Question 1

A student nurse is observed providing care to a woman in active labor.The instructor recognizes the need for corrective action when the student makes which statement?&#10;A) &#34;You're doing great with your breathing during contractions.&#34;&#10;B) &#34;Your partner could roll tennis balls over your back during contractions to reduce pain.&#34;&#10;C) &#34;Only your obstetrician can tell you how far your cervix has dilated.&#34;&#10;D) &#34;I will stay with you as long as I can to help you manage labor pain.&#34;&#10;

Accepted Answer

Only a healthcare provider, such as a midwife or obstetrician, should be determining the dilation of the cervix during labor. The statement implies that the student nurse is overstepping her scope of practice.

Question 2

After observing a laboring patient,the experienced nurse tells the student nurse that a cervical examination will likely confirm the transition phase has begun.What did the experienced nurse observe to suggest this diagnosis?

A) The woman reports that rupture of the membranes has occurred.
B) The woman keeps saying she is so glad to finally be in labor.
C) The contractions are 2 to 3 minutes apart.
D) The woman is irritable and has trouble concentrating.

Accepted Answer

The transition phase of labor is characterized by increased irritability and difficulty concentrating due to the intensity of contractions and the nearing of full cervical dilation.

Question 3

Which is the priority of nursing care for a woman in the early latent phase of labor?&#10;A) Encourage rest between contractions&#10;B) Encourage activity such as walking&#10;C) Perform frequent cervical checks&#10;D) Encourage acceptance of pain medications&#10;

Accepted Answer

Encouraging rest between contractions during early latent phase is the priority of nursing care for a woman in labor. This is because labor contractions can be physically and emotionally exhausting. Resting in between contractions can help the woman to conserve her energy for more active phases of labor. Encouraging activity such as walking or performing frequent cervical checks may cause unnecessary fatigue and discomfort for the woman. Encouraging acceptance of pain medications is also not a priority during the early latent phase.

Question 4

When assessing maternal response to labor,the nurse sees the most significant responses in which system?&#10;A) Cardiovascular&#10;B) Respiratory&#10;C) Gastrointestinal&#10;D) Reproductive&#10;

Accepted Answer

The reproductive system shows the most significant responses during labor, as it involves uterine contractions and cervical changes essential for childbirth.

Question 5

The nurse expects expulsion of the head to occur following which fetal movement?&#10;A) Restitution and external rotation&#10;B) Extension&#10;C) Internal rotation&#10;D) Flexion&#10;

Accepted Answer

The answer of The nurse expects expulsion of the head...

Question 6

While the doctor awaits delivery of the placenta after delivery of the newborn,the nurse documents that the patient is in which state of labor?&#10;A) Latent&#10;B) Second&#10;C) Transition&#10;D) Third&#10;

Accepted Answer

The third stage of labor occurs after the delivery of the baby and ends with the delivery of the placenta. This stage can last up to 30 minutes and the uterus will continue to contract to help the placenta separate and be expelled.

Question 7

As the fetal head moves through the birth canal,the nurse expects which assessment finding?&#10;A) Reduction in heart rate&#10;B) Increase in fetal oxygen pressure&#10;C) Decrease in fetal arterial carbon dioxide pressure&#10;D) Increase in fetal breathing movements&#10;

Accepted Answer

As the fetal head moves through the birth canal, it is common to observe a reduction in heart rate due to the compression of the fetal head, which can stimulate the vagus nerve and lead to a transient decrease in heart rate. This is a normal physiological response during labor.

Question 8

Which finding does the nurse identify as unexpected and concerning when assessing a woman in labor during the peak of a contraction? A) Increased blood pressure B) Decreased pulse rate C) Increase in depth and rate of respirations D) White blood cell (WBC)count of 26,000/mm³

Accepted Answer

An elevated WBC count suggests infection or inflammation, which can be concerning during labor and delivery as it may increase the risk of maternal and fetal complications. The other options are expected physiological responses during labor.

Question 9

After handing a wrapped newborn to the mother,the nurse sees the umbilical cord lengthening and a sudden trickle of blood at the vaginal opening and recognizes what is about to happen?&#10;A) Hemorrhage&#10;B) Multiple birth&#10;C) Placental separation&#10;D) Uterine inversion&#10;

Accepted Answer

The lengthening of the umbilical cord and sudden trickle of blood at the vaginal opening indicates that the placenta is separating from the uterine wall, which can result in postpartum hemorrhage. This is known as placental separation. Options B and D are not indicated by the given symptoms.

