 37 of 83

A nurse is assessing the fundus of a client during the immediate postpartum period. Which of the following actions indicates that the nurse is performing the skill correctly?

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HESI RN · Comfort Measures During Labor

Question 38 of 83

How soon should delivery occur with a Category III FHR tracing?

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HESI RN · Comfort Measures During Labor

Question 39 of 83

What is the cause of this abnormal tracing?

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HESI RN · Comfort Measures During Labor

Question 40 of 83

What position is consistent with the findings from Leopold's maneuvers?

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HESI RN · Comfort Measures During Labor

Question 41 of 83

What is a religious mandate for observant Jewish women?

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HESI RN · Comfort Measures During Labor

Question 42 of 83

What is the correct sequence of cardinal moves of labor?

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HESI RN · Comfort Measures During Labor

Question 43 of 83

Which breech position is depicted if one leg is extended through the cervix and vagina?

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HESI RN · Comfort Measures During Labor

Question 44 of 83

What is the primary goal of fetal heart rate monitoring during the second stage?

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HESI RN · Comfort Measures During Labor

Question 45 of 83

What should the nurse do if the fetal heart rate is 152 bpm?

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HESI RN · Comfort Measures During Labor

Question 46 of 83

What nursing intervention should be initiated for an FHR tracing with early decelerations?

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HESI RN · Comfort Measures During Labor

Question 47 of 83

What type of counter pressure is the nurse providing?

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HESI RN · Comfort Measures During Labor

Question 48 of 83

On which of the postpartum days can the client expect lochia serosa?

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HESI RN · Comfort Measures During Labor

Question 49 of 83

What assessments should the nurse perform to report the client's status? Select all that apply.

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HESI RN · Comfort Measures During Labor

Question 50 of 83

What position facilitates epidural insertion?

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HESI RN · Comfort Measures During Labor

Question 51 of 83

What is malnutrition during pregnancy associated with?

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HESI RN · Comfort Measures During Labor

Question 52 of 83

What nursing intervention is performed for preeclampsia?

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HESI RN · Comfort Measures During Labor

Question 53 of 83

What may the birthing person experience during the third stage of labor?

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HESI RN · Comfort Measures During Labor

Question 54 of 83

What is the most common cause of placenta accreta?

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HESI RN · Comfort Measures During Labor

Question 55 of 83

The nurse is caring for an Orthodox Jewish woman in labor. It would be appropriate for the nurse to include which of the following in the plan of care?

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HESI RN · Comfort Measures During Labor

Question 56 of 83

A nurse in the labor and delivery unit is completing an admission assessment for a client who is at 39 weeks of gestation. The client reports that she has been leaking fluid from her vagina for 2 days. Which condition is the client most at risk for developing?

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HESI RN · Comfort Measures During Labor

Question 57 of 83

What is the likely outcome for a multipara at 3 station in the LOA position?

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HESI RN · Comfort Measures During Labor

Question 58 of 83

What is the nurse's immediate action for a boggy uterus?

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HESI RN · Comfort Measures During Labor

Question 59 of 83

When does the active phase of labor begin according to ACOG?

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HESI RN · Comfort Measures During Labor

Question 60 of 83

What is the condition where the umbilical cord vessels cross the cervix?

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HESI RN · Comfort Measures During Labor

Question 61 of 83

The nurse should note how long the interval between contractions lasts because:

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HESI RN · Comfort Measures During Labor

Question 62 of 83

Why does the nurse turn the laboring person to a side-lying position?

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HESI RN · Comfort Measures During Labor

Question 63 of 83

What causes a decrease in fetal heart rate variability?

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HESI RN · Comfort Measures During Labor

Question 64 of 83

A client delivered a baby 2 months ago. Her partner calls into the office to report that the woman is angry, confused, and having conversations with herself. Which response by the nurse is most appropriate?

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HESI RN · Comfort Measures During Labor

Question 65 of 83

What is an appropriate action by the doula?

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HESI RN · Comfort Measures During Labor

Question 66 of 83

What is the most therapeutic breathing technique for the latent phase of labor?

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HESI RN · Comfort Measures During Labor

Question 67 of 83

When should the nurse consider suggesting a doula?

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HESI RN · Comfort Measures During Labor

Question 68 of 83

The nurse is assessing an internal fetal heart monitor tracing of an unmedicated, full-term gravida who is in transition. Which of the following heart rate patterns would the nurse interpret as normal?

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HESI RN · Comfort Measures During Labor

Question 69 of 83

What do decreased capillary refill and diminished peripheral pulses indicate?

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HESI RN · Comfort Measures During Labor

Question 70 of 83

What does a presenting part at -3 station indicate?

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HESI RN · Comfort Measures During Labor

Question 71 of 83

What presenting part questions the nurse's judgment of a vertical lie?

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HESI RN · Comfort Measures During Labor

Question 72 of 83

During a breast exam, the midwife notes that the woman has a transdermal contraceptive patch applied to her breast. The midwife should:

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HESI RN · Comfort Measures During Labor

Question 73 of 83

What is the nurse's priority action after rupture of membranes?

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HESI RN · Comfort Measures During Labor

Question 74 of 83

What is the disadvantage of local anesthesia?

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HESI RN · Comfort Measures During Labor

Question 75 of 83

The practitioner is performing a fetal scalp stimulation test. Which of the following fetal responses would the nurse expect to see?

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HESI RN · Comfort Measures During Labor

Question 76 of 83

What can the nurse conclude about the fetal position if a hard round mass is felt in the fundal area and a soft round mass is felt above the symphysis?

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HESI RN · Comfort Measures During Labor

Question 77 of 83

Which breathing technique is used during stage 2 of labor?

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HESI RN · Comfort Measures During Labor

Question 78 of 83

A nurse is assisting an anesthesiologist who is inserting an epidural catheter. Which of the following positions should the nurse assist the woman into?

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HESI RN · Comfort Measures During Labor

Question 79 of 83

What indicates the completion of the second stage of labor?

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HESI RN · Comfort Measures During Labor

Question 80 of 83

The physician writes the following order for a newly admitted client in labor: Begin a 1000 cc IV of D5 1/2 NS at 150 cc/hr. The IV tubing states that the drop factor is 10 gtt/cc. Calculate the drip rate.

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HESI RN · Comfort Measures During Labor

Question 81 of 83

A multipara, LOA, station 3, who has had no pain medication during her labor, is now in stage 2. She states that her pain is 6 on a 10-point scale and that she wants an epidural. Which of the following responses by the nurse is appropriate?

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HESI RN · Comfort Measures During Labor

Question 82 of 83

What is the expected fetal heart response to scalp stimulation?

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HESI RN · Comfort Measures During Labor

Question 83 of 83

A woman, G1 P0000, 40 weeks' gestation, entered the labor suite stating that she is in labor. Upon examination it is noted that the woman is 2 cm dilated, 30% effaced, contracting every 12 min 30 sec. Fetal heart rate is in the 140s with good variability and spontaneous accelerations. What should the nurse conclude when reporting the findings to the primary health care practitioner?

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