Question 1

The slight overlapping of cranial bones or shaping of the fetal head during labor is called:&#10;A)Lightening&#10;B)Molding&#10;C)Ferguson reflex&#10;D)Valsalva maneuver

Accepted Answer

Molding also permits adaptation to various diameters of the maternal pelvis.Lightening is the mother's sensation of decreased abdominal distention,which usually occurs the week before labor.The Ferguson reflex is the contraction urge of the uterus after stimulation of the cervix.The Valsalva maneuver describes conscious pushing during the second stage of labor.

Question 2

Which presentation is described accurately in terms of both presenting part and frequency of occurrence?&#10;A)Cephalic: occiput;at least 96%&#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 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.In a cephalic presentation the part of the head or cranium that emerges first is the occiput;cephalic presentations occur in 96% of births.

Question 3

Signs that precede labor include (choose all that apply):&#10;A)Lightening&#10;B)Exhaustion&#10;C)Bloody show&#10;D)Rupture of membranes&#10;E)Decreased fetal movement

Accepted Answer

Signs that precede labor may include lightening,urinary frequency,backache,weight loss,surge of energy,bloody show,and rupture of membranes.Many women experience a burst of energy before labor.A decrease in fetal movement is an ominous sign that does not always correlate with labor.

Question 4

When assessing a woman in labor,the nurse is aware that the relationship of the fetal body parts to one another is called fetal:&#10;A)Lie&#10;B)Presentation&#10;C)Attitude&#10;D)Position

Accepted Answer

Attitude is the relation of the fetal body parts to each other.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 labor at term.Position is the relation of the presenting part to the four quadrants of the mother's pelvis.

Question 5

A pregnant woman is at 38 weeks of gestation.She wants to know if any signs indicate "labor is getting closer to starting." The nurse informs the woman that which of the following is a sign that labor may begin soon?

A)Weight gain of 1.5 to 2 kg (3 to 4 lb)
B)Increase in fundal height
C)Urinary retention
D)Surge of energy

Accepted Answer

Women speak of having a burst of energy before labor.The woman may lose 0.5 to 1.5 kg,the result of water loss caused by electrolyte shifts,which in turn are caused by changes in the estrogen and progesterone levels.When the fetus descends into the true pelvis (called lightening),the fundal height may decrease.Urinary frequency may return before labor.

Question 6

The nurse recognizes that a woman is in true labor when she states:&#10;A)&#34;I passed some thick,pink mucus when I urinated this morning.&#34;&#10;B)&#34;My bag of waters just broke.&#34;&#10;C)&#34;The contractions in my uterus are getting stronger and closer together.&#34;&#10;D)&#34;My baby dropped,and I have to urinate more frequently now.&#34;

Accepted Answer

Regular,strong contractions with the presence of cervical change indicate that the woman is experiencing true labor.Loss of the mucous plug (operculum)often occurs during the first stage of labor or before the onset of labor,but it is not the indicator of true labor.Spontaneous rupture of membranes often occurs during the first stage of labor,but it is not the indicator of true labor.The presenting part of the fetus typically becomes engaged in the pelvis at the onset of labor,but this is not the indicator of true labor.

Question 7

The factors that affect the process of labor and birth,known commonly as the five Ps,include all except:&#10;A)Passenger&#10;B)Passageway&#10;C)Powers&#10;D)Pressure

Accepted Answer

The five Ps are passenger (fetus and placenta),passageway (birth canal),powers (contractions),position of the mother,and psychologic response.Pressure is not one of the five Ps.The passenger (fetus and placenta)is one of the five Ps.The passageway (birth canal)is also one of the five Ps.Powers (contractions)are a necessary component of the five Ps.

Question 8

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

Accepted Answer

Full dilation may occur in less than 1 hour,but in first-time pregnancies it can take up to 20 hours.The second stage extends from full dilation to birth and takes an average of 20 to 50 minutes,although 2 hours is still considered normal.The third stage extends from birth to expulsion of the placenta and usually takes a few minutes.The fourth stage begins after expulsion of the placenta and lasts until homeostasis is reestablished (about 2 hours).

