Question 1

The nurse knows that the second stage of labor,the descent phase,has begun when:

Accepted Answer

A) The amniotic membranes rupture 
B) The cervix cannot be felt during a vaginal examination 
C) The woman experiences a strong urge to bear down 
D) The presenting part is below the ischial spines 
A) The amniotic membranes rupture 
B) The cervix cannot be felt during a vaginal examination 
C) The woman experiences a strong urge to bear down 
D) The presenting part is below the ischial spines

Question 2

Because the risk for childbirth complications may be revealed,nurses should know that the point of maximal intensity (PMI)of the fetal heart rate (FHR)is:

Accepted Answer

A) Usually directly over the fetal abdomen 
B) In a vertex position,heard above the mother's umbilicus 
C) Heard lower and closer to the midline of the mother's abdomen as the fetus descends and rotates internally 
D) In a breech position,heard below the mother's umbilicus 
A) Usually directly over the fetal abdomen 
B) In a vertex position,heard above the mother's umbilicus 
C) Heard lower and closer to the midline of the mother's abdomen as the fetus descends and rotates internally 
D) In a breech position,heard below the mother's umbilicus

Question 3

With regard to a woman's intake and output during labor,nurses should be aware that:

Accepted Answer

A) The tradition of restricting the laboring woman to clear liquids and ice chips is being challenged because regional anesthesia is used more often than general anesthesia 
B) IV fluids usually are necessary to ensure that the laboring woman stays hydrated 
C) Routine use of an enema empties the rectum and is very helpful for producing a clean,clear delivery 
D) When a nulliparous woman experiences the urge to defecate,it often means birth will follow quickly 
A) The tradition of restricting the laboring woman to clear liquids and ice chips is being challenged because regional anesthesia is used more often than general anesthesia 
B) IV fluids usually are necessary to ensure that the laboring woman stays hydrated 
C) Routine use of an enema empties the rectum and is very helpful for producing a clean,clear delivery 
D) When a nulliparous woman experiences the urge to defecate,it often means birth will follow quickly

Question 4

In the recovery room,if a woman is asked either to raise her legs (knees extended)off the bed or to flex her knees,place her feet flat on the bed,and raise her buttocks well off the bed,most likely she is being tested to see whether she:

Accepted Answer

A) Has recovered from epidural or spinal anesthesia 
B) Has hidden bleeding underneath her 
C) Has regained some flexibility 
D) Is a candidate to go home after 6 hours 
A) Has recovered from epidural or spinal anesthesia 
B) Has hidden bleeding underneath her 
C) Has regained some flexibility 
D) Is a candidate to go home after 6 hours

Question 5

With regard to the procedures and criteria for admitting a woman to the hospital labor unit,nurses should be aware that:

Accepted Answer

A) She is not considered to be in true labor (according to the Emergency Medical Treatment and Active Labor Act [EMTALA])until a qualified health care provider says she is 
B) She can have only her male partner or predesignated doula with her at assessment 
C) Her weight gain is calculated to determine whether she is at greater risk for complications 
D) The nurse should listen politely to the woman's previous birthing experiences but should keep in mind that each birth is a unique experience 
A) She is not considered to be in true labor (according to the Emergency Medical Treatment and Active Labor Act [EMTALA])until a qualified health care provider says she is 
B) She can have only her male partner or predesignated doula with her at assessment 
C) Her weight gain is calculated to determine whether she is at greater risk for complications 
D) The nurse should listen politely to the woman's previous birthing experiences but should keep in mind that each birth is a unique experience

Question 6

The nurse recognizes that a woman is in true labor when she states:

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 7

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

Accepted Answer

A) Latent: mild,regular contractions;no dilation;bloody show 
B) Active: moderate,regular contractions;4 to 7 cm dilation 
C) Lull: no contractions;dilation stable 
D) Transition: very strong but irregular contractions;8 to 10 cm dilation 
A) Latent: mild,regular contractions;no dilation;bloody show 
B) Active: moderate,regular contractions;4 to 7 cm dilation 
C) Lull: no contractions;dilation stable 
D) Transition: very strong but irregular contractions;8 to 10 cm dilation

Question 8

Women who have participated in childbirth education classes often bring a birth plan with them to the hospital.This document includes the couple's preference related to (choose all that apply):

Accepted Answer

A) Presence of companions 
B) Clothing to be worn 
C) Care and handling of the newborn 
D) Medical interventions 
E) Environmental modifications 
A) Presence of companions 
B) Clothing to be worn 
C) Care and handling of the newborn 
D) Medical interventions 
E) Environmental modifications

Question 9

When planning care for a laboring woman whose membranes have ruptured,the nurse recognizes that the woman's risk for _____ has increased.

