Question 1

Which presentation is described accurately in terms of both presenting part and frequency of occurrence?&#10;A) Cephalic: occiput;at least 95%&#10;B) Breech: sacrum;10 to 15%&#10;C) Shoulder: scapula;10 to 15%&#10;D) Cephalic: cranial;80 to 85%

Accepted Answer

In cephalic presentations (head first)the presenting part of the head or cranium is the occiput;this occurs in 96% of births.In a breech birth the sacrum emerges first;this occurs in about 3% of births.In shoulder presentations the scapula emerges first;this occurs in only 1% of births.

Question 2

What should the nurse know with regard to primary and secondary powers?&#10;A) Primary and secondary powers are responsible for effacement and dilation of the cervix.&#10;B) Effacement generally is well ahead of dilation in women giving birth for the first time;effacement and dilation are more together in subsequent pregnancies.&#10;C) Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful,but it should not slow or inhibit dilation.&#10;D) Pushing in the second stage of labour is more effective if the woman can breathe deeply and control some of her involuntary needs to push,as the nurse directs.

Accepted Answer

Effacement generally is well ahead of dilation in first-timers;they are more together in subsequent pregnancies.The primary powers are responsible for dilation and effacement;secondary powers are concerned with expulsion of the fetus.Scarring of the cervix may slow dilation.Pushing is more effective and less fatiguing when the woman begins to push only after she has the urge to do so.

Question 3

What should the nurse be aware of with regard to fetal positioning during labour?&#10;A) Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal.&#10;B) Birth is imminent when the presenting part is at +4 to +5 cm,below the spine.&#10;C) The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter.&#10;D) Engagement is the term used to describe the beginning of labour.

Accepted Answer

The station of the presenting part should be noted at the beginning of labour so that the rate of descent can be determined.Position is the relation of the presenting part of the fetus to the four quadrants of the mother's pelvis;station is the measure of degree of descent.The largest diameter usually is the biparietal diameter.The suboccipitobregmatic diameter is the smallest,although one of the most critical measurements.Engagement often occurs in the weeks just before labour in nulliparas and before or during labour in multiparas.

Question 4

What is the term for the relationship of the fetal body parts to one another?&#10;A) Lie&#10;B) Presentation&#10;C) Attitude&#10;D) Position

Accepted Answer

Attitude is the relation of the fetal body parts to one another.Lie is the relation of the long axis (spine)of the fetus to the long axis (spine)of the mother.Presentation refers to the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labour at term.Position is the relation of the presenting part to the four quadrants of the mother's pelvis.

Question 5

A new mother asks the nurse when the &#34;soft spot&#34; on her son's head will go away.The nurse's answer is based on the knowledge that the anterior fontanel closes how many months after birth?&#10;A) 2 months&#10;B) 8 months&#10;C) 12 months&#10;D) 18 months

Accepted Answer

The larger of the two fontanels,the anterior fontanel,closes by 18 months after birth.

Question 6

What should the nurse be aware of to accurately assess the health of the mother during labour?&#10;A) The woman's blood pressure will increase during contractions and fall back to prelabour normal between contractions.&#10;B) Use of the Valsalva manoeuvre is encouraged during the second stage of labour to relieve fetal hypoxia.&#10;C) Having the woman point her toes will reduce leg cramps.&#10;D) The endogenous endorphins released during labour will raise the woman's pain threshold and produce sedation.

Accepted Answer

The endogenous endorphins released during labour will raise the woman's pain threshold and produce sedation.In addition,physiological anaesthesia of the perineal tissues,caused by the pressure of the presenting part,decreases the mother's perception of pain.Blood pressure increases during contractions but remains somewhat elevated between them.Use of the Valsalva manoeuvre is discouraged during second-stage labour because it can lead to a number of unhealthy outcomes,including fetal hypoxia.Pointing the toes can cause leg cramps,as can the process of labour itself.

Question 7

Which basic type of pelvis includes the correct description and percentage of occurrence in women?&#10;A) Gynecoid: classic female;heart shaped;75%&#10;B) Android: resembling the male;wider oval;15%&#10;C) Anthropoid: resembling the ape;narrower;10%&#10;D) Platypelloid: flattened,wide,shallow;3%

Accepted Answer

A platypelloid pelvis is flattened,wide,and shallow;about 3% of women have this shape.The gynecoid shape is the classical female shape,slightly ovoid and rounded;about 50% of women have this shape.An android,or male-like,pelvis is heart shaped;about 23% of women have this shape.An anthropoid,or apelike,pelvis is oval and wider;about 24% of women have this shape.

Question 8

To adequately care for a labouring woman,the nurse should know that which stage of labour varies most in length?&#10;A) First&#10;B) Second&#10;C) Third&#10;D) Fourth

Accepted Answer

The first stage of labour is considered to last from the onset of regular uterine contractions to full dilation of the cervix.The first stage is much longer than the second and third stages combined.In a first-time pregnancy the first stage of labour can take up to 18 hours or longer.The second stage of labour lasts from the time the cervix is fully dilated to the birth of the fetus and is relatively short.The third stage of labour lasts from the birth of the fetus until the placenta is delivered.This stage may be as short as 3 to 5 minutes or as long as 1 hour.The fourth stage of labour,recovery,lasts about 2 hours after delivery of the placenta.

