Question 1

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 appear before the shiny fetal surface. 
D)  the major risk for women during the third stage is a rapid heart rate.

Question 2

MATCHING
The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 2

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 3

After an emergency birth,the nurse encourages the woman to breastfeed her newborn.The primary purpose of this activity is to:

Accepted Answer

A)  facilitate maternal-newborn interaction. 
B)  stimulate the uterus to contract. 
C)  prevent neonatal hypoglycemia. 
D)  initiate the lactation cycle.

Question 4

When assessing a multiparous woman who has just given birth to an 8-lb boy,the nurse notes that the woman's fundus is firm and has become globular in shape.A gush of dark red blood comes from her vagina.The nurse concludes that:

Accepted Answer

A)  the placenta has separated. 
B)  a cervical tear occurred during the birth. 
C)  the woman is beginning to hemorrhage. 
D)  clots have formed in the upper uterine segment.

Question 5

A laboring woman is lying in the supine position.The most appropriate nursing action at this time is to:

Accepted Answer

A)  ask her to turn to one side. 
B)  elevate her feet and legs. 
C)  take her blood pressure. 
D)  determine whether fetal tachycardia is present.

Question 6

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.

Question 7

Which collection of risk factors most likely would 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.

Question 8

A pregnant woman is in her third trimester.She asks the nurse to explain how she can tell true labor from false labor.The nurse would explain that "true" labor contractions:

Accepted Answer

A)  increase with activity such as ambulation. 
B)  decrease with activity. 
C)  are always accompanied by the rupture of the bag of waters. 
D)  alternate between a regular and an irregular pattern.

Question 9

MATCHING
The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 7

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 10

For the labor nurse,care of the expectant mother begins with any or all of these situations,with the exception of:

Accepted Answer

A)  the onset of progressive, regular contractions. 
B)  the bloody, or pink, show. 
C)  the spontaneous rupture of membranes. 
D)  formulation of the woman's plan of care for labor.

Question 11

Nurses alert to signs of the onset of the second stage of labor can be certain that this stage has begun when:

Accepted Answer

A)  the woman has a sudden episode of vomiting. 
B)  the nurse is unable to feel the cervix during a vaginal examination. 
C)  bloody show increases. 
D)  the woman involuntarily bears down.

Question 12

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage.The nurse's best response is:

Accepted Answer

A)  "Don't worry about it. You'll do fine." 
B)  "It's normal to be anxious about labor. Let's discuss what makes you afraid." 
C)  "Labor is scary to think about, but the actual experience isn't." 
D)  "You can have an epidural. You won't feel anything."

Question 13

The primary difference between the labor of a nullipara and that of a multipara is the:

Accepted Answer

A)  amount of cervical dilation. 
B)  total duration of labor. 
C)  level of pain experienced. 
D)  sequence of labor mechanisms.

Question 14

MATCHING
The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 4

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 15

MATCHING
The vaginal examination is an essential component of labor assessment. It reveals whether the patient is in true labor and enables the examiner to determine whether membranes have ruptured. This examination is often stressful and uncomfortable for the patient and should be performed only when indicated. Please match the correct step number, from 1 to 7, with each component of a vaginal examination of the laboring woman.

-Step 1

Accepted Answer

A) After obtaining permission, gently insert the index and middle fingers into the vagina. 
B) Explain findings to the patient. 
C) Position the woman to prevent supine hypotension. 
D) Use sterile gloves and soluble gel for lubrication. 
E) Document findings and report to the provider.
F)Cleanse the perineum and vulva if necessary.
G)Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

Question 16

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

Accepted Answer

A)  The fetal head is felt at 0 station during vaginal examination. 
B)  Bloody mucus discharge increases. 
C)  The vulva bulges and encircles the fetal head. 
D)  The membranes rupture during a contraction.

Question 17

For women who have a history of sexual abuse,a number of traumatic memories may be triggered during labor.The woman may fight the labor process and react with pain or anger.Alternately,she may become a passive player and emotionally absent herself from the process.The nurse is in a unique position of being able to assist the patient to associate the sensations of labor with the process of childbirth and not the past abuse.The nurse can implement a number of care measures to help the patient view the childbirth experience in a positive manner.Which intervention would be key for the nurse to use while providing care?

Accepted Answer

A)  Telling the patient to relax and that it won't hurt much. 
B)  Limiting the number of procedures that invade her body. 
C)  Reassuring the patient that as the nurse you know what is best. 
D)  Allowing unlimited care providers to be with the patient.

Question 18

The nurse teaches a pregnant woman about the characteristics of true labor contractions.The nurse evaluates the woman's understanding of the instructions when she states,"True labor contractions will:

Accepted Answer

A)  subside when I walk around." 
B)  cause discomfort over the top of my uterus." 
C)  continue and get stronger even if I relax and take a shower." 
D)  remain irregular but become stronger."

Question 19

The nurse thoroughly dries the infant immediately after birth primarily to:

Accepted Answer

A)  stimulate crying and lung expansion. 
B)  remove maternal blood from the skin surface. 
C)  reduce heat loss from evaporation. 
D)  increase blood supply to the hands and feet.

Question 20

A woman who is gravida 3 para 2 enters the intrapartum unit.The most important nursing assessments are:

Accepted Answer

A)  contraction pattern, amount of discomfort, and pregnancy history. 
B)  fetal heart rate, maternal vital signs, and the woman's nearness to birth. 
C)  identification of ruptured membranes, the woman's gravida and para, and her support person. 
D)  last food intake, when labor began, and cultural practices the couple desires.

Exam 16: Nursing Care of the Family During Labor and Birth

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

After an emergency birth,the nurse encourages the woman to breastfeed her newborn.The primary purpose of this activity is to:

When assessing a multiparous woman who has just given birth to an 8-lb boy,the nurse notes that the woman's fundus is firm and has become globular in shape.A gush of dark red blood comes from her vagina.The nurse concludes that:

A laboring woman is lying in the supine position.The most appropriate nursing action at this time is to:

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

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

A pregnant woman is in her third trimester.She asks the nurse to explain how she can tell true labor from false labor.The nurse would explain that "true" labor contractions:

For the labor nurse,care of the expectant mother begins with any or all of these situations,with the exception of:

Nurses alert to signs of the onset of the second stage of labor can be certain that this stage has begun when:

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage.The nurse's best response is:

The primary difference between the labor of a nullipara and that of a multipara is the:

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

The nurse teaches a pregnant woman about the characteristics of true labor contractions.The nurse evaluates the woman's understanding of the instructions when she states,"True labor contractions will:

The nurse thoroughly dries the infant immediately after birth primarily to:

A woman who is gravida 3 para 2 enters the intrapartum unit.The most important nursing assessments are: