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A comprehensive exam covering key aspects of labor and birth processes in maternity nursing. it includes multiple-choice questions assessing knowledge of fetal positioning, stages of labor, maternal physiological changes, and the mechanisms of labor. The questions are designed to test understanding of critical concepts and clinical applications in obstetric care. This resource is valuable for nursing students preparing for exams or reinforcing their learning.
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Chapter 13: Labor and Birth Processes
a. 2 c. 12
b. 8 d. 18
d. 18
a. Lie. c. Attitude.
b. Presentation. d. Position.
c. Attitude.
a. ROA c. RSA
b. LSP d. LOA
c. RSA
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.
b. The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
a. First c. Third
b. Second d. Fourth
a. First
a. Cephalic: occiput; at least 95%
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.
c. The normal attitude of the fetus is called general flexion.
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. Birth is imminent when the presenting part is at +4 to +5 cm below the spine.
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%
d. Platypelloid: flattened, wide, shallow; 3%
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.
a. Primary powers are responsible for effacement and dilation of the cervix
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
c. Frequent changes in position will help relieve her fatigue and increase her comfort.
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)
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.
c. Diminishes as the spiral arteries are compressed.
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.
b. Maternal circulating blood volume increases temporarily during contractions.
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.
d. Pulling the cervix over the fetus and amniotic sac.
a. Bloody show c. Fetal descent into the pelvic inlet
b. Cervical dilation and effacement d. Uterine contractions every 7 minutes
b. Cervical dilation and effacement
a. Bloody show c. Lightening
b. False labor d. Bladder distention
a. Bloody show
a. Amount of cervical dilation. c. Level of pain experienced. b. Total duration of labor. d. Sequence of labor mechanisms.
b. Total duration of labor.
a. Admitted and prepared for a cesarean birth.
b. Admitted for extended observation.
c. Discharged home with a sedative.
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
a. Strong uterine contractions
b. The force of the presenting fetal part against the cervix
d. The pressure applied by the amniotic sac
e. Scarring of the cervix
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
Chapter 14: Pain Management
a. Assess for fetal well-being.
b. Encourage the woman to lie on her side.
c. Disturb the woman as little as possible.
d. Recognize that pain is personalized for each individual.
d. Recognize that pain is personalized for each individual.
c. Monitor the maternal blood pressure for possible hypotension.
a. The mother gives birth without any analgesic or anesthetic.
b. The mother and familys priorities and preferences are incorporated into the plan.
c. The primary health care provider decides the best pain relief for the mother and family.
d. The nurse informs the family of all alternative methods of pain relief available in the hospital setting.
b. The mother and familys priorities and preferences are incorporated into the plan.
a. Notify the womans physician.
b. Tell the woman to slow the pace of her breathing.
c. Administer oxygen via a mask or nasal cannula.
d. Help her breathe into a paper bag
d. Help her breathe into a paper bag
a. Counterpressure against the sacrum.
b. Pant-blow (breaths and puffs) breathing techniques.
c. Effleurage.
d. Conscious relaxation or guided imagery.
a. Counterpressure against the sacrum.
a. Her pain will decrease.
b. Her pain will return.
c. She will feel less anxious.
d. She will no longer feel the urge to push.
b. Her pain will return.
a. She is too far dilated. c. She has thrombocytopenia.
b. She is anemic. d. She is septic.
c. She has thrombocytopenia.
a. Inform the client about the procedure and have her sign the consent form.
b. Act as a client advocate and help clarify the procedure and the options.
b. Upright positions in labor increase the pain factor because they cause greater fatigue.
c. Women who move around trying different positions are experiencing more pain.
d. Levels of pain-mitigating b-endorphins are higher during a spontaneous, natural childbirth.
d. Levels of pain-mitigating b-endorphins are higher during a spontaneous, natural childbirth.
a. Chinese c. Hispanic
b. Arab or Middle Eastern d. African-American
c. Hispanic
a. Even mild anxiety must be treated.
b. Severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety, and so on.
c. Anxiety may increase the perception of pain, but it does not affect the mechanism of labor.
d. Women who have had a painful labor will have learned from the experience and have less anxiety the second time because of increased familiarity.
b. Severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety, and so on.
a. Sensory pain for nulliparous women often is greater than for multiparous women during early labor.
b. Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor.
c. Women with a history of substance abuse experience more pain during labor.
d. Multiparous women have more fatigue from labor and therefore experience more pain.
a. Sensory pain for nulliparous women often is greater than for multiparous women during early labor.
a. The Dick-Read (natural) childbirth method.
b. The Lamaze (psychoprophylactic) method.
c. The Bradley (husband-coached) method.
d. Having expectant parents attend childbirth preparation in any or no specific method.
d. Having expectant parents attend childbirth preparation in any or no specific method
a. Breathing techniques in the first stage of labor are designed to increase the size of the abdominal
cavity to reduce friction.
b. By the time labor has begun, it is too late for instruction in breathing and relaxation.
c. Controlled breathing techniques are most difficult near the end of the second stage of labor.
d. The patterned-paced breathing technique can help prevent hyperventilation.
a. Breathing techniques in the first stage of labor are designed to increase the size of the abdominal
cavity to reduce friction.
c. A pudendal nerve block is designed to relieve the pain from uterine contractions.
d. A pudendal nerve block, if done correctly, does not significantly lessen the bearing-down reflex.
a. Most local agents are related chemically to cocaine and end in the suffix - caine.
a. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births.
b. A high incidence of after-birth headache is seen with spinal blocks.
c. Epidural blocks allow the woman to move freely.
d. Spinal and epidural blocks are never used together.
b. A high incidence of after-birth headache is seen with spinal blocks.
a. Not used much anymore.
b. Likely to be used in the second stage of labor but not in the first stage.
c. An application of nitrous oxide.
d. A prelude to cesarean birth.
c. An application of nitrous oxide.
a. Have the woman use a visual analog scale (VAS) to determine her level of pain.
b. Note drowsiness as a sign that the medications were working.
c. Interpret a womans fist clenching as an indication that she is angry at her male partner and the physician.
d. Evaluate the womans skin turgor to see whether she needs a gentle oil massage.
a. Have the woman use a visual analog scale (VAS) to determine her level of pain.
a. Visceral. c. Somatic.
b. Referred. d. Afterpain.
b. Referred
a. Greater and more complete pain relief is possible.
b. No side effects or risks to the fetus are involved.
c. The woman remains fully alert at all times.
d. A more rapid labor is likely.
b. No side effects or risks to the fetus are involved.
a. Respiratory depression. c. Acrocyanosis.