Question 9

Which position would be least effective when gravity is needed to assist in fetal descent?&#10;A) Lithotomy&#10;B) Kneeling&#10;C) Sitting&#10;D) Walking

Accepted Answer

Lithotomy position requires a woman to be in a reclined position with her legs in stirrups.Gravity has little effect in this position.Kneeling,sitting,and walking help align the fetus with the pelvic outlet and allow gravity to assist in fetal descent.

Question 10

What is the term for the slight overlapping of cranial bones or shaping of the fetal head during labour?&#10;A) Lightening&#10;B) Moulding&#10;C) Ferguson reflex&#10;D) Valsalva manoeuvre

Accepted Answer

Moulding permits adaptation to various diameters of the maternal pelvis.Lightening is the mother's sensation of decreased abdominal distension,which usually occurs the week before labour.Fetal head formation is called moulding.The Ferguson reflex is the contraction urge of the uterus after stimulation of the cervix.The Valsalva manoeuvre describes conscious pushing during the second stage of labour.

Question 11

What should nurses be aware of with regard to the turns and other adjustments of the fetus during the birth process?&#10;A) The seven critical movements must progress in a more or less orderly sequence.&#10;B) Asynclitism sometimes is achieved by means of the Leopold manoeuvre.&#10;C) The effects of the forces determining descent are modified by the shape of the woman's pelvis and the size of the fetal head.&#10;D) At birth the baby is said to achieve &#34;restitution&#34; (i.e. ,a return to the C-shape of the womb).

Accepted Answer

The answer of What should nurses be aware of with...

Question 12

Which description of the four stages of labour is correct for both definition and duration?&#10;A) First stage: onset of regular uterine contractions to full dilation;less than 1 hour to 18 hours&#10;B) Second stage: full effacement to 4 to 5 cm;visible presenting part;1 to 2 hours&#10;C) Third state: active pushing to birth;20 minutes (multipara),50 minutes (primipara)&#10;D) Fourth stage: delivery of the placenta to recovery;30 minutes to 1 hour

Accepted Answer

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Question 13

The nurse would expect which maternal cardiovascular finding during labour?&#10;A) Increased cardiac output&#10;B) Decreased pulse rate&#10;C) Decreased white blood cell (WBC)count&#10;D) Decreased blood pressure

Accepted Answer

The answer of The nurse would expect which maternal cardiovascular...

Question 14

Which represents one of the factors that affect the process of labour and birth,known commonly as the five P's?&#10;A) Pelvic diameters&#10;B) Position&#10;C) Powers&#10;D) Pressure

Accepted Answer

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Question 15

Which is true with regard to factors that affect how the fetus moves through the birth canal?&#10;A) The fetal attitude describes the angle at which the fetus exits the uterus.&#10;B) Of the two primary fetal lies,the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother.&#10;C) The normal attitude of the fetus is called general flexion.&#10;D) The transverse lie is preferred for vaginal birth.

Accepted Answer

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Question 16

The nurse has received a report about a woman in labour.The woman's last vaginal examination was recorded as 3 cm,30%,and -2.What is the nurse's interpretation of this assessment?&#10;A) The cervix is effaced 3 cm,it is dilated 30%,and the presenting part is 2 cm above the ischial spines.&#10;B) The cervix is 3 cm dilated,it is effaced 30%,and the presenting part is 2 cm above the ischial spines.&#10;C) The cervix is effaced 3 cm,it is dilated 30%,and the presenting part is 2 cm below the ischial spines.&#10;D) The cervix is dilated 3 cm,it is effaced 30%,and the presenting part is 2 cm below the ischial spines.

Accepted Answer

The answer of The nurse has received a report about...

Question 17

Which position would the nurse suggest for second-stage labour if the pelvic outlet needs to be increased?&#10;A) Semirecumbent&#10;B) Sitting&#10;C) Squatting&#10;D) Semi-Fowler's

Accepted Answer

The answer of Which position would the nurse suggest for...

Question 18

Which may be a sign that precedes labour?&#10;A) Lightening&#10;B) Exhaustion&#10;C) Weight gain&#10;D) Decreased fetal movement

Accepted Answer

The answer of Which may be a sign that precedes...

Question 19

Which factor influences cervical dilation?&#10;A) The size of the fetus&#10;B) The diameters of the bony pelvis&#10;C) The size of the female&#10;D) The pressure applied by the amniotic sac

Accepted Answer

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Question 20

What should the nurse teach the woman about her position during labour?&#10;A) The supine position increases blood flow.&#10;B) The &#34;all fours&#34; position,on her hands and knees,is hard on her back.&#10;C) Frequent changes in position will help relieve her fatigue and increase her comfort.&#10;D) In a sitting or squatting position her abdominal muscles will have to work harder.

Accepted Answer

The answer of What should the nurse teach the woman...

Question 21

Which are possible signs preceding labour? Select all that apply.Express answer in small letters,with a comma followed by a space-e.g. ,a,b,C&#10;A) Weight loss of 2 to 2.5 kg&#10;B) Surge of energy&#10;C) Decreased vaginal discharge&#10;D) Bloody show&#10;E) Relief from urinary frequency&#10;F) Backache

Accepted Answer

The answer of Which are possible signs preceding labour? Select...

Deck 16: Labour and Birth Processes