Deck 6: Nursing Care of Mother and Infant During Labor and Birth

Question 1

Why is the relaxation phase between contractions important?

A) The laboring woman needs to rest.
B) The uterine muscles fatigue without relaxation.
C) The contractions can interfere with fetal oxygenation.
D) The infant progresses toward delivery at these times.

Answer 1

The contractions can interfere with fetal oxygenation.

Question 2

What marks the end of the third stage of labor?

A) Full cervical dilation
B) Expulsion of the placenta and membranes
C) Birth of the infant
D) Engagement of the head

Answer 2

Expulsion of the placenta and membranes

Question 3

How should the nurse intervene to relieve perineal bruising and edema following delivery?

A) Place an ice pack on the area for 12 hours.
B) Place a warm pack on the perineal area for 24 hours.
C) Administer aspirin to relieve inflammation.
D) Change the perineal pad frequently.

Answer 3

Place an ice pack on the area for 12 hours.

Question 4

The nurse is caring for a woman in the first stage of labor.What will the nurse remind the patient about contractions during this stage of labor?

A) They get the infant positioned for delivery.
B) They push the infant into the vagina.
C) They dilate and efface the cervix.
D) They get the mother prepared for true labor.

Question 5

Why should the nurse encourage the mother to void during the fourth stage of labor?

A) A full bladder could interfere with cervical dilation.
B) A full bladder could obstruct progress of the infant through the birth canal.
C) A full bladder could obstruct the passage of the placenta.
D) A full bladder could predispose the mother to uterine hemorrhage.

Question 6

While discussing labor and delivery during a prenatal visit,a primigravida asks the nurse when she should go to the hospital.What is the nurse's most informative response?

A) "When you feel increased fetal movement"
B) "When contractions are 10 minutes apart"
C) "When membranes have ruptured"
D) "When abdominal or groin discomfort occurs"

Question 7

The nurse observes on the fetal monitor a pattern of a 15-beat increase in the fetal heart rate that lasts 15 to 20 seconds.What does this pattern indicate?

A) A well-oxygenated fetus
B) Compression of the umbilical cord
C) Compression of the fetal head
D) Uteroplacental insufficiency

Question 8

Vaginal examination reveals the presenting part is the infant's head,which is well flexed on the chest.What is this presentation?

A) Vertex
B) Military
C) Brow
D) Face

Question 9

What contraction duration and interval does the nurse recognize could result in fetal compromise?

A) Duration shorter than 30 seconds, interval longer than 75 seconds
B) Duration shorter than 90 seconds, interval longer than 120 seconds
C) Duration longer than 90 seconds, interval shorter than 60 seconds
D) Duration longer than 60 seconds, interval shorter than 90 seconds

Question 10

While caring for a laboring woman,the nurse notices a pattern of variable decelerations in fetal heart rate with uterine contractions.What is the nurse's initial action?

A) Stop the oxytocin infusion.
B) Increase the intravenous flow rate.
C) Reposition the woman on her side.
D) Start oxygen via nasal cannula.

Question 11

What does the nurse note when measuring the frequency of a laboring woman's contractions?

A) How long the patient states the contractions last
B) The time between the end of one contraction and the beginning of the next
C) The time between the beginning and the end of one contraction
D) The time between the beginning of one contraction and the beginning of the next

Question 12

The nurse observes the patient bearing down with contractions and crying out,"The baby is coming!" What is the best nursing intervention?

A) Find the physician.
B) Stay with the woman and use the call bell to get help.
C) Send the woman's partner to locate a registered nurse.
D) Assist with deep breathing to slow the labor process.

Question 13

At a prenatal visit,a primigravida asks the nurse how she will know her labor has started.The nurse knows that what indicates the beginning of true labor?

A) Contractions that are relieved by walking
B) Discomfort in the abdomen and groin
C) A decrease in vaginal discharge
D) Regular contractions becoming more frequent and intense

Question 14

What does meconium-stained amniotic fluid indicate when the infant is in a vertex presentation?

A) Fetal distress
B) Fetal maturity
C) Intact gastrointestinal tract
D) Dehydration in the mother

Question 15

What is the most important nursing intervention during the fourth stage of labor?

A) Monitor the frequency and intensity of contractions.
B) Provide comfort measures.
C) Assess for hemorrhage.
D) Promote bonding.

Question 16

It is determined that the presenting part of the fetus is the buttocks.At delivery the fetus's hips are flexed and the knees are extended.How would the nurse record this presentation?

A) Complete breech
B) Frank breech
C) Double footling
D) Buttocks presentation

Question 17

A woman is 7 cm dilated,and her contractions are 3 minutes apart.When she begins cursing at her birthing coach and the nurse,what does the nurse assess as the most likely explanation for the woman's change in behavior?

A) Labor has progressed to the transition phase.
B) She lacked adequate preparation for the labor experience.
C) The woman would benefit from a different form of analgesia.
D) The contractions have increased from mild to moderate intensity.

Question 18

What is the function of contractions during the second stage of labor?

