Download Maternity Nursing Exam 1: Labor and Birth Processes and more Exams Nursing in PDF only on Docsity!
Maternity Test Bank Exam 1 FOR
NURSING 2025-.
Chapter 13: Labor and Birth Processes
- A new mother asks the nurse when the soft spot on her sons head will go away. The nurses answer is based on the knowledge that the anterior fontanel closes after birth by _____ months.
a. 2 c. 12
b. 8 d. 18
d. 18
- 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.
c. Attitude.
- 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 mothers right side close to midline. What is the likely position of the fetus?
a. ROA c. RSA
b. LSP d. LOA
c. RSA
- The nurse has received report regarding her patient in labor. The womans last vaginal examination was recorded as 3 cm, 30%, and ?2-2. The nurses 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.
b. The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
- 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
a. First
- The nurse would expect which maternal cardiovascular finding during labor?
a. Cephalic: occiput; at least 95%
- 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.
c. The normal attitude of the fetus is called general flexion.
- 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.
b. Birth is imminent when the presenting part is at +4 to +5 cm below the spine.
- 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%
d. Platypelloid: flattened, wide, shallow; 3%
- 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.
a. Primary powers are responsible for effacement and dilation of the cervix
- 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
c. Frequent changes in position will help relieve her fatigue and increase her comfort.
- 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)
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.
- 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.
b. Maternal circulating blood volume increases temporarily during contractions.
- 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.
d. Pulling the cervix over the fetus and amniotic sac.
- 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
b. Cervical dilation and effacement
- Which occurrence is associated with cervical dilation and effacement?
a. Bloody show c. Lightening
b. False labor d. Bladder distention
a. Bloody show
- 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.
b. Total duration of labor.
- 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.
- 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
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
- One
- Two
- Three
- Four
- Five
- Six
- Seven
- E
- F
- A
- B
- G
- C
- D
Chapter 14: Pain Management
- An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The woman states, My contractions are so strong that I dont know what to do with myself. The nurse should:
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.
- Nursing care measures are commonly offered to women in labor. Which nursing measure reflects application of the gate-control theory?
c. Monitor the maternal blood pressure for possible hypotension.
- The nurse should be aware that an effective plan to achieve adequate pain relief without maternal risk is most effective if:
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 woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:
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 woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure would be to use:
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.
- If an opioid antagonist is administered to a laboring woman, she should be told that:
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 woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the womans intravenous fluid for a preprocedural bolus. She reviews her laboratory values and notes that the womans hemoglobin is 12 g/dL, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for the woman?
a. She is too far dilated. c. She has thrombocytopenia.
b. She is anemic. d. She is septic.
c. She has thrombocytopenia.
- The role of the nurse with regard to informed consent is to:
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.
- Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help clients. Nurses should know that _____ women may be stoic until late in labor, when they may become vocal and request pain relief.
a. Chinese c. Hispanic
b. Arab or Middle Eastern d. African-American
c. Hispanic
- With regard to a pregnant womans anxiety and pain experience, nurses should be aware that:
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.
- Nurses should be aware of the differences experience can make in labor pain such as:
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.
- In the current practice of childbirth preparation, emphasis is placed on:
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
- With regard to breathing techniques during labor, maternity nurses should understand that:
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.
- With regard to spinal and epidural (block) anesthesia, nurses should know that:
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 woman in labor is breathing into a mouthpiece just before the start of her regular contractions. As she inhales, a valve opens, and gas is released. She continues to inhale the gas slowly and deeply until the contraction starts to subside. When the inhalation stops, the valve closes. This procedure is:
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.
- In assessing a woman for pain and discomfort management during labor, a nurse most likely would:
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.
- After change-of-shift report the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is:
a. Visceral. c. Somatic.
b. Referred. d. Afterpain.
b. Referred
- It is important for the nurse to develop a realistic birth plan with the pregnant woman in her care. The nurse can explain that a major advantage of nonpharmacologic pain management is:
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.
- The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is:
a. Respiratory depression. c. Acrocyanosis.
