Ch 13 14 Flashcards
Ch 13
1.
A woman in her 40th week of pregnancy calls the nurse at the clinic and says she’s not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?
A)
ìI’m feeling contractions mostly in my back.î
B)
ìMy contractions are about 6 minutes apart and regular.î
C)
ìThe contractions slow down when I walk around.î
D)
ìIf I try to talk to my partner during a contraction, I can’t.î
The contractions slow down when I walk around.
2. Which of the following would indicate to the nurse that the placenta is separating? A) Uterus becomes globular B) Fetal head is at vaginal opening C) Umbilical cord shortens D) Mucous plug is expelled
Uterus becomes globular
3. When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics? A) Extent of opening to its widest diameter B) Degree of thinning C) Passage of the mucous plug D) Fetal presenting part
Degree of thinning
4.
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following?
A)
Increased energy level with alternating strong and weak contractions
B)
Moderately strong contractions every 4 minutes, lasting about 1 minute
C)
Contractions noted in the front of abdomen that stop when she walks
D)
Pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds
Moderately strong contractions every 4 minutes, lasting about 1 minute
5. A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A) Supine B) Lithotomy C) Upright D) Kneeñchest
upright
6.
A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:
A)
Latent phase of the first stage of labor
B)
Active phase of the first stage of labor
C)
Transition phase of the first stage of labor
D)
Pelvic phase of the second stage of labor
Transition phase of the first stage of labor
7. The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth? A) Cesarean B) Vaginal C) Forceps-assisted D) Vacuum extraction
cesarean
8. Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: A) Latent phase of the first stage B) Active phase of the first stage C) Transition phase of the first stage D) Perineal phase of the second stage
Latent phase of the first stage
9. A client is admitted to the labor and birthing suite in early labor. On review of her medical record, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted? A) Platypelloid B) Gynecoid C) Android D) Anthropoid
Gynecoid
10.
A woman telephones her health care provider and reports that her ìwater just broke.î Which suggestion by the nurse would be most appropriate?
A)
ìCall us back when you start having contractions.î
B)
ìCome to the clinic or emergency department for an evaluation.î
C)
ìDrink 3 to 4 glasses of water and lie down.î
D)
ìCome in as soon as you feel the urge to push.î
Come to the clinic or emergency department for an evaluation
11.
After teaching a group of students about the maternal bony pelvis, which statement by the group indicates that the teaching was successful?
A)
The bony pelvis plays a lesser role during labor than soft tissue.
B)
The pelvic outlet is associated with the true pelvis.
C)
The false pelvis lies below the imaginary linea terminalis.
D)
The false pelvis is the passageway through which the fetus travels.
The pelvic outlet is associated with the true pelvis.
12. A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as: A) \+4 B) \+2 C) 0 D) -2
-2
13. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A) Frank B) Full C) Complete D) Footling
frank
14. A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure , cramping and lower back pain. The nurse determines that which of the following has most likely occurred? A) Cervical dilation B) Lightening C) Bloody show D) Braxton-Hicks contractions
lightening
15. After teaching a group of students about the factors affecting the labor process, the instructor determines that the teaching was successful when the group identifies which of the following as a component of the true pelvis? (Select all that apply.) A) Pelvic inlet B) Cervix C) Mid pelvis D) Pelvic outlet E) Vagina F) Pelvic floor muscles
pelvic inlet, mid pelvis, pelvic outlet
16. A nurse is documenting fetal lie of a woman in labor. Which term would the nurse most likely use? A) Flexion B) Extension C) Longitudinal D) Cephalic
Longitudinal
17. The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which of the following is the presenting part? A) Occiput B) Face C) Buttocks D) Shoulder
Buttocks
18. A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which of the following would the nurse most likely include? (Select all that apply.) A) Internal rotation B) Abduction C) Descent D) Pronation E) Flexion
Internal rotation
Descent
Flexion
19. The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which of the following? A) Increment B) Acme C) Peak D) Decrement
Increment
20.
A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction?
A)
Heart rate increase from 76 bpm to 90 bpm
B)
Blood pressure rise from 110/60 mm Hg to 120/74
C)
White blood cell count of 12,000 cells/mm3
D)
Respiratory rate of 10 breaths /minute
Respiratory rate of 10 breaths /minute
21. When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage? A) Regular contractions B) Cervical dilation C) Fetal movement through the birth canal D) Placental separation
Cervical dilation
22.
A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor?
A)
Contractions every 5 minutes, cervical dilation 3 cm
B)
Contractions every 3 minutes, cervical dilation 5 cm
C)
Contractions every 2Ω minutes, cervical dilation 7 cm
D)
Contractions every 1 minute, cervical dilation 9 cm
Contractions every 1 minute, cervical dilation 9 cm
