Deck 26: Labor and Delivery

Question 1

The nurse plans to use a picture to show the area of the uterus that provides the force during a contraction,which is the:

A) lower portion.
B) middle portion.
C) upper portion.
D) cervical portion.

Answer 1

upper portion.

Question 2

Using Leopold's maneuvers to assess fetal position,the nurse finds a soft rounded prominence at the level of the fundus,a hard round prominence just above the symphysis pubis,and nodulations on the left side of the uterus.The fetal position is:

A) right occiput anterior (ROA),vertex.
B) left occiput anterior (LOA),vertex.
C) right occiput transverse (ROT),breech.
D) left occiput anterior (LOA)breech.

Answer 2

right occiput anterior (ROA),vertex.

Question 3

When monitoring the fetal heart rate (FHR),the nurse recognizes indications that the FHR is nonreassuring.This indicates to the nurse that the fetus is experiencing fetal distress most likely related to:

A) birth trauma.
B) strong contractions.
C) hypoxia.
D) aspiration.

Answer 3

hypoxia.

Question 4

The relationship of fetal body parts to one another during labor is called fetal attitude.The nurse explains that the ideal attitude for the fetal body is:

A) extension.
B) lateral.
C) flexion.
D) transverse.

Question 5

The first-time mother has been told by the nurse that the first stage of labor is the longest.An appropriate nursing intervention for comfort during this time would be:

A) cool fluids to drink.
B) a backrub in the sacral area.
C) assisting to lie in a supine position.
D) decreasing illumination in the room.

Question 6

Braxton-Hicks contractions,which may begin in the first trimester and become increasingly stronger during the pregnancy,differ from labor contractions in that they:

A) last several minutes.
B) are always regular.
C) do not dilate the cervix.
D) are only mild.

Question 7

A woman is admitted in active labor,and the nurse assesses the fetal heart rate (FHR)at 124 beats per minute.Based on that assessment,the nurse should:

A) position patient on her left side.
B) start oxygen per nasal cannula.
C) reassure the mother the rate is normal.
D) notify the physician at once.

Question 8

The nurse is assessing the printout from the fetal monitor.The nurse is legally responsible for:

A) recognizing deviations and taking appropriate action to prevent harm to the fetus.
B) recognizing deviations and notifying the physician.
C) recognizing and documenting deviations.
D) providing technical assessment.

Question 9

The nurse clarifies that the type of monitor that will assess the intensity of the contractions is a(n):

A) external monitor.
B) fetal monitor.
C) maternal monitor.
D) internal monitor.

Question 10

The pelvis is divided into two parts,the false and true pelvis.The nurse explains that the size of the true pelvis is most important because:

A) the fetal head must pass through this part.
B) these are the mother's measurements.
C) the false pelvis can change.
D) it needs to be larger.

Question 11

The nurse is alarmed as she assesses a protruding umbilical cord from the vagina.The immediate action the nurse should take is:

A) to monitor intensity of contractions.
B) place the patient in the knee-chest position.
C) notify the charge nurse.
D) ask the patient to perform a Valsalva maneuver.

Question 12

The nurse teaches a group of primigravidas that during delivery,pressure on the fetal skull may produce changes in the shape of the skull called:

A) pressure response.
B) overlapping.
C) molding.
D) spacing.

Question 13

A woman who is 38 weeks pregnant tells the nurse that the baby has dropped and she is having urinary frequency again.The nurse recognizes this as:

A) lightening.
B) Braxton-Hicks contractions.
C) initiation of labor.
D) engagement.

Question 14

The nurse reassures the patient that the method used to determine the size of the true pelvis for over 20 years with no detrimental effects to the fetus is:

A) pelvimetry.
B) palpation.
C) ultrasonography.
D) x-ray.

Question 15

The nurse differentiates false from true labor by explaining that in true labor:

A) discomfort of the contraction is in the fundus.
B) contractions do not follow a pattern.
C) contractions get stronger with ambulation.
D) contractions may stop with ambulation.

Question 16

When observing the fetal heart monitor,the nurse recognizes the fetal heart rate (FHR)decreases to 120 beats per minute at the beginning of a contraction and returns to a baseline of 155 beats per minute at the end of the contraction.This indicates:

A) early deceleration due to head compression.
B) that the fetus is in acute distress.
C) variable decelerations due to cord compression.
D) that these are late decelerations.

Question 17

The patient's membranes have just ruptured.The nurse is with her and knows that the first thing that must be done is to:

A) turn the patient on the left side.
B) perform a Nitrazine test.
C) check the fetal heart rate (FHR).
D) perform a vaginal examination.

