ch 16 labor and birth process

Question 1

1.A new mother asks the nurse when the “soft spot” on her son’s head will go away. What is the
nurse’s best response, based upon her understanding of when the anterior frontal closes?

Answer 1

18 months

Question 2

2.The nurse is performing an initial assessment of a client in labor. What is the appropriate
terminology for the relationship of the fetal body parts to one another?

Answer 2

Attitude

Question 3

3.When assessing the fetus using Leopold’s maneuvers, the nurse feels a round, firm, and
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 position of the fetus?

Answer 3

RSA

Question 4

4.Which statement by the client would lead the nurse to believe that labor has been established?

Answer 4

“The contractions in my uterus are getting stronger and closer together.”

Question 5

5.The nurse has received a report regarding a client in labor. The woman’s last vaginal
examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this
assessment?

Answer 5

Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines.

Question 6

6.A pregnant woman is at 38 weeks of gestation. She wants to know whether there are any signs
that “labor is getting close to starting.” Which finding is an indication that labor may begin soon?

Answer 6

Surge of energy

Question 7

7.Which stage of labor varies the most in length?

Answer 7

First

Question 8

8.The nurse expects which maternal cardiovascular finding during labor?

Answer 8

Increased cardiac output

Question 9

9.What is the correct term describing the slight overlapping of cranial bones or shaping of the
fetal head during labor?

Answer 9

Molding

Question 10

10.Which presentation is accurately described in terms of both the resenting part and the
frequency of occurrence?

Answer 10

Cephalic: occiput, at least 96%

Question 11

11.A labor and delivery nurse should be cognizant of which information regarding how the fetus
moves through the birth canal?

Answer 11

Normal attitude of the fetus is calledgeneral flexion.

Question 12

12.A woman’s position is an important component of the labor progress. Which guidance is
important for the nurse to provide to the laboring client?

Answer 12

Frequent changes in position help relieve fatigue and increase the comfort of the laboring
client.

Question 13

13.Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus
for initiating respirations immediately after birth. Which change in fetal physiologic activity
isnotpart of this process?

Answer 13

Fetal respiratory movements increase during labor.

Question 14

14.Which description of the four stages of labor iscorrectfor both the definition and the
duration?

Answer 14

First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours

Question 15

15.Nurses should be cognizant of what regarding the mechanism of labor?

Answer 15

Effects of the forces determining descent are modified by the shape of the woman’s pelvis
and the size of the fetal head.

Question 16

16.Which statement related to fetal positioning during labor iscorrectand important for the
nurse to understand?

Answer 16

Birth is imminent when the presenting part is at +4 to +5 cm below the spine.

Question 17

17.Which basic type of pelvis includes thecorrectdescription and percentage of occurrence in
women?

Answer 17

Platypelloid: flattened, wide, and shallow pelvis; 3%

Question 18

18.What is the nurse’s understanding of the appropriate role of primary and secondary powers?

Answer 18

Primary powers are responsible for the effacement and dilation of the cervix.

Question 19

19.Which statement regarding the care of a client in labor iscorrectand important to the nurse as
he or she formulates the plan of care?

Answer 19

Endogenous endorphins released during labor will raise the woman’s pain threshold and
produce sedation.

Question 20

20.Which adaptation of the maternal-fetal exchange of oxygen occurs in response to uterine
contraction?

Answer 20

It diminishes as the spiral arteries are compressed.

Question 21

21.Which statement is thebestrationale for assessing the maternal vital signs between uterine
contractions?

Answer 21

Maternal circulating blood volume temporarily increases during contractions.

Question 22

22.What is the primary difference between the labor of a nullipara and that of a multipara?

Answer 22

Total duration of labor

Question 23

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

Answer 23

Vulva bulges and encircles the fetal head.

Question 24

24.Nurses can help their clients by keeping them informed about the distinctive stages of labor.
Which description of the phases of the first stage of labor isaccurate?

Answer 24

Active: Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours

Question 25

1.Which changes take place in the woman’s reproductive system, days or even weeks before the
commencement of labor?(Select all that apply.)

Answer 25

a. Lightening
c. Bloody show
d. Rupture of membranes

Question 26

2.Which factors influence cervical dilation?(Select all that apply.)

Answer 26

a. Strong uterine contractions
b. Force of the presenting fetal part against the cervix

d. Pressure applied by the amniotic sac
e. Scarring of the cervix

Question 27

3.At least five factors affect the process of labor and birth. These are easily remembered as the
fivePs. Which factors are included in this process?(Select all that apply.)

Answer 27

a. Passenger
b. Passageway
c. Powers
e. Psychologic response

Question 28

4.Because of its size and rigidity, the fetal head has a major effect on the birth process. Which
bones comprise the structure of the fetal skull?(Select all that apply.)

Answer 28

a. Parietal
b. Temporal
d. Occipital