Chapter 54: Female Reproductive Cycle II: Labor, Delivery, and Preterm Neonatal Drugs Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 54: Female Reproductive Cycle II: Labor, Delivery, and Preterm Neonatal Drugs

Test Bank

MULTIPLE CHOICE

1. The healthcare provider orders hydroxyzine (Vistaril) for a client in labor. To achieve a positive outcome, the nurse plans to administer the drug via which route?

a.

Intradermally

b.

Intravenously

c.

Intramuscularly via Z-track technique

d.

Subcutaneously via Z-track technique

ANS: C

Hydroxyzine should be administered intramuscularly via Z-track technique. It should not be given intradermally, subcutaneously, or intravenously.

DIF: Cognitive Level: Application REF: p. 828

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. An epidural block is ordered for a primipara client in labor. The nurse anticipates that this epidural block will be given when the cervix is dilated at _____ centimeters.

a.

2 to 3

b.

3 to 4

c.

4 to 5

d.

5 to 6

ANS: D

An epidural block is given to a primipara at 5 to 6 cm and multipara at 3 to 4 cm.

DIF: Cognitive Level: Application REF: p. 835

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A client is being treated with an ergot alkaloid medication. Which observation would cause the nurse to contact the primary healthcare provider?

a.

Hypertension

b.

Itching

c.

Jugular vein distention

d.

Seizure activity

ANS: D

Signs of ergot toxicity (ergotism) include pain in arms, legs, and lower back; numbness; cold hands and feet; muscular weakness; diarrhea; hallucinations; seizures; and blood hypercoagulability.

DIF: Cognitive Level: Application REF: p. 843

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. What would be a positive outcome of administration of oxytocin (Pitocin) 10 units (intramuscularly) after the third stage of labor?

a.

Relaxation of the uterus

b.

Relief of afterbirth discomfort

c.

Suppression of lactation

d.

Prevention of uterine atony

ANS: D

Oxytocin tones the uterus after delivery to decrease blood loss.

DIF: Cognitive Level: Application REF: p. 841

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The client is scheduled for an epidural anesthetic as she delivers. What will be the highest priority nursing intervention?

a.

Administer 1 L of an isotonic IV solution and encourage use of a bedpan after spinal anesthesia.

b.

Administer 500 mL of a hypotonic IV solution and assess the level of consciousness because the patient is sedated.

c.

Administer 500 mL of a hypertonic IV solution and assess fetal heart rate and progress of labor as per pregnancy protocol.

d.

Administer 1 L of hypotonic IV solution and allow the client to ambulate during the spinal anesthesia.

ANS: A

This prevents maternal hypotension.

DIF: Cognitive Level: Application REF: p. 834

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The best candidate for induction of labor is the woman:

a.

experiencing a multiple gestation pregnancy.

b.

experiencing umbilical cord prolapse.

c.

whose fetus will probably be premature.

d.

who fetus is post due date.

ANS: D

Post due date is an indication for induction.

DIF: Cognitive Level: Application REF: p. 838

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Antepartal Care

7. The best candidate for treatment with dinoprostone (Cervidil) is the woman who needs her:

a.

labor stopped.

b.

cervix ripened.

c.

labor stimulated.

d.

labor prolonged.

ANS: B

This medication allows the cervix to efface and dilate.

DIF: Cognitive Level: Application REF: p. 839

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. Which will most likely be part of the nursing care of a woman postcaesarean section with spinal anesthesia?

a.

Early ambulation to avoid constipation

b.

Fluid restrictions to decrease blood volume

c.

Lying flat 6 to 8 hours to avoid spinal headache

d.

IV antibiotics to avoid postpartum infection

ANS: C

This is the most likely because of the spinal anesthesia. Although antibiotics may be ordered, this is not the most likely.

DIF: Cognitive Level: Application REF: pp. 829-830, 832-833

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Reduction of Risk Potential

9. The client is scheduled to be treated with Oxytocin by nasal spray. The nurse plans to administer the drug:

a.

2 to 3 minutes after the client nurses her baby.

b.

2 to 3 minutes before the client nurses her baby.

c.

after delivery of the placenta.

d.

as delivery of the placenta is imminent.

ANS: B

Oxytocin given via nasal spray should be administered 2 to 3 minutes before the client is ready to nurse and should not be administered to a pregnant client.

DIF: Cognitive Level: Application REF: p. 841

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client received a score of 9 on the Modified Bishop Scoring System. The nurse interprets this to mean that the client:

a.

cannot be considered for labor induction because of to her overall health status.

b.

can be considered for labor induction but the risks should be evaluated.

c.

cannot be considered for labor induction due to the risks to the fetus.

d.

can be considered for a labor induction, which is anticipated to be successful.

ANS: D

A score of 8 or greater on the Modified Bishop Scoring system means that the client should be able to successfully be induced.

DIF: Cognitive Level: Application REF: pp. 838-839

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. A gravida 3, para 2 woman at 41 weeks gestation is 1 cm dilated and 60% effaced. She has not ruptured her membranes, has not passed a mucus plug, and is not experiencing labor. It is decided that if she does not experience labor by the next day, she will be induced with oxytocin (Pitocin). Which actions are key to the nursing care of a woman experiencing induction? (Select all that apply.)

a.

Provide an explanation of all procedures to the client.

b.

Monitor mothers vital signs throughout the procedure.

c.

Insert and monitor arterial blood pressure via an inserted arterial line.

d.

Continuously monitor fetal toleration to the induction.

e.

Insert a Foley catheter and monitor hourly urine outputs.

f.

Assess for obstetric complications and notify physician as warranted.

g.

Monitor the intravenous infusion of medication.

h.

Continue to increase dosage, titrating until fetal distress is marked.

ANS: A, B, D, F, G

An arterial line and Foley catheter are not needed. The dosage is set according to uterine contractions, not fetal responses.

DIF: Cognitive Level: Application REF: pp. 838-839

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Antepartal Care

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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