Question 18

A patient arrives at the hospital and is not sure if she is in true labor.The nurse does an assessment and assures her she is in true labor because:

A) there is no dilatation.
B) the contractions are in the fundus.
C) the cervix has softened and effaced.
D) the contractions are irregular.

Question 19

The nurse points out the largest diameter of the fetal skull is the:

A) transverse.
B) biparietal.
C) lateral.
D) frontal-occipital.

Question 20

During the second stage of labor,the nurse should monitor the fetal heart rate every:

A) 5 minutes.
B) 10 minutes.
C) 15 minutes.
D) 20 minutes.

Question 21

A primigravida patient is admitted to the labor and delivery unit.During initial assessment,the baby is found to be engaged.The nurse recognizes this means that the:

A) narrowest diameter of the presenting part has reached the pelvic outlet.
B) descending part is being initiated through the midpelvis.
C) widest diameter of the presenting part has reached the pelvic outlet.
D) narrowest diameter of the presenting part is at the ischial spines.

Question 22

Which assessment findings suggest probable fetal distress? (Select all that apply.)

A) Fetal heart rate (FHR)of 120
B) Meconium-stained amniotic fluid
C) Decreased FHR during contractions
D) Strong contractions 10 seconds apart
E) Slow return of FHR to baseline

Question 23

The nurse shows the patient an x-ray of the fetal spine in parallel alignment with the mother's to demonstrate a ________ lie.

Question 24

The nurse clarifies to a primigravida that her pelvis is of the android type,which usually means the delivery will be a _______________.

Question 25

As the second stage of labor begins,the mother has an urge to push.The nurse encourages her to use her abdominal muscles to assist with pushing because:

A) the cervix is completely dilated.
B) the baby needs to be brought down.
C) the cervix needs to be enlarged.
D) effacement needs to be completed.

Question 26

Following delivery,the nurse must assess the mother to identify physiological changes during this stage.For the first hour,this assessment is done every:

A) 5 minutes.
B) 10 minutes.
C) 15 minutes.
D) 30 minutes.

Question 27

A mother is in early labor and asks the nurse how long this will last.The nurse explains that the first stage of labor lasts from the beginning of regular contractions until the:

A) cervix is completely effaced.
B) baby is in position.
C) cervix is fully dilated.
D) woman begins pushing.

Question 28

The physical condition of the infant is assessed at birth through the use of an Apgar score.If the infant has a heart rate of 105,is crying,has some flexion in the arms,sneezes,and has a pink body and blue limbs 5 minutes after delivery,the baby's Apgar score is:

A) 5.
B) 7.
C) 8.
D) 10.

Question 29

A mother has entered the second stage of labor.The nurse states that this stage begins with complete dilatation of the cervix and ends:

A) when the mother begins to push.
B) when the baby's head crowns.
C) with delivery of the baby.
D) with delivery of the placenta.

Question 30

The nurse is admitting a patient to the labor and delivery unit.While performing the initial assessment,it is most important to assess:

A) food and drug allergies.
B) when the baby is due.
C) when the patient last ate.
D) the timing of contractions.

Question 31

After the delivery of the baby,the placenta is delivered in the third stage of labor.Oxytocin is administered.The nurse explains that the purpose of the drug is to:

A) stimulate lactation.
B) relieve postpartum pain.
C) stimulate uterine contractions.
D) sedate the mother so she can rest.

Question 32

During labor,the patient screams at her husband to get out of her sight.The nurse's most appropriate action would be to:

A) encourage the husband to stay.
B) assure the husband that such behavior is normal.
C) remind the patient that the husband wants to help.
D) change the patient's position.

Question 33

After the delivery of a newborn,the nurse's first action to meet the priority need of the newborn is to:

A) place the newborn on the right side.
B) cover the cord stump.
C) dry the infant immediately.
D) suction nose and mouth.

Question 34

The nurse explains to the patient whose membranes ruptured an hour ago that delivery is usually accomplished in ____ to _____ hours postrupture.

Question 35

In the illustration below,which item depicts the LOT position?

Question 36

When the nurse performs the Nitrazine test on vaginal secretions of a primigravida who thinks her membranes have ruptured,the paper turns yellow.The nurse assesses this finding to indicate:

A) acidic discharge,membranes intact.
B) acidic discharge,membranes have ruptured.
C) neutral,not enough discharge to measure.
D) alkaline,membranes have ruptured.

Question 37

The physician has decided to induce labor with prostaglandin gel and an amniotomy.The nurse assures the patient that labor will probably start in:

A) 1 hour.
B) 4 hours.
C) 8 hours.
D) 12 hours.