Question 1

What should the nurse teach the woman about her position during labour?&#10;A) The supine position commonly used in North America 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

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 2

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 correct description of the vaginal examination for this woman in labour is the cervix is 3 cm dilated,it is effaced 30%,and the presenting part is 2 cm above the ischial spines.The sterile vaginal examination is recorded as centimeters of cervical dilation,percentage of cervical dilation,and the relationship of the presenting part to the ischial spines (either above or below).

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 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 5

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

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 re-established (about 2 hours).

Question 6

Which of the following 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

The five P's are passenger (fetus and placenta),passageway (birth canal),powers (contractions),position of the mother,and psychological response.

Question 7

What should the nurse know with regard to primary and secondary powers?&#10;A) Primary 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

The primary powers are responsible for dilation and effacement; secondary powers are concerned with expulsion of the fetus.Effacement generally is well ahead of dilation in first-timers; they are more together in subsequent pregnancies.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 8

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 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 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

The predominant position in North America for physician-attended births is the lithotomy position,which 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

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

During each contraction 400 mL of blood is emptied from the uterus into the maternal vascular system.This increases cardiac output by about 12% to 31% in the first stage of labour and by about 50% in the second stage.The heart rate increases slightly during labour.The WBC count can increase during labour.During the first stage of labour uterine contractions cause systolic readings to increase by about 10 mm Hg.During the second stage contractions may cause systolic pressures to increase by 30 mm Hg and diastolic readings to increase by 25 mm Hg.

Question 11

With regard to the turns and other adjustments of the fetus during the birth process,known as the mechanism of labour,nurses should be aware of which of the following?&#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 With regard to the turns and other...

Question 12

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

The answer of Which basic type of pelvis includes the...

Question 13

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 answer of To adequately care for a labouring woman,the...

Question 14

Which of the following 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 of the following may be a...

Question 15

When assessing the fetus using Leopold manoeuvres,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 manoeuvres,the...

Question 16

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) Side-lying

Accepted Answer

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

Question 17

With regard to factors that affect how the fetus moves through the birth canal,nurses should be aware of which of the following?&#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 With regard to factors that affect how...

Question 18

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 answer of What should the nurse be aware of...

Question 19

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

Question 20

When assessing a woman in labour,the nurse is aware that the relationship of the fetal body parts to one another is referred to as which of the following?&#10;A) Lie&#10;B) Presentation&#10;C) Attitude&#10;D) Position

Accepted Answer

The answer of When assessing a woman in labour,the nurse...

Question 21

Which of the following factors 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

The answer of Which of the following factors influences cervical...

Deck 15: Labour and Birth Processes