Question 1

Which stage of labor varies the most in length?

Accepted Answer

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

Question 2

A labor and delivery nurse should be cognizant of which information regarding how the fetus moves through the birth canal?

Accepted Answer

A)  Fetal attitude describes the angle at which the fetus exits the uterus. 
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. 
C)  Normal attitude of the fetus is called general flexion. 
D)  Transverse lie is preferred for vaginal birth. 
A)  Fetal attitude describes the angle at which the fetus exits the uterus. 
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. 
C)  Normal attitude of the fetus is called general flexion. 
D)  Transverse lie is preferred for vaginal birth. C

Question 3

Which statement related to fetal positioning during labor is correct and important for the nurse to understand?

Accepted Answer

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. 
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. B

Question 4

When assessing the fetus using Leopold's maneuvers,the nurse feels a round,firm,and 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 position of the fetus?

Accepted Answer

A)  ROA 
B)  LSP 
C)  RSA 
D)  LOA 
A)  ROA 
B)  LSP 
C)  RSA 
D)  LOA

Question 5

What is the nurse's understanding of the appropriate role of primary and secondary powers?

Accepted Answer

A)  Primary powers are responsible for the effacement and dilation of the cervix. 
B)  Effacement is generally well ahead of dilation in women giving birth for the first time; they are closer together 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. 
A)  Primary powers are responsible for the effacement and dilation of the cervix. 
B)  Effacement is generally well ahead of dilation in women giving birth for the first time; they are closer together 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 6

Which adaptation of the maternal-fetal exchange of oxygen occurs in response to uterine contraction?

Accepted Answer

A)  The maternal-fetal exchange of oxygen and waste products continues except when placental functions are reduced. 
B)  This maternal-fetal exchange increases as the blood pressure decreases. 
C)  It diminishes as the spiral arteries are compressed. 
D)  This exchange of oxygen and waste products is not significantly affected by contractions. 
A)  The maternal-fetal exchange of oxygen and waste products continues except when placental functions are reduced. 
B)  This maternal-fetal exchange increases as the blood pressure decreases. 
C)  It diminishes as the spiral arteries are compressed. 
D)  This exchange of oxygen and waste products is not significantly affected by contractions.

Question 7

The nurse expects which maternal cardiovascular finding during labor?

Accepted Answer

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

Question 8

Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth.Which change in fetal physiologic activity is not part of this process?

Accepted Answer

A)  Fetal lung fluid is cleared from the air passages during labor and vaginal birth. 
B)  Fetal partial pressure of oxygen (PO₂) decreases. 
C)  Fetal partial pressure of carbon dioxide in arterial blood (PaCO₂) increases. 
D)  Fetal respiratory movements increase during labor. 
A)  Fetal lung fluid is cleared from the air passages during labor and vaginal birth. 
B)  Fetal partial pressure of oxygen (PO₂) decreases. 
C)  Fetal partial pressure of carbon dioxide in arterial blood (PaCO₂) increases. 
D)  Fetal respiratory movements increase during labor.

Question 9

Which changes take place in the woman's reproductive system,days or even weeks before the commencement of labor?
(Select all that apply).

Accepted Answer

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

Question 10

A pregnant woman is at 38 weeks of gestation.She wants to know whether there are any signs that "labor is getting close to starting." Which finding is an indication that labor may begin soon?

Accepted Answer

A)  Weight gain of 1.5 to 2 kg (3 to 4 lb) 
B)  Increase in fundal height 
C)  Urinary retention 
D)  Surge of energy 
A)  Weight gain of 1.5 to 2 kg (3 to 4 lb) 
B)  Increase in fundal height 
C)  Urinary retention 
D)  Surge of energy

Question 11

The nurse is performing an initial assessment of a client in labor.What is the appropriate terminology for the relationship of the fetal body parts to one another?

Accepted Answer

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

Question 12

Nurses can help their clients by keeping them informed about the distinctive stages of labor.Which description of the phases of the first stage of labor is accurate?

Accepted Answer

A)  Latent: Mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hours 
B)  Active: Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours 
C)  Lull: No contractions; dilation stable; duration of 20 to 60 minutes 
D)  Transition: Very strong but irregular contractions; 8- to 10-cm dilation; duration of 1 to 2 hours 
A)  Latent: Mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hours 
B)  Active: Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours 
C)  Lull: No contractions; dilation stable; duration of 20 to 60 minutes 
D)  Transition: Very strong but irregular contractions; 8- to 10-cm dilation; duration of 1 to 2 hours

Question 13

What is the primary difference between the labor of a nullipara and that of a multipara?

Accepted Answer

A)  Amount of cervical dilation 
B)  Total duration of labor 
C)  Level of pain experienced 
D)  Sequence of labor mechanisms 
A)  Amount of cervical dilation 
B)  Total duration of labor 
C)  Level of pain experienced 
D)  Sequence of labor mechanisms

Question 14

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

Accepted Answer

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 stage: active pushing to birth; 20 minutes (multiparous woman), 50 minutes (nulliparous woman) 
D)  Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour 
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 stage: active pushing to birth; 20 minutes (multiparous woman), 50 minutes (nulliparous woman) 
D)  Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

Question 15

Which factors influence cervical dilation?
(Select all that apply).