A) Align the infant into the proper position for delivery
B) Dilate and efface the cervix
C) Push the infant out of the mother's body
D) Separate the placenta from the uterine wall

Question 19

What is the most appropriate statement from the nurse when coaching the laboring woman with a fully dilated cervix to push?

A) "At the beginning of a contraction, hold your breath and push for 10 seconds."
B) "Take a deep breath and push between contractions."
C) "Begin pushing when a contraction starts and continue for the duration of the contraction."
D) "At the beginning of a contraction, take two deep breaths and push with the second exhalation."

Question 20

One hour postdelivery the nurse notes the new mother has saturated three perineal pads.What is the most appropriate nursing action?

A) Check the fundus for position and firmness.
B) Report to the doctor immediately.
C) Change the pads and chart the time.
D) Time how long it takes to soak one pad.

Question 21

The physician performs an amniotomy on a laboring woman.What will be the nurse's priority assessment immediately following this procedure?

A) Fetal heart rate
B) Fluid amount
C) Maternal blood pressure
D) Deep tendon reflexes

Question 22

The nurse formulates a nursing diagnosis for a woman in the fourth stage of labor.What is the most appropriate nursing diagnosis?

A) Pain related to increasing frequency and intensity of contractions.
B) Fear related to the probable need for cesarean delivery.
C) Dysuria related to prolonged labor and decreased intake.
D) Risk for injury related to hemorrhage.

Question 23

Using a diagram,the nurse demonstrates the sequence of the mechanisms of labor.Place the seven mechanisms of labor in sequential order.Put a comma and space between each answer choice (a,b,c,d,etc.)

A) Extension
B) Engagement
C) Descent
D) Flexion
E) Expulsion
F) Internal rotation
G) External rotation

Question 24

The nurse may assist the health care provider in determining the fetal position and presentation by abdominal palpations called _____________________________ _____________________________.

Question 25

The nurse is caring for a patient who is not certain if she is in true labor.How might the nurse attempt to stimulate cervical effacement and intensify contractions in the patient?

A) By offering the patient warm fluids to drink
B) By helping the patient to ambulate in the room
C) By seating the patient upright in a straight-back chair
D) By positioning the patient on her right side

Question 26

The nurse explains that the "four Ps" of the birth process are __________,__________,__________,and __________.

Question 27

What are the advantages of a freestanding birth center?

A) Home-like setting
B) Designed for high-risk pregnancies
C) Lower costs
D) Attended by certified obstetricians
E) Immediate emergency access

Question 28

What is the best nursing action to implement when late decelerations occur?

A) Reposition the patient to supine
B) Decrease flow of intravenous (IV) fluids
C) Increase oxygen to 10 L/minute
D) Prepare to increase oxytocin drip

Question 29

What do late decelerations indicate?

A) A nonreassuring pattern
B) Uteroplacental insufficiency
C) Fetal heart depression
D) Cord compression
E) Head compression

Question 30

The husband of a woman in labor asks,"What does it mean when the baby is at minus 1 station?" After giving an explanation,what statement by the husband indicates that teaching was effective?

A) "Fetal head is above the ischial spines."
B) "Fetal head is below the ischial spines."
C) "Fetal head is engaged in the mother's pelvis."
D) "Fetal head is visible at the perineum."

Question 31

A pregnant woman arrives at the emergency department (ED)and reports she is in labor.After a thorough examination and diagnostic testing,it is determined to be false (prodromal)labor.What signs and symptoms would lead the nurse to suspect false (prodromal)labor?

A) Leaking of vaginal fluid
B) Contractions intensify with ambulation
C) Pink spotting
D) Painless tightening of abdominal muscles
E) Cervix thick and not effaced

Question 32

At 1 and 5 minutes of life,a newborn's Apgar score is 9.What does the nurse understand that a score of 9 indicates?

A) The newborn will require resuscitation.
B) The newborn may have physical disabilities.
C) The newborn will have above average intelligence.
D) The newborn is in stable condition.

Question 33

After the membranes have ruptured,the nurse should assess the fetal heart rate (FHR)for ________ minute(s).

Question 34

A nursing student is observing prenatal exams in the office setting.The health care provider informs the student that the fetal position is LSA.The student interprets this as a ____________________ presentation.

Question 35

After the pregnant woman is admitted to the labor suite,the nurse assesses the position of the infant as ROA; this means that the infant's head is _________ __________ _________.

Question 36

What is the nurse primarily concerned about maintaining in the initial care of the newborn?

A) Fluid intake
B) Feeding schedule
C) Thermoregulation
D) Parental bonding

Question 37

A pregnant woman,gravida 2,para 1,tells the nurse she desires a VBAC (vaginal birth after cesarean section)with this pregnancy.What is the primary concern regarding complications for this patient during labor and birth?

A) Eclampsia
B) Placental abruption
C) Congestive heart failure
D) Uterine rupture

Question 38

While caring for an Arab woman in labor,the nurse should provide cultural sensitivity through which interventions?

A) Provide for extreme modesty.
B) Assign a male caregiver.
C) Arrange for the husband/partner to participate in labor.
D) Provide adequate pain control.
E) Respect protective amulets.