NURS 4403 Chapter 13: Labor and Birth Processes,100% CORRECT

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NURS 4403 Chapter 13: Labor and Birth Processes MULTIPLE CHOICE 1. A new mother asks the nurse when the “soft spot” on her son’s head will go away. The nurse’s answer is based on the k... nowledge that the anterior fontanel closes after birth by months. a. 2 c. 12 b. 8 d. 18 2. When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal: a. Lie. c. Attitude. b. Presentation. d. Position. 3. When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, 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 likely position of the fetus? a. ROA c. RSA b. LSP d. LOA 4. The nurse has received report regarding her patient in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and ?2-2. The nurse’s interpretation of this assessment is that: a. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines. b. The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines. c. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines. d. The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines. 5. To care for a laboring woman adequately, the nurse understands that the stage of labor varies the most in length? a. First c. Third b. Second d. Fourth 6. The nurse would expect which maternal cardiovascular finding during labor? a. Increased cardiac output b. Decreased pulse rate c. Decreased white blood cell (WBC) count d. Decreased blood pressure 7. The factors that affect the process of labor and birth, known commonly as the five Ps, include all except: a. Passenger. c. Powers. b. Passageway. d. Pressure. 8. The slight overlapping of cranial bones or shaping of the fetal head during labor is called: a. Lightening. c. Ferguson reflex. b. Molding. d. Valsalva maneuver. 9. Which presentation is described accurately in terms of both presenting part and frequency of occurrence? a. Cephalic: occiput; at least 95% c. Shoulder: scapula; 10% to 15% b. Breech: sacrum; 10% to 15% d. Cephalic: cranial; 80% to 85% 10. With regard to factors that affect how the fetus moves through the birth canal, nurses should be aware that: a. The 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. The normal attitude of the fetus is called general flexion. d. The transverse lie is preferred for vaginal birth. 11. As relates to fetal positioning during labor, nurses should be aware that: 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. 12. Which basic type of pelvis includes the correct description and percentage of occurrence in women? a. Gynecoid: classic female; heart shaped; 75% b. Android: resembling the male; wider oval; 15% c. Anthropoid: resembling the ape; narrower; 10% d. Platypelloid: flattened, wide, shallow; 3% 13. In relation to primary and secondary powers, the maternity nurse comprehends that: a. Primary powers are responsible for effacement and dilation of the cervix. b. Effacement generally is 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. 14. While providing care to a patient in active labor, the nurse should instruct the woman that: a. The supine position commonly used in the United States increases blood flow. b. The “all fours” position, on her hands and knees, is hard on her back. c. Frequent changes in position will help relieve her fatigue and increase her comfort. d. In a sitting or squatting position, her abdominal muscles will have to work harder. 15. Which description of the four stages of labor is correct for both definition and duration? 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 state: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first-timer) d. Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour 16. With regard to the turns and other adjustments of the fetus during the birth process, known as the mechanism of labor, nurses should be aware that: a. The seven critical movements must progress in a more or less orderly sequence. b. Asynclitism sometimes is achieved by means of the Leopold maneuver. c. The effects of the forces determining descent are modified by the shape of the woman’s pelvis and the size of the fetal head. d. At birth the baby is said to achieve “restitution” (i.e., a return to the C-shape of the womb). 17. In order to evaluate the condition of the patient accurately during labor, the nurse should be aware that: a. The woman’s blood pressure will increase during contractions and fall back to prelabor normal between contractions. b. Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia. c. Having the woman point her toes will reduce leg cramps. d. The endogenous endorphins released during labor will raise the woman’s pain threshold and produce sedation. 18. The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products: a. Continues except when placental functions are reduced. b. Increases as blood pressure decreases. c. Diminishes as the spiral arteries are compressed. d. Is not significantly affected. 19. Which statement is the best rationale for assessing maternal vital signs between contractions? a. During a contraction, assessing fetal heart rates is the priority. b. Maternal circulating blood volume increases temporarily during contractions. c. Maternal blood flow to the heart is reduced during contractions. d. Vital signs taken during contractions are not accurate. 20. In order to care for obstetric patients adequately, the nurse understands that labor contractions facilitate cervical dilation by: a. Contracting the lower uterine segment. b. Enlarging the internal size of the uterus. c. Promoting blood flow to the cervix. d. Pulling the cervix over the fetus and amniotic sac. 21. To teach patients about the process of labor adequately, the nurse knows that which event is the best indicator of true labor? a. Bloody show c. Fetal descent into the pelvic inlet b. Cervical dilation and effacement d. Uterine contractions every 7 minutes 22. Which occurrence is associated with cervical dilation and effacement? a. Bloody show c. Lightening b. False labor d. Bladder distention 23. The primary difference between the labor of a nullipara and that of a multipara is the: a. Amount of cervical dilation. c. Level of pain experienced. b. Total duration of labor. d. Sequence of labor mechanisms. 24. A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be: a. Admitted and prepared for a cesarean birth. b. Admitted for extended observation. c. Discharged home with a sedative. d. Discharged home to await the onset of true labor. 25. Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth? 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. MULTIPLE RESPONSE 26. Signs that precede labor include (Select all that apply): a. Lightening. b. Exhaustion. c. Bloody show. d. Rupture of membranes. e. Decreased fetal movement. 27. Which factors influence cervical dilation (Select all that apply) ? a. Strong uterine contractions b. The force of the presenting fetal part against the cervix c. The size of the female pelvis d. The pressure applied by the amniotic sac e. Scarring of the cervix MATCHING For vaginal birth to be successful, the fetus must adapt to the birth canal during the descent. The turns and other adjustments necessary in the human birth process are termed the “mechanism of labor.” Please list the seven cardinal movements in the mechanism of labor in the correct order. a. Flexion e. Engagement b. Internal rotation f. Descent c. External rotation g. Extension d. Expulsion 28. One 29. Two 30. Three 31. Four 32. Five 33. Six 34. Seven 28. ANS: E PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). 29. ANS: F PTS: 1 DIF: Cognitive Level: Comprehension REF: 352 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). 30. ANS: A PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). 31. ANS: B PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). 32. ANS: G PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). 33. ANS: C PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). 34. ANS: D PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: In a vertex presentation the cardinal movements, in order, are: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and finally birth by expulsion. Although these movements are discussed separately, in actuality a combination of movements occurs simultaneously (i.e., engagement involves both descent and flexion). [Show More]

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