Accepted Answer

A)  Strong uterine contractions 
B)  Force of the presenting fetal part against the cervix 
C)  Size of the woman 
D)  Pressure applied by the amniotic sac 
E)  Scarring of the cervix 
A)  Strong uterine contractions 
B)  Force of the presenting fetal part against the cervix 
C)  Size of the woman 
D)  Pressure applied by the amniotic sac 
E)  Scarring of the cervix

Question 16

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth?

Accepted Answer

A)  Fetal head is felt at 0 station during the vaginal examination. 
B)  Bloody mucous discharge increases. 
C)  Vulva bulges and encircles the fetal head. 
D)  Membranes rupture during a contraction. 
A)  Fetal head is felt at 0 station during the vaginal examination. 
B)  Bloody mucous discharge increases. 
C)  Vulva bulges and encircles the fetal head. 
D)  Membranes rupture during a contraction.

Question 17

Which statement by the client would lead the nurse to believe that labor has been established?

Accepted Answer

A)  "I passed some thick, pink mucus when I urinated this morning." 
B)  "My bag of waters just broke." 
C)  "The contractions in my uterus are getting stronger and closer together." 
D)  "My baby dropped, and I have to urinate more frequently now." 
A)  "I passed some thick, pink mucus when I urinated this morning." 
B)  "My bag of waters just broke." 
C)  "The contractions in my uterus are getting stronger and closer together." 
D)  "My baby dropped, and I have to urinate more frequently now."

Question 18

Because of its size and rigidity,the fetal head has a major effect on the birth process.Which bones comprise the structure of the fetal skull?
(Select all that apply).

Accepted Answer

A)  Parietal 
B)  Temporal 
C)  Fontanel 
D)  Occipital 
E)  Femoral 
A)  Parietal 
B)  Temporal 
C)  Fontanel 
D)  Occipital 
E)  Femoral

Question 19

Which statement is the best rationale for assessing the maternal vital signs between uterine contractions?

Accepted Answer

A)  During a contraction, assessing the fetal heart rate is the priority. 
B)  Maternal circulating blood volume temporarily increases during contractions. 
C)  Maternal blood flow to the heart is reduced during contractions. 
D)  Vital signs taken during contractions are not accurate. 
A)  During a contraction, assessing the fetal heart rate is the priority. 
B)  Maternal circulating blood volume temporarily increases during contractions. 
C)  Maternal blood flow to the heart is reduced during contractions. 
D)  Vital signs taken during contractions are not accurate.

Question 20

A woman's position is an important component of the labor progress.Which guidance is important for the nurse to provide to the laboring client?

Accepted Answer

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

Exam 16: Labor and Birth Processes

Which stage of labor varies the most in length?

A labor and delivery nurse should be cognizant of which information regarding how the fetus moves through the birth canal?

Which statement related to fetal positioning during labor is correct and important for the nurse to understand?

When assessing the fetus using Leopold's maneuvers,the nurse feels a round,firm,and 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 position of the fetus?

What is the nurse's understanding of the appropriate role of primary and secondary powers?

Which adaptation of the maternal-fetal exchange of oxygen occurs in response to uterine contraction?

The nurse expects which maternal cardiovascular finding during labor?

Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth.Which change in fetal physiologic activity is not part of this process?

Which changes take place in the woman's reproductive system,days or even weeks before the commencement of labor? (Select all that apply).

A pregnant woman is at 38 weeks of gestation.She wants to know whether there are any signs that "labor is getting close to starting." Which finding is an indication that labor may begin soon?

The nurse is performing an initial assessment of a client in labor.What is the appropriate terminology for the relationship of the fetal body parts to one another?

Nurses can help their clients by keeping them informed about the distinctive stages of labor.Which description of the phases of the first stage of labor is accurate?

What is the primary difference between the labor of a nullipara and that of a multipara?

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

Which factors influence cervical dilation? (Select all that apply).

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth?

Which statement by the client would lead the nurse to believe that labor has been established?

Because of its size and rigidity,the fetal head has a major effect on the birth process.Which bones comprise the structure of the fetal skull? (Select all that apply).

Which statement is the best rationale for assessing the maternal vital signs between uterine contractions?

A woman's position is an important component of the labor progress.Which guidance is important for the nurse to provide to the laboring client?

21st Century Maternity and Women’s Health Nursing

Community Care: The Family and Culture

Nursing and Genomics

Assessment and Health Promotion

Violence Against Women

Reproductive System Concerns

Sexually Transmitted and Other Infections

Contraception and Abortion

Infertility

Problems of the Breast

Structural Disorders and Neoplasms of the Reproductive System

Conception and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care of the Family During Pregnancy

Maternal and Fetal Nutrition

Maximizing Comfort for the Laboring Woman

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Postpartum Physiologic Changes

Nursing Care of the Family During the Postpartum Period

Transition to Parenthood

Physiologic and Behavioral Adaptations of the Newborn

Nursing Care of the Newborn and Family

Newborn Nutrition and Feeding

Assessment of High Risk Pregnancy

Hypertensive Disorders

Hemorrhagic Disorders

Endocrine and Metabolic Disorders

Medical-Surgical Disorders

Mental Health Disorders and Substance Abuse

Labor and Birth Complications

Postpartum Complications

Nursing Care of the High Risk Newborn

Acquired Problems of the Newborn

Hemolytic Disorders and Congenital Anomalies

Perinatal Loss, Bereavement, and Grief

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