Chapter 16: Labor and Birth Process Flashcards
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?
d. 18 months
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?
c. Attitude
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?
c. RSA
Which statement by the client would lead the nurse to believe that labor has been
established?
c. “The contractions in my uterus are getting stronger and closer
together.”
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?
b. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2
cm above the ischial spines.
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?
d. Surge of energy
Which stage of labor varies the most in length?
a. First
The nurse expects which maternal cardiovascular finding during labor?
a. Increased
cardiac output
What is the correct term describing the slight overlapping of cranial bones or shaping of
the fetal head during labor?
b. Molding
Which presentation is accurately described in terms of both the resenting part and the
frequency of occurrence?
a. Cephalic: occiput, at least 96%
A labor and delivery nurse should be cognizant of which information regarding how the
fetus moves through the birth canal?
c. Normal attitude of the fetus is called general
flexion.
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?
c. Frequent changes in
position help relieve fatigue and increase the comfort of the laboring client.
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 isnot part of this process?
d. Fetal respiratory movements increase during
labor.
Which description of the four stages of labor is correct for both the definition and the
duration?
a. First stage: onset of regular uterine contractions to full dilation; less
than 1 hour to 20 hours
Nurses should be cognizant of what regarding the mechanism of labor?
c. Effects of
the forces determining descent are modified by the shape of the woman’s pelvis
and the size of the fetal head.
Which statement related to fetal positioning during labor is correct and important for the
nurse to understand?
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?
d. Platypelloid: flattened, wide, and shallow pelvis; 3%
What is the nurse’s understanding of the appropriate role of primary and secondary
powers?
a. Primary powers are responsible for the effacement and dilation of the
cervix
Which statement regarding the care of a client in labor is correct and important to the
nurse as he or she formulates the plan of care?
d. Endogenous endorphins released
during labor will raise the woman’s pain threshold and produce sedation.
Which statement is the best rationale for assessing the maternal vital signs between
uterine contractions?
b. Maternal circulating blood volume temporarily increases
during contractions.
Which adaptation of the maternal-fetal exchange of oxygen occurs in response to uterine
contraction?
c. It diminishes as the spiral arteries are compressed.
What is the primary difference between the labor of a nullipara and that of a multipara?
b. Total duration of labor
Which nursing assessment indicates that a woman who is in second-stage labor is
almost ready to give birth?
c. Vulva bulges and encircles the fetal head.
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 is accurate?
b. Active:
Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours
Which changes take place in the woman’s reproductive system, days or even weeks
before the commencement of labor? (Select all that apply.)
a. Lightening b. Exhaustion
c. Bloody show d. Rupture of membranes e. Decreased fetal movement ANS: A, C, D
Which factors influence cervical dilation? (Select all that apply.)
a. Strong uterine
contractions b. Force of the presenting fetal part against the cervix c. Size of the woman
d. Pressure applied by the amniotic sac e. Scarring of the cervix ANS: A, B, D, E
At least five factors affect the process of labor and birth. These are easily remembered
as the five Ps. Which factors are included in this process? (Select all that apply.)
a.
Passenger b. Passageway c. Powers d. Pressure e. Psychologic response ANS: A, B,
C, E
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.)
a. Parietal
b. Temporal c. Fontanel d. Occipital e. Femoral ANS: A, B, D