Question 9

A woman's position is very important in the progress of labor.While discussing optimal positioning,maternity nurses should be able to tell the client that:&#10;A)The supine position commonly used in the United States 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 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

Frequent position changes relieve fatigue,increase comfort,and improve circulation.Blood flow can be compromised in the supine position;any upright position benefits cardiac output.The "all fours" position is used to relieve backache in certain situations.In a sitting or squatting position,the abdominal muscles work in greater harmony with uterine contractions.

Question 10

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

Accepted Answer

The first stage of labor 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 labor can take up to 20 hours.The second stage of labor lasts from the time the cervix is fully dilated to the birth of the fetus.The average length is 20 minutes for a multiparous woman and 50 minutes for a nulliparous woman.The third stage of labor lasts from the birth of the fetus until the placenta is delivered.This stage may be as short as 3 minutes or as long as 1 hour.The fourth stage of labor,recovery,lasts about 2 hours after delivery of the placenta.

Question 11

With regard to the turns and other adjustments of the fetus during the birth process,known as the mechanism of labor,nurses should be aware that:&#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 maneuver&#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;;that is,a return to the C-shape of the womb

Accepted Answer

The answer of With regard to the turns and other...

Question 12

To provide the necessary assessment of parent education,the nurse must know which bone is not a bone in the fetal skull?&#10;A)Parietal&#10;B)Temporal&#10;C)Fontanel&#10;D)Occipital

Accepted Answer

The answer of To provide the necessary assessment of parent...

Question 13

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 after birth by:&#10;A)2 months&#10;B)8 months&#10;C)12 months&#10;D)18 months

Accepted Answer

The answer of A new mother asks the nurse when...

Question 14

The nurse expects which maternal cardiovascular finding during labor?&#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 expects which maternal cardiovascular finding...

Question 15

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

Accepted Answer

The answer of What position is least effective when gravity...

Question 16

Regarding how the fetus moves through the birth canal,nurses should be aware that:&#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

The answer of Regarding how the fetus moves through the...

Question 17

The nurse has received a report about a woman in labor.The woman's last vaginal examination was recorded as 3 cm,30%,and -2.The nurse's interpretation of this assessment is that:&#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 18

When assessing the fetus using Leopold maneuvers,the nurse feels a round,firm,movable fetal part in the fundal portion of the uterus and a long,smooth surface in the mother's right side close to midline.What is the likely position of the fetus?

A)ROA
B)LSP
C)RSA
D)LOA

Accepted Answer

The answer of When assessing the fetus using Leopold maneuvers,the...

Question 19

Which factors influence cervical dilation? Choose all that apply.&#10;A)Strong uterine contractions&#10;B)The force of the presenting fetal part against the cervix&#10;C)The size of the female&#10;D)The pressure applied by the amniotic sac&#10;E)Scarring of the cervix

Accepted Answer

The answer of Which factors influence cervical dilation? Choose all...

Question 20

Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth.These changes occur naturally during labor and include all except:

A)Fetal lung fluid is cleared from the air passages during labor and vaginal birth
B)Fetal oxygen pressure decreases (PO2)
C)Fetal arterial carbon dioxide increases (PCO2)
D)Fetal respiratory movements increase during labor

Accepted Answer

The answer of Certain changes stimulate chemoreceptors in the aorta...

Question 21

The woman in labor should be encouraged to use the Valsalva maneuver (holding one's breath and tightening abdominal muscles)for pushing during the second stage.Is this statement true or false?

Accepted Answer

The answer of The woman in labor should be encouraged...

Question 22

Which pelvic shape is ideal for a vaginal birth? __________________

Accepted Answer

The answer of Which pelvic shape is ideal for a...

Deck 16: Labor and Birth Processes