Question 10

Which assessment finding does the nurse recognize is the result of the laboring patient's increasing anxiety level as contractions become stronger?&#10;A) Abnormal fetal heart rate patterns&#10;B) Increased uterine contractility&#10;C) Shorter second stage of labor&#10;D) Reduced maternal heart rate&#10;

Accepted Answer

Abnormal fetal heart rate patterns during labor can be an indication of fetal distress. This can be caused by the mother's anxiety and stress during labor, which can lead to changes in the uterine blood flow, affecting the fetal oxygen supply. Therefore, this assessment finding can be indicative of the laboring patient's increasing anxiety level as contractions become stronger. Increased uterine contractility (B) is a usual finding during active labor, regardless of anxiety level. Shorter second stage of labor (C) can be an indication of efficient contractions and pushing efforts, and it is not related to anxiety. Reduced maternal heart rate (D) can be a finding in early labor, due to the initial increase in vagal tone, or a result of the use of medication, like opioids or epidural anesthesia.

Question 11

A laboring patient asks the nurse if the baby is injured during the delivery process.Which response by the nurse demonstrates understanding of fetal response to labor and delivery?&#10;A) &#34;Circulation and perfusion stop during contractions,so it is important not to labor too long.&#34;&#10;B) &#34;The baby can't breathe,so carbon dioxide builds up in the bloodstream and the oxygen level falls.&#34;&#10;C) &#34;The stress of labor does not produce any ill effects for the baby as long as the baby is healthy.&#34;&#10;D) &#34;No one really knows what happens to the baby during delivery,but it is a normal process.&#34;&#10;

Accepted Answer

The answer of A laboring patient asks the nurse if...

Question 12

While being admitting,a patient in labor says,"I want plenty of narcotics so I am asleep until the baby comes." The nurse recognizes that meeting this request will cause which risk for cesarean section?

A) The patient's inability to push and participate in delivery
B) Risk for fetal harm secondary to medications passing through the placenta
C) Elimination of the partner's involvement in the labor and delivery process
D) Increased contractility of the uterus as a potential side effect

Accepted Answer

The answer of While being admitting,a patient in labor says,&#34;I...

Question 13

The triage nurse receives a call from a pregnant woman.Which statement by the pregnant woman makes the nurse suspect the woman is experiencing false labor?&#10;A) &#34;The pain is in my back and circles around to the front.&#34;&#10;B) &#34;The pain gets more intense when I walk.&#34;&#10;C) &#34;The pain is becoming more intense and more frequent.&#34;&#10;D) &#34;I've been timing the contractions,and they are not regular.&#34;&#10;

Accepted Answer

The answer of The triage nurse receives a call from...

Question 14

A laboring patient begins to demonstrate irritability,snapping at her labor coach and complaining of pelvic pressure.The nurse suspects cervical assessment will reveal which dilation measurement?&#10;A) 2 to 3 cm&#10;B) 4 to 5 cm&#10;C) 5 to 6 cm&#10;D) 8 to 9 cm&#10;

Accepted Answer

The answer of A laboring patient begins to demonstrate irritability,snapping...

Question 15

After reinforcing teaching on how to determine the duration of a contraction,the nurse determines further teaching is needed when the mother makes which statement?&#10;A) &#34;I will time from the end of one contraction to the end of the next contraction.&#34;&#10;B) &#34;As soon as the contraction stops,I will time until the next one begins.&#34;&#10;C) &#34;I will write down the exact time the contraction begins and ends.&#34;&#10;D) &#34;I will time from the beginning of one contraction till the beginning of the next one.&#34;&#10;

Accepted Answer

The answer of After reinforcing teaching on how to determine...

Question 16

When reviewing a laboring patient's medical record,the nurse sees that a longitudinal lie has been documented.How is the fetus positioned?&#10;A) The fetus is lying parallel with the mother's body.&#10;B) The fetus is lying perpendicular to the mother's body.&#10;C) The fetus is lying at an angle to the mother's body,between parallel and perpendicular.&#10;D) The fetus is in the head-down position.&#10;

Accepted Answer

The answer of When reviewing a laboring patient's medical record,the...

Question 17

The nurse reviews the medical record of a woman admitted in labor and sees she has a narrow pelvis.Which of the seven Ps of labor does this impact?&#10;A) Passage&#10;B) Passenger&#10;C) Power&#10;D) Presentation&#10;

Accepted Answer

The answer of The nurse reviews the medical record of...

Question 18

Which cervical change does the nurse caring for a primipara expect to find during an assessment?&#10;A) The cervix dilates first,then begins to efface.&#10;B) Cervical dilation occurs at the same rate as cervical effacement.&#10;C) Cervical effacement occurs slowly,before significant dilation occurs.&#10;D) Cervical dilation begins; then effacement reaches 100% before dilation is complete.&#10;

Accepted Answer

The answer of Which cervical change does the nurse caring...

Deck 8: Process and Stages of Labor and Birth