NUR-227 Practice Exam Questions and Correct Answers
2 views 0 purchase
Course
NUR 227
Institution
NUR 227
A nurse receives the shift report when coming onto the antepartum floor. Which patient does the nurse anticipate will require a cesarean delivery? A patient who reports exhaustion A patient with complete placenta previa A patient with genital herpes who has not had an outbreak in 6 months A patient...
NUR-227 Practice Exam Questions and
Correct Answers
A nurse receives the shift report when coming onto the antepartum floor. Which patient
does the nurse anticipate will require a cesarean delivery?
A patient who reports exhaustion
A patient with complete placenta previa
A patient with genital herpes who has not had an outbreak in 6 months
A patient with a history of cesarean delivery with a low vertical uterine incision ✅A
patient with complete placenta previa
Complete placenta previa is an indication for cesarean delivery, as this condition may
result in hemorrhage during labor.
The charge nurse is planning nursing assignments on a busy antepartum unit. For
which patient does the nurse know that cesarean delivery is contraindicated?
A patient with preeclampsia
A patient with cephalopelvic disproportion
A patient with a confirmed absence of fetal heartbeat
A patient with premature rupture of membranes (PROM ✅A patient with a confirmed
absence of fetal heartbeat
Fetal death is a contraindication for cesarean delivery. The surgical risk(s) to the mother
(infection, hemorrhage, atelectasis, and anesthesia complications) outweigh the benefit
of cesarean delivery in this cas
The antepartum nurse is caring for a patient who is scheduled for cesarean delivery.
The patient reports anxiety about the procedure because she is unsure of her exact due
date and whether the fetus is mature enough for cesarean delivery. Which is the best
response made by the nurse to this patient?
"The exact due date can be determined with a gynecological assessment."
"Cesarean delivery can be performed after spontaneous onset of labor to verify
gestational age."
"Amniocentesis can be performed prior to cesarean delivery to verify that delivery is
safe for your infant."
"Ultrasound can be performed prior to cesarean delivery to verify that cesarean delivery
on the scheduled date is safe for the infant." ✅"Amniocentesis can be performed prior
to cesarean delivery to verify that delivery is safe for your infant."
Amniocentesis may be done prior to cesarean delivery to verify fetal lung maturity for
patients with questionable due dates.
A patient having a scheduled cesarean delivery asks the nurse why the provider plans
to use a Pfannenstiel incision (transverse skin incision). Which is the most accurate
response by the nurse?
"There is usually a longer recovery time with a Pfannenstiel incision."
,"There likely will be less post-operative pain with a transverse incision."
"The transverse incision allows for more space and better access to the fetus."
"The transverse incision allows for faster uterine access, thus speeding up the delivery."
✅"There likely will be less post-operative pain with a transverse incision."
A low transverse incision causes less disruption of abdominal wall musculature, and
thus is less painful than a vertical, midline incision.
The antepartum nurse is caring for a patient with a history of one cesarean birth via low
transverse incision. The patient asks the nurse what her chances are of a successful
vaginal birth for the current pregnancy. Which is the appropriate nursing education for
this patient?
"Because of the risk of cervical laceration with low transverse incisions, vaginal birth
after cesarean is not recommended."
"With low transverse incisions, vaginal birth after cesarean is a possibility, because of a
decreased risk of incision rupture."
"Because of the increased risk of infection, vaginal birth after cesarean is not indicated
for patients with a history of low transverse incision."
"Vaginal birth after cesarean is not a possibility for patients with a history of low vertical
incision, because the uterine incision may lead to lots of scar tissue." ✅"With low
transverse incisions, vaginal birth after cesarean is a possibility, because of a
decreased risk of incision rupture."
Vaginal birth after cesarean is a possibility for patients with a history of low transverse
incisions due to a decreased risk of uterine rupture.
A nurse is caring for a patient following cesarean delivery. According to the operative
report, the patient had a low transverse uterine incision. Which interpretation of this data
by the nurse is accurate?
The patient had minimal blood loss during the surgery.
The patient is no longer a candidate for subsequent vaginal delivery.
The patient is at risk for a uterine tear that could extend down into the cervix.
The patient is at risk for uterine incisional rupture during a subsequent birth. ✅The
patient had minimal blood loss during the surgery.
A low transverse uterine incision is preferred since one advantage is that there is
typically little blood loss during the procedure. This is related to its small size and
placement on the uterus.
The nurse is preparing a patient for cesarean delivery. After the epidural anesthetic is
initiated, the patient reports anxiety about being alone and awake in the operating room
(OR) during delivery. Which nursing interventions are appropriate for this patient?
Select all that apply.
Reassure the patient that the procedure will not take very long.
Inform the patient that a nurse will be present in the OR during the procedure.
Describe the OR and the people who will be present during the delivery to the patient.
Explain to the patient that because of the anesthesia, it is unlikely that the patient will
remember very much about the delivery.
,Inform the patient that a family member is allowed in the OR for support, although he or
she may have to wait a few minutes to come in. ✅Inform the patient that a nurse will
be present in the OR during the procedure.
The nurse preparing the patient is often the circulating nurse during cesarean delivery.
Having a familiar face and voice present can reassure the patient.
Describe the OR and the people who will be present during the delivery to the patient.
Describing the OR and the people who will be present during delivery helps the patient
know what to expect and may help alleviate anxiety.
Inform the patient that a family member is allowed in the OR for support, although he or
she may have to wait a few minutes to come in.
The patient may have a support person in the OR during the delivery. Preparatory
procedures such as catheter insertion may occur before the support person enters,
which can take 30 minutes to 45 minutes. Knowing that a family member will be present
may help alleviate the patient's anxiety.
The nurse is assessing a patient in the post-anesthesia care unit (PACU) following a
cesarean delivery under general anesthesia. After confirming respiratory status, which
is the next assessment the nurse should complete?
Fundal height
Color of lochia
Blood pressure (BP)
Level of consciousness (LOC) ✅Level of consciousness (LOC)
Following confirmation of an adequate airway and respiratory status, LOC is next
assessed. The patient needs to be alert and oriented in order to continue respiratory
(breathing) effort. Consider the ABC principle of prioritization.
The nurse is assessing the fundus of a patient who had a cesarean delivery. The patient
reports abdominal discomfort during palpation. Which instructions should the nurse give
the patient regarding abdominal pain during fundal assessment?
"Turn to your side."
"Empty your bladder before the fundal assessment."
"Relax and breathe slowly during the fundal assessment."
"Take deep breaths and hold them during the fundal assessment." ✅"Relax and
breathe slowly during the fundal assessment."
Relaxing the abdominal muscles and taking slow, deep breaths can help prevent
discomfort during abdominal assessment.
A patient carrying twins desires an elective cesarean delivery. Which statement
indicates a need for further teaching regarding cesarean delivery?
"I might need a blood transfusion after the surgery."
"Having a c-section might make my hospital stay longer."
"Since I am not having a vaginal birth, my babies can't be harmed during delivery."
, "Depending on how they do the incision, I may be able to have a vaginal delivery if I
become pregnant again." ✅"Since I am not having a vaginal birth, my babies can't be
harmed during delivery."
Cesarean delivery carries risk of injury to the newborn, such as bruising, fractures, or
other trauma.
Which patient laboratory value would the nurse validate as part of routine preparation
for cesarean delivery, in order to determine adequate fetal maturity?
Rh-positive antibody test performed 4 weeks prior to surgery.
Negative rubella titer performed 6 weeks prior to surgery.
Positive serum pregnancy test performed at least 36 weeks prior to surgery.
High serum alpha-fetoprotein (AFP) level performed 26 weeks prior to surgery.
✅Positive serum pregnancy test performed at least 36 weeks prior to surgery.
Positive serum pregnancy test, performed at least 36 weeks prior to the date of
cesarean delivery, can be used to verify gestational age.
The patient is discussing with the nurse her preference for a vaginal delivery for her
current pregnancy. Which statement by the patient indicates the need for further
teaching?
"I had general anesthesia during my last c-section."
"Before my last c-section, the doctor tried to induce labor."
"My ultrasound showed a lot of scar tissue from my last c-section."
"I had a c-section with my last pregnancy because of placenta previa." ✅"I had a c-
section with my last pregnancy because of placenta previa."
Cesarean delivery due to placenta previa is typically done using a classic uterine
incision, which eliminates the option for vaginal birth after cesarean (VBAC).
The postpartum nurse is caring for a patient who experienced a cesarean delivery and
whose vertical skin incision is closed with sutures and surgical glue. Which step should
the nurse take to ensure the patient's comfort during the assessment?
Assist the patient to extend her legs prior to palpating the fundus.
Avoid palpating the area around the incision during assessment.
Decrease the frequency of assessments to allow for patient rest.
Administer the patient's pain medication before fundal assessment. ✅Administer the
patient's pain medication before fundal assessment.
Patients with vertical skin incisions often experience greater discomfort during fundal
assessment than patients with Pfannenstiel incisions. Therefore, administering pain
medication before fundal assessment helps ensure patient comfort and is a step the
nurse should take during assessment.
The antepartum nurse is caring for a patient with a body mass index (BMI) of 30 who is
scheduled for a planned cesarean delivery. The patient asks the nurse why the provider
has told her that a midline vertical incision will be done for the procedure. Which
explanation by the nurse is accurate?
"The midline vertical incision is less likely to lead to hernia formation later in life."
"The midline vertical incision will heal more quickly than a Pfannenstiel incision."
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller twishfrancis. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