Accepted Answer

A) Intrauterine infection 
B) Hemorrhage 
C) Precipitous labor 
D) Supine hypotension 
A) Intrauterine infection 
B) Hemorrhage 
C) Precipitous labor 
D) Supine hypotension

Question 10

A 25-year-old gravida 2,para 2-0-0-2 gave birth 4 hours ago to a 9-lb,7-oz boy after augmentation of labor with oxytocin (Pitocin).She puts on her call light and asks for her nurse right away,stating "I'm bleeding a lot." The most likely cause of postpartum hemorrhage in this woman is:

Accepted Answer

A) Retained placental fragments 
B) Unrepaired vaginal lacerations 
C) Uterine atony 
D) Puerperal infection 
A) Retained placental fragments 
B) Unrepaired vaginal lacerations 
C) Uterine atony 
D) Puerperal infection

Question 11

A nulliparous woman who has just begun the second stage of her labor most likely:

Accepted Answer

A) Experiences a strong urge to bear down 
B) Shows perineal bulging 
C) Feels tired yet relieved that the worst is over 
D) Shows an increase in bright red bloody show 
A) Experiences a strong urge to bear down 
B) Shows perineal bulging 
C) Feels tired yet relieved that the worst is over 
D) Shows an increase in bright red bloody show

Question 12

The nurse expects to administer an oxytocic (e.g.,Pitocin,Methergine)to a woman after expulsion of her placenta to:

Accepted Answer

A) Relieve pain 
B) Stimulate uterine contraction 
C) Prevent infection 
D) Facilitate rest and relaxation 
A) Relieve pain 
B) Stimulate uterine contraction 
C) Prevent infection 
D) Facilitate rest and relaxation

Question 13

Which collection of risk factors will most likely result in damaging lacerations (including episiotomies)?

Accepted Answer

A) A dark-skinned woman who has had more than one pregnancy,who is going through prolonged second-stage labor,and who is attended by a midwife 
B) A reddish-haired mother of two who is going through a breech birth 
C) A dark-skinned first-time mother who is going through a long labor 
D) A first-time mother with reddish hair whose rapid labor was overseen by an obstetrician 
A) A dark-skinned woman who has had more than one pregnancy,who is going through prolonged second-stage labor,and who is attended by a midwife 
B) A reddish-haired mother of two who is going through a breech birth 
C) A dark-skinned first-time mother who is going through a long labor 
D) A first-time mother with reddish hair whose rapid labor was overseen by an obstetrician

Question 14

When assessing a woman in the first stage of labor,the nurse recognizes that the most conclusive sign that uterine contractions are effective is:

Accepted Answer

A) Dilation of the cervix 
B) Descent of the fetus 
C) Rupture of the amniotic membranes 
D) Increase in bloody show 
A) Dilation of the cervix 
B) Descent of the fetus 
C) Rupture of the amniotic membranes 
D) Increase in bloody show

Question 15

Concerning the third stage of labor,nurses should be aware that:

Accepted Answer

A) The placenta eventually detaches itself from a flaccid uterus 
B) An expectant or active approach to managing this stage of labor reduces the risk of complications 
C) It is important that the dark,roughened maternal surface of the placenta appears before the shiny fetal surface 
D) The major risk for women during the third stage is a rapid heart rate 
A) The placenta eventually detaches itself from a flaccid uterus 
B) An expectant or active approach to managing this stage of labor reduces the risk of complications 
C) It is important that the dark,roughened maternal surface of the placenta appears before the shiny fetal surface 
D) The major risk for women during the third stage is a rapid heart rate

Exam 19: Nursing Care of the Family During Labor and Birth

The nurse knows that the second stage of labor,the descent phase,has begun when:

Because the risk for childbirth complications may be revealed,nurses should know that the point of maximal intensity (PMI)of the fetal heart rate (FHR)is:

With regard to a woman's intake and output during labor,nurses should be aware that:

In the recovery room,if a woman is asked either to raise her legs (knees extended)off the bed or to flex her knees,place her feet flat on the bed,and raise her buttocks well off the bed,most likely she is being tested to see whether she:

With regard to the procedures and criteria for admitting a woman to the hospital labor unit,nurses should be aware that:

The nurse recognizes that a woman is in true labor when she states:

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

Women who have participated in childbirth education classes often bring a birth plan with them to the hospital.This document includes the couple's preference related to (choose all that apply):

When planning care for a laboring woman whose membranes have ruptured,the nurse recognizes that the woman's risk for _____ has increased.

A 25-year-old gravida 2,para 2-0-0-2 gave birth 4 hours ago to a 9-lb,7-oz boy after augmentation of labor with oxytocin (Pitocin).She puts on her call light and asks for her nurse right away,stating "I'm bleeding a lot." The most likely cause of postpartum hemorrhage in this woman is:

A nulliparous woman who has just begun the second stage of her labor most likely:

The nurse expects to administer an oxytocic (e.g.,Pitocin,Methergine)to a woman after expulsion of her placenta to:

Which collection of risk factors will most likely result in damaging lacerations (including episiotomies)?

When assessing a woman in the first stage of labor,the nurse recognizes that the most conclusive sign that uterine contractions are effective is:

Concerning the third stage of labor,nurses should be aware that:

21st Century Maternity and Womens Health Nursing

Community Care: the Family and Culture

Clinical Genetics

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

Maternal and Fetal Nutrition

Nursing Care of the Family During Pregnancy

Labor and Birth Processes

Pain Management

Fetal Assessment During Labor

Postpartum Physiology

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 for Risk Factors in Pregnancy

Hypertensive Disorders in Pregnancy

Antepartum Hemorrhagic Disorders

Endocrine and Metabolic Disorders in Pregnancy

Medical-Surgical Problems in Pregnancy

Obstetric Critical Care

Mental Health Disorders and Substance Abuse in Pregnancy

Labor and Birth Complications

Postpartum Complications

Acquired Problems of the Newborn

Hemolytic Disorders and Congenital Anomalies

Nursing Care of the High Risk Newborn

Perinatal Loss and Grief

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