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

Question 1

While discussing labor and delivery during a prenatal visit, a primigravida asks the nurse when she should go to the hospital. The nurse's most informative response would be that the woman should come when she:

A) Feels increased fetal movement
B) Has contractions that are 10 minutes apart
C) Thinks her membranes have ruptured
D) Has abdominal or groin discomfort

Answer 1

Thinks her membranes have ruptured

Question 2

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

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

Answer 2

Labor has progressed to the transition phase

Question 3

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. The nurse would record this presentation as:

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

Answer 3

Frank breech

Question 4

One hour postdelivery the nurse notes the new mother has saturated three perineal pads. The nurse should:

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 5

The most important nursing activity during the fourth stage of labor is to:

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

Question 6

To relieve perineal bruising and edema following delivery the nurse should:

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

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. The nurse knows that this pattern is indicative of:

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

Question 8

The nurse explains that the function of contractions during the second stage of labor is to:

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

Question 9

When the infant is in a vertex presentation, meconium-stained amniotic fluid indicates:

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

Question 10

During the fourth stage of labor, the nurse encourages the mother to void, because a full bladder may:

A) Interfere with cervical dilation
B) Obstruct progress of the infant through the birth canal
C) Obstruct the passage of the placenta
D) Predispose the mother to uterine hemorrhage

Question 11

The nurse explains that the third stage of labor ends with:

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

Question 12

When the nurse observes the patient bearing down with contractions and crying out, "The baby is coming!" the nurse should:

A) Go and 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

The nurse would coach the laboring woman with a fully dilated cervix to push by saying:

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 14

The nurse, while caring for a woman in the first stage of labor, reminds the patient that contractions during this stage of labor:

A) Get the baby positioned for delivery
B) Push the baby into the vagina
C) Dilate and efface the cervix
D) Get the mother prepared for true labor

Question 15

The nurse measures the frequency of a laboring woman's contractions by noting:

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 16

The relaxation phase between contractions is important because:

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

Question 17

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

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

Question 18

At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse instructs the woman that the beginning of true labor is indicated by:

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 19

Vaginal examination reveals the presenting part is the infant's head, which is well flexed on his/her chest. This presentation is referred to as:

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

Question 20

The nurse recognizes the contraction duration and interval that could result in fetal compromise is:

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 21

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

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 22

After the membranes have ruptured, the nurse should assess the FHR for ____________________ minute(s).

Question 23

The nurse explains that the "four P's" of the birth process are ____________________, ____________________, ____________________, and ____________________.

Question 24

At 1 and 5 minutes of life, a newborn's Apgar score is 9. The nurse understands that a score of 9 indicates this newborn:

A) Will require resuscitation
B) May have physical disabilities
C) Will have above average intelligence
D) Is in stable condition

Question 25

The husband of a woman in labor asks, "What does it mean when the baby is at -1 station?" After giving an explanation, the nurse determines that teaching was effective when the husband states the fetal head is:

A) Above the ischial spines
B) Below the ischial spines
C) Engaged in the mother's pelvis
D) Visible at the perineum

Question 26

After the pregnant woman is admitted to the labor suite, the nurse assesses the position of the baby as ROA; this means that the baby's head is ______ ___________ _____________.

Question 27

Using a diagram, the nurse demonstrates the sequence of the mechanisms of labor. Place the 7 mechanisms of labor in the appropriate order.

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

Question 28

While caring for an Arab woman in labor, the nurse will be culturally sensitive and will: Select all that apply.

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