A nurse is providing care to a client in labor.

A pelvic exam reveals a vertex presentation with the presenting part tilted toward the left side of the mother's pelvis and directed toward the anterior portion of the pelvis.

When developing this client's plan of care, which intervention would the nurse include?

Implementing measures for a vaginal birth.

Instituting continuous internal fetal monitoring.

Assisting with artificial rupture of the membranes.

Preparing the client for a cesarean birth.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Implementing measures for a vaginal birth is a reasonable intervention as the baby is in a favorable position for a normal delivery.

Choice B rationale:

Continuous internal fetal monitoring is not necessary unless there are complications or high-risk factors present.

Choice C rationale:

Artificial rupture of the membranes can be done to induce or augment labor, but it’s not necessary in this case.

Choice D rationale:

Preparing for a cesarean birth is not necessary as the baby is in a favorable position for a vaginal birth.

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Correct Answer is C

Explanation

Choice A rationale:

The back of the hand is sensitive to temperature, not pressure, making it less suitable for assessing contraction intensity.

Choice B rationale:

Finger tips are sensitive and can detect small changes, but they may not cover a large enough area to accurately assess contraction intensity.

Choice C rationale:

The palm of the hand covers a larger area and can better gauge the overall firmness of the uterus.

Choice D rationale:

Finger pads are sensitive to texture, not pressure, making them less suitable for this task.

A. 3 1 2 2 3. B. 3 2 1 0 3. C. 4 1 1 1 3. D. 4 2 1 3 1.

Correct Answer is D

Explanation

Choice A rationale:

This choice indicates 3 pregnancies, 1 term, 2 preterm, 2 living children, and 3 abortions. However, the client has had 4 pregnancies (twins, a son, and a miscarriage), so this choice is incorrect.

Choice B rationale:

This choice indicates 3 pregnancies, 2 term, 1 preterm, no living children, and 3 abortions. The client has 3 living children (twins and a son), so this choice is incorrect.

Choice C rationale:

This choice indicates 4 pregnancies, 1 term, 1 preterm, 1 living child, and 3 abortions. The client has 3 living children (twins and a son), so this choice is incorrect.

Choice D rationale:

This choice indicates 4 pregnancies, 2 term, 1 preterm, 3 living children, and 1 abortion. This correctly reflects the client’s obstetric history.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse palpates a woman's fundus to determine contraction intensity. What would be most appropriate for the nurse to use for palpation?.

Correct Answer is C

Explanation

Correct Answer is D

Explanation

Your patient is receiving Heparin via a continuous IV infusion at a rate of 1600 units per hour. The bag is labeled N/S 500 mLs and contains Heparin 40,000 units. What rate should the IV pump be set at to deliver this ordered amount of Heparin? mLs/hr.

A nurse is explaining the fetus's position to a female client whose baby is in the frank breech position. Which statement by the client would indicate that the teaching was understood?.

The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. What will the mother likely experience at that time?.

A nurse is caring for several women in labor. The nurse determines that which woman is in the latent phase of labor?.

A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction?.

Touch and massage can be helpful during labor. Which touch and massage methods are used in labor? Select all that apply.

A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome?.

After describing continuous internal electronic fetal monitoring to a laboring woman and her partner, which statement by the woman would indicate the need for additional teaching?.