Question 1

The labor and delivery nurse is preparing a prenatal class about facilitating the progress of labor. Which of the following frequent responses to pain should the nurse indicate is most likely to impede progress in labor?
A) Increased pulse
B) Elevated blood pressure
C) Muscle tension
D) Increased respirations

Accepted Answer

Muscle tension can impede the progress of labor by preventing the body from relaxing and dilating effectively. Relaxation is crucial for the cervix to dilate and for the labor to progress smoothly. Increased muscle tension can counteract this process, making labor more difficult and potentially longer.

Question 2

Childbirth preparation offers several advantages including which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
A) It helps a pregnant woman and her support person understand the choices in the birth setting.
B) It promotes awareness of available options.
C) It provides tools for a pregnant woman and her support person to use during labor and birth.
D) Women who receive continuous support during labor require more analgesia, and have more cesarean and instrument births.
E) Each method has been shown to shorten labor.

Accepted Answer

The answer of Childbirth preparation offers several advantages including which...

Question 3

When comparing the anterior and posterior fontanelles of a newborn, the nurse knows that both are what?
A) Both are approximately the same size.
B) Both close within 12 months of birth.
C) Both are used in labor to identify station.
D) Both allow for assessing the status of the newborn after birth.

Accepted Answer

The anterior and posterior fontanelles are soft spots on a newborn's skull that allow for brain growth and can be used to assess the newborn's hydration status and general health after birth. The anterior fontanelle is larger and closes later (around 18-24 months) compared to the posterior fontanelle, which usually closes by 1-2 months of age. They are not the same size, do not both close within 12 months, and are not used to identify station in labor.

Question 4

The nurse is aware that labor and birth will most likely proceed normally when the fetus is in what position?
A) Right-acromion-dorsal-anterior
B) Right-sacrum-transverse
C) Occiput anterior
D) Posterior position

Accepted Answer

The answer of The nurse is aware that labor and...

Question 5

The nurse has just palpated a laboring woman's contractions. The uterus cannot be indented during a contraction. What would the intensity of these contractions best be characterized as?
A) Weak
B) Mild
C) Moderate
D) Strong

Accepted Answer

When the uterus cannot be indented during a contraction, it indicates that the contractions are strong. This is a measure of the intensity of uterine contractions during labor.

Question 6

The nurse is caring for a laboring client. A cervical exam indicates 8 c m dilation. The client is restless, frequently changing position in an attempt to get comfortable. Which nursing action is most important?
A) Leave the client alone so she can rest.
B) Ask the family to take a coffee-and-snack break.
C) Encourage the client to have an epidural for pain.
D) Reassure the client that she will not be left alone.

Accepted Answer

At 8 cm dilation, the client is in the transition phase of labor, which can be very intense and uncomfortable. Reassuring the client that she will not be left alone addresses her emotional needs and provides support during this challenging phase.

Question 7

The nurse is assisting in the delivery of a pregnant patient's placenta post-delivery. The placenta appears as follows. What term should the nurse use to document this placental delivery? 
A) Schultz mechanism of delivery
B) Duncan mechanism of delivery
C) Complete mechanism of delivery
D) Incomplete mechanism of delivery

Accepted Answer

The answer of The nurse is assisting in the delivery...

Question 8

A pregnant patient's fetus is in the left-occiput-transverse position. Which diagram should the nurse use to explain this position to the patient?
A)

B)

C)

D)

Accepted Answer

The answer of A pregnant patient's fetus is in the...

Question 9

The labor and delivery nurse is reviewing charts. The nurse should inform the supervisor about which client?
A) Client at 5 c m requesting labor epidural analgesia
B) Client whose cervix remains at 6 c m for 4 hours
C) Client who has developed nausea and vomiting
D) Client requesting her partner to stay with her

Accepted Answer

The client whose cervix remains at 6 cm for 4 hours may be experiencing a labor dystocia or arrest of dilation, which can indicate a complication requiring further medical intervention or assessment.

Question 10

During the fourth stage of labor, the client's assessment includes a B P of 110/60, pulse 90, and the fundus is firm midline and halfway between the symphysis pubis and the umbilicus.
What is the priority action of the nurse?
A) Turn the client onto her left side.
B) Place the bed in Trendelenburg position.
C) Massage the fundus.
D) Continue to monitor.

Accepted Answer

The client's vital signs are stable, and the fundus is firm and in the expected position for the fourth stage of labor, indicating no immediate concerns. Therefore, the priority action is to continue to monitor the client.

Question 11

The cervix of a laboring patient is measured as being 50% effaced. Which diagram should the nurse use to explain this finding to the patient?
A)

B)

C)

D)

Accepted Answer

The answer of The cervix of a laboring patient is...

Question 12

The fetus of a patient in labor is determined to be in the brow presentation. Which diagram should the nurse provide to the patient to explain this position?
A)

B)

C)

D)

Accepted Answer

The answer of The fetus of a patient in labor...

Question 13

The nurse is reviewing educational material on newborn care with a patient in the 3^rd trimester of pregnancy. Which area on the following diagram should the nurse point out as being the anterior fontanelle? A) A B) B C) C D) D

Accepted Answer

The answer of The nurse is reviewing educational material on...

Question 14

Which client requires immediate intervention by the labor and delivery nurse? A) Client at 8 c m, systolic blood pressure has increased 35 m m H g B) Client who delivered 1 hour ago with W B C of 50,000/m m³ C) Client at 5 c m with a respiratory rate of 22 between contractions D) Client in active labor with polyuria

Accepted Answer

A WBC count of 50,000/mm³ is significantly elevated and may indicate a serious infection or other medical condition requiring immediate attention.

Question 15

While caring for a client in labor, the nurse notices during a vaginal exam that the fetus's head has rotated internally. What would the nurse expect the next set of cardinal movements for a fetus in a vertex presentation to be?
A) Flexion, extension, restitution, external rotation, and expulsion
B) Expulsion, external rotation, and restitution
C) Restitution, flexion, external rotation, and expulsion
D) Extension, restitution, external rotation, and expulsion

Accepted Answer

After the fetus's head rotates internally, the next movements in the sequence for a fetus in a vertex presentation are extension (as the head passes under the pubic symphysis), restitution (the head rotates to align with the body after delivery), external rotation (shoulders align with the pelvic inlet), and finally expulsion (delivery of the rest of the body).

Question 16

The midwife performs a vaginal exam and determines that the fetal head is at a -2 station. What does this indicate to the nurse about the birth?
A) The birth is imminent.
B) The birth is likely to occur in 1-2 hours.
C) The birth will occur later in the shift.
D) The birth is difficult to predict.

Accepted Answer

The fetal station of -2 indicates that the fetal head is 2 centimeters above the ischial spines, which means the baby has not descended far into the pelvis. This makes the timing of birth difficult to predict as it depends on various factors including the progression of labor and whether it is a first or subsequent pregnancy.

Quiz 19: Processes and Stages of Labor and Birth

The labor and delivery nurse is preparing a prenatal class about facilitating the progress of labor. Which of the following frequent responses to pain should the nurse indicate is most likely to impede progress in labor?

Childbirth preparation offers several advantages including which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected.

When comparing the anterior and posterior fontanelles of a newborn, the nurse knows that both are what?

The nurse is aware that labor and birth will most likely proceed normally when the fetus is in what position?

The nurse has just palpated a laboring woman's contractions. The uterus cannot be indented during a contraction. What would the intensity of these contractions best be characterized as?

The nurse is caring for a laboring client. A cervical exam indicates 8 c m dilation. The client is restless, frequently changing position in an attempt to get comfortable. Which nursing action is most important?

The nurse is assisting in the delivery of a pregnant patient's placenta post-delivery. The placenta appears as follows. What term should the nurse use to document this placental delivery?

A pregnant patient's fetus is in the left-occiput-transverse position. Which diagram should the nurse use to explain this position to the patient?

The labor and delivery nurse is reviewing charts. The nurse should inform the supervisor about which client?

During the fourth stage of labor, the client's assessment includes a B P of 110/60, pulse 90, and the fundus is firm midline and halfway between the symphysis pubis and the umbilicus. What is the priority action of the nurse?

The cervix of a laboring patient is measured as being 50% effaced. Which diagram should the nurse use to explain this finding to the patient?

The fetus of a patient in labor is determined to be in the brow presentation. Which diagram should the nurse provide to the patient to explain this position?

The nurse is reviewing educational material on newborn care with a patient in the 3rd trimester of pregnancy. Which area on the following diagram should the nurse point out as being the anterior fontanelle?

Which client requires immediate intervention by the labor and delivery nurse?

While caring for a client in labor, the nurse notices during a vaginal exam that the fetus's head has rotated internally. What would the nurse expect the next set of cardinal movements for a fetus in a vertex presentation to be?

The midwife performs a vaginal exam and determines that the fetal head is at a -2 station. What does this indicate to the nurse about the birth?

The nurse is reviewing educational material on newborn care with a patient in the 3^rd trimester of pregnancy. Which area on the following diagram should the nurse point out as being the anterior fontanelle?