Labor Flashcards
Which of the following is NOT a potential trigger for the start of labor?
A. Placental aging
B. Prostaglandin release from uterine stretching
C. Increased levels of cortisol in the fetus
D. Sudden maternal blood sugar spike
D. Sudden maternal blood sugar spike
During a Leopold’s maneuver, the third step is intended to determine:
A. The part of the fetus located in the fundus
B. The location of the fetal back
C. The fetal presenting part
D. The position of the cephalic prominence
C. The fetal presenting part
“Fetal attitude” refers to:
A. The fetus’s head flexion in relation to its body
B. The station of the fetal head within the pelvis
C. The fetus’s movement frequency
D. The size of the fetal head
A. The fetus’s head flexion in relation to its body
Which fetal presentation is considered most optimal for navigating the pelvis during labor?
A. Breech
B. Shoulder
C. Cephalic
D. Transverse
C. Cephalic
The “Four P’s” that influence labor progression include all of the following EXCEPT:
A. Passageway
B. Passenger
C. Placenta
D. Powers
C. Placenta
In terms of fetal head positioning, which of the following closes around 6-8 weeks after birth?
A. Anterior fontanel
B. Posterior fontanel
C. Occipital fontanel
D. Parietal fontanel
B. Posterior fontanel
In determining fetal station, a +1 station indicates that the presenting part is:
A. 1 cm above the ischial spines
B. 1 cm below the ischial spines
C. At the level of the ischial spines
D. 2 cm above the ischial spines
1 cm below the ischial spines
The “Passageway” involved in labor progression does NOT include:
A. The bony pelvis
B. Pelvic musculature
C. Cervix
D. Amniotic sac
D. Amniotic sac
Which factor related to the fetus can impact the ease of labor progression?
A. Fetal size and presentation
B. Maternal position
C. Cervical dilation
D. Contraction strength
Answer: A. Fetal size and presentation
During the first stage of labor, contractions aim to:
A. Expel the fetus from the uterus
B. Push the fetal head into a lower station
C. Efface and dilate the cervix
D. Separate the placenta from the uterine wall
C. Efface and dilate the cervix
The Ferguson reflex stimulates which hormone to aid in labor progression?
A. Estrogen
B. Progesterone
C. Prostaglandin
D. Oxytocin
D. Oxytocin
The passageway in labor includes all of the following EXCEPT:
A. Bony pelvis
B. Amniotic sac
C. Cervix
D. Pelvic musculature
Answer: B. Amniotic sac
The primary purpose of contractions in the first stage of labor is to:
A. Deliver the placenta
B. Efface and dilate the cervix
C. Stop fetal movement
D. Maintain fetal heart rate
Answer: B. Efface and dilate the cervix
The first stage of labor is characterized by:
A. Delivery of the placenta
B. Cervical dilation and effacement
C. Crowning of the baby’s head
D. Skin-to-skin contact
Answer: B. Cervical dilation and effacement
The second stage of labor lasts from:
A. Full dilation until birth of the fetus
B. Start of regular contractions to complete effacement
C. Delivery of the fetus until delivery of the placenta
D. Complete effacement to start of transition
Answer: A. Full dilation until birth of the fetus
The third stage of labor involves:
A. Full dilation until delivery of the baby
B. Delivery of the placenta
C. Onset of regular contractions
D. Complete cervical effacement
Answer: B. Delivery of the placenta
The fourth stage of labor is primarily focused on:
A. Skin-to-skin bonding and monitoring recovery
B. Cervical effacement
C. Delivery of the fetus
D. Pushing during contractions
Answer: A. Skin-to-skin bonding and monitoring recovery
In assessing the psychological response during labor, which of the following factors is LEAST likely to impact a laboring person’s emotions?
A. Cultural background
B. Support system
C. Weather outside
D. Prenatal education
C. Weather outside
Which of the following is most likely to positively impact the psychological response of the birthing person during labor?
A. Anxiety and fear
B. Cultural support
C. Minimal prenatal education
D. Limited support system
Answer: B. Cultural support
True labor can be distinguished from false labor by:
A. The presence of cervical change
B. Contractions felt only in the lower abdomen
C. Contractions that weaken with activity
D. Contractions with no pattern
A. The presence of cervical change
When triaging a laboring patient, which question is most relevant to determining if the patient is experiencing labor?
A. How is your baby moving?
B. Are you feeling thirsty?
C. What time did you wake up today?
D. Do you have any body aches?
A. How is your baby moving?
Fetal heart rate monitoring is essential during labor. A normal baseline for fetal heart rate is:
A. 80-120 beats per minute
B. 110-160 beats per minute
C. 150-180 beats per minute
D. 170-200 beats per minute
B. 110-160 beats per minute
The second stage of labor lasts from:
A. The start of regular contractions to complete effacement
B. Full dilation until birth of the fetus
C. Delivery of the fetus until delivery of the placenta
D. Onset of labor until complete dilation
B. Full dilation until birth of the fetus
During external fetal monitoring, a tocometer (toco) is used to measure:
A. Fetal heart rate only
B. Contraction frequency and duration
C. Contraction intensity in mmHg
D. Baseline uterine pressure
B. Contraction frequency and duration
Which deceleration type mirrors contractions, is usually benign, and often caused by fetal head compression?
A. Early deceleration
B. Late deceleration
C. Variable deceleration
D. Prolonged deceleration
A. Early deceleration
Late decelerations in fetal heart rate may indicate:
A. Fetal sleep cycles
B. Umbilical cord compression
C. Poor placental perfusion
D. Excessive fetal movement
C. Poor placental perfusion
Moderate variability in fetal heart rate indicates:
A. Neurological impairment
B. Fetal hypoxemia
C. Acid-base balance and fetal well-being
D. The need for immediate intervention
C. Acid-base balance and fetal well-being
Moderate variability in fetal heart rate is defined by fluctuations of:
A. Less than 5 bpm
B. Greater than 25 bpm
C. 5-25 bpm
D. No detectable fluctuation
Answer: C. 5-25 bpm
Minimal variability in fetal heart rate is defined by fluctuations of:
A. Less than 5 bpm
B. 5-25 bpm
C. Greater than 25 bpm
D. No fluctuation
Answer: A. Less than 5 bpm
Marked variability in fetal heart rate is characterized by fluctuations of:
A. 5-25 bpm
B. Greater than 25 bpm
C. Less than 5 bpm
D. No detectable fluctuation
Answer: B. Greater than 25 bpm
Absent variability in fetal heart rate means there is:
A. No detectable fluctuation
B. Greater than 25 bpm fluctuation
C. 5-25 bpm fluctuation
D. Less than 5 bpm fluctuation
Answer: A. No detectable fluctuation
Moderate variability in fetal heart rate generally indicates:
A. Fetal hypoxemia or neurological impairment
B. Fetal well-being and balanced acid-base status
C. Fetal sleep cycles or medication effects
D. Fetal distress or excessive movement
Answer: B. Fetal well-being and balanced acid-base status
Minimal variability in fetal heart rate may indicate:
A. Normal fetal movement and oxygenation
B. Fetal distress or excessive movement
C. Fetal sleep cycles or effects of certain medications
D. A relaxed uterine environment
Answer: C. Fetal sleep cycles or effects of certain medications
Marked variability in fetal heart rate is often a sign of:
A. Fetal distress or excessive movement
B. Well-being and balanced acid-base status
C. Fetal sleep cycles
D. Fetal hypoxemia or neurological impairment
Answer: A. Fetal distress or excessive movement
Absent variability in fetal heart rate is concerning because it may indicate:
A. Fetal well-being and acid-base balance
B. Fetal hypoxemia or neurological impairment
C. Normal fetal sleep cycles
D. A calm uterine environment
Answer: B. Fetal hypoxemia or neurological impairment
An intervention appropriate for managing variable decelerations due to umbilical cord compression might include:
A. Providing narcotics
B. Changing maternal position
C. Increasing pitocin dosage
D. Applying an external monitor
B. Changing maternal position
An acceleration in fetal heart rate is defined as:
A. A decrease of 15 beats per minute lasting at least 10 seconds
B. An increase of 15 beats per minute lasting at least 15 seconds
C. A steady heart rate with no fluctuation
D. A decrease of 10 beats per minute lasting at least 15 seconds
B. An increase of 15 beats per minute lasting at least 15 seconds
Which of the following is true about accelerations in fetal heart rate?
A. They indicate potential fetal distress
B. They reflect fetal hypoxia
C. They are a sign of fetal well-being
D. They are caused by head compression
C. They are a sign of fetal well-being
Early decelerations in fetal heart rate are typically caused by:
A. Umbilical cord compression
B. Fetal hypoxia
C. Placental insufficiency
D. Fetal head compression
D. Fetal head compression
What is the most appropriate nursing intervention for early decelerations?
A. Change the mother’s position
B. Administer oxygen
C. No intervention needed
D. Increase IV fluids
C. No intervention needed
Variable decelerations in fetal heart rate are often related to:
A. Fetal head compression
B. Umbilical cord compression
C. Placental insufficiency
D. Contractions only
B. Umbilical cord compression
Which intervention is most appropriate for managing variable decelerations?
A. Administering a fluid bolus
B. Applying a fetal scalp electrode
C. Position change and amnioinfusion if needed
D. Giving narcotics
C. Position change and amnioinfusion if needed
Late decelerations typically begin:
A. Before the start of a contraction
B. At the peak of a contraction
C. After the peak of a contraction
D. At the end of the contraction
C. After the peak of a contraction
Late decelerations are concerning because they may indicate:
A. Umbilical cord compression
B. Fetal sleep cycles
C. Placental insufficiency or fetal hypoxia
D. Fetal head compression
C. Placental insufficiency or fetal hypoxia
A common cause of late decelerations includes:
A. Maternal fever
B. Umbilical cord prolapse
C. Maternal hypotension or poor placental perfusion
D. Fetal movement
C. Maternal hypotension or poor placental perfusion
Which of the following interventions is appropriate for late decelerations?
A. Increasing pitocin
B. Positioning the patient on her side and stopping pitocin
C. Performing a cervical exam
D. Giving the mother food or water
B. Positioning the patient on her side and stopping pitocin
Minimal variability in fetal heart rate may be observed during:
A. Fetal sleep cycles
B. Accelerations
C. Placental insufficiency
D. Maternal positioning
A. Fetal sleep cycles
Which fetal heart rate pattern requires immediate intervention to prevent fetal distress?
A. Early decelerations
B. Accelerations
C. Late decelerations with minimal variability
D. Moderate variability
C. Late decelerations with minimal variability
Variable decelerations are characterