Deck 9: Labor and Birth Processes

Question 1

Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased?

A) Semirecumbent
B) Sitting
C) Squatting
D) Side-lying

Answer 1

Squatting

Question 2

With regard to fetal positioning during labor, nurses should be aware that:

A) Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal.
B) Birth is imminent when the presenting part is at +4 to +5 cm, below the spine.
C) The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter.
D) Engagement is the term used to describe the beginning of labor.

Answer 2

Birth is imminent when the presenting part is at +4 to +5 cm, below the spine.

Question 3

When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:

A) Lie.
B) Presentation.
C) Attitude.
D) Position.

Answer 3

Attitude.

Question 4

The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:

A) Passenger.
B) Passageway.
C) Powers.
D) Pressure.

Question 5

Which description of the four stages of labor is correct for both definition and duration?

A) First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
B) Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
C) Third state: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first-timer)
D) Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

Question 6

To assess the health of the mother accurately during labor, the nurse should be aware that:

A) The woman's blood pressure will increase during contractions and fall back to prelabor normal between contractions.
B) Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia.
C) Having the woman point her toes will reduce leg cramps.
D) The endogenous endorphins released during labor will raise the woman's pain threshold and produce sedation.

Question 7

The nurse would expect which maternal cardiovascular finding during labor?

A) Increased cardiac output
B) Decreased pulse rate
C) Decreased white blood cell (WBC) count
D) Decreased blood pressure

Question 8

To adequately care for a laboring woman, the nurse should know which stage of labor varies the most in length?

A) First
B) Second
C) Third
D) Fourth

Question 9

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:

A) The seven critical movements must progress in a more or less orderly sequence.
B) Asynclitism sometimes is achieved by means of the Leopold maneuver.
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.
D) At birth the baby is said to achieve "restitution" (i.e., a return to the C-shape of the womb).

Question 10

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:

A) The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines.
B) The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
C) The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines.
D) The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.

Question 11

A new mother asks the nurse when the "soft spot" 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:

A) 2 months.
B) 8 months.
C) 12 months.
D) 18 months.

Question 12

With regard to primary and secondary powers, the maternity nurse should know that:

A) Primary powers are responsible for effacement and dilation of the cervix.
B) Effacement generally is well ahead of dilation in women giving birth for the first time; they are closer together in time in subsequent pregnancies.
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.
D) Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs.

Question 13

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

Question 14

The _________ pelvic shape is ideal for a vaginal birth.

Question 15

Signs that precede labor include (choose all that apply):

A) Lightening.
B) Exhaustion.
C) Bloody show.
D) Rupture of membranes.
E) Decreased fetal movement.

Question 16

With regard to the position of the laboring woman, maternity nurses should be able to tell the woman that:

A) The supine position commonly used in the United States increases blood flow.
B) The "all fours" position, on her hands and knees, is hard on her back.
C) Frequent changes in position will help relieve her fatigue and increase her comfort.
D) In a sitting or squatting position her abdominal muscles will have to work harder.