Deck 13: Labor and Birth Process

Question 1

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?

A) "I'm feeling contractions mostly in my back."
B) "My contractions are about 6 minutes apart and regular."
C) "The contractions slow down when I walk around."
D) "If I try to talk to my partner during a contraction, I can't."

Answer 1

"The contractions slow down when I walk around."

Question 2

Which of the following would indicate to the nurse that the placenta is separating?

A) Uterus becomes globular
B) Fetal head is at vaginal opening
C) Umbilical cord shortens
D) Mucous plug is expelled

Answer 2

Uterus becomes globular

Question 3

When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics?

A) Extent of opening to its widest diameter
B) Degree of thinning
C) Passage of the mucous plug
D) Fetal presenting part

Answer 3

Degree of thinning

Question 4

A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following?

A) Increased energy level with alternating strong and weak contractions
B) Moderately strong contractions every 4 minutes, lasting about 1 minute
C) Contractions noted in the front of abdomen that stop when she walks
D) Pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds

Question 5

A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:

A) Latent phase of the first stage of labor
B) Active phase of the first stage of labor
C) Transition phase of the first stage of labor
D) Pelvic phase of the second stage of labor

Question 6

Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in:

A) Latent phase of the first stage
B) Active phase of the first stage
C) Transition phase of the first stage
D) Perineal phase of the second stage

Question 7

A woman telephones her health care provider and reports that her "water just broke." Which suggestion by the nurse would be most appropriate?

A) "Call us back when you start having contractions."
B) "Come to the clinic or emergency department for an evaluation."
C) "Drink 3 to 4 glasses of water and lie down."
D) "Come in as soon as you feel the urge to push."

Question 8

After teaching a group of students about the maternal bony pelvis, which statement by the group indicates that the teaching was successful?

A) The bony pelvis plays a lesser role during labor than soft tissue.
B) The pelvic outlet is associated with the true pelvis.
C) The false pelvis lies below the imaginary linea terminalis.
D) The false pelvis is the passageway through which the fetus travels.

Question 9

A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as:

A) +4
B) +2
C) 0
D) -2

Question 10

After teaching a group of students about the factors affecting the labor process, the instructor determines that the teaching was successful when the group identifies which of the following as a component of the true pelvis? (Select all that apply.)

A) Pelvic inlet
B) Cervix
C) Mid pelvis
D) Pelvic outlet
E) Vagina
F) Pelvic floor muscles

Question 11

A nurse is documenting fetal lie of a woman in labor. Which term would the nurse most likely use?

A) Flexion
B) Extension
C) Longitudinal
D) Cephalic

Question 12

The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which of the following is the presenting part?

A) Occiput
B) Face
C) Buttocks
D) Shoulder

Question 13

A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which of the following would the nurse most likely include? (Select all that apply.)

A) Internal rotation
B) Abduction
C) Descent
D) Pronation
E) Flexion

Question 14

The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which of the following?

A) Increment
B) Acme
C) Peak
D) Decrement

Question 15

A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction?

A) Heart rate increase from 76 bpm to 90 bpm
B) Blood pressure rise from 110/60 mm Hg to 120/74
C) White blood cell count of 12,000 cells/mm3
D) Respiratory rate of 10 breaths /minute

Question 16

When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage?

A) Regular contractions
B) Cervical dilation
C) Fetal movement through the birth canal
D) Placental separation

Question 17

A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor?

A) Contractions every 5 minutes, cervical dilation 3 cm
B) Contractions every 3 minutes, cervical dilation 5 cm
C) Contractions every 2½ minutes, cervical dilation 7 cm
D) Contractions every 1 minute, cervical dilation 9 cm

Question 18

A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which of the following would the nurse most likely include when discussing measures to promote coping for a positive labor experience? (Select all that apply.)

A) Presence of a support partner
B) View of birth as a stressor
C) Low anxiety level
D) Fear of loss of control
E) Participation in a pregnancy exercise program

Question 19

During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate?

A) "It's difficult to predict how your labor will progress, but we'll be there for you the entire time."
B) "Since this is your first pregnancy, you can estimate it will be about 10 hours."
C) "It will depend on how big the baby is when you go into labor."
D) "Time isn't important; your health and the baby's health are key."

Question 20

A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse identify as being most important in allowing the fetal head to move through the pelvis?

A) Sutures
B) Fontanelles
C) Frontal bones
D) Biparietal diameter

Question 21

Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station?

A) -2
B) -1
C) 0
D) +1