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?

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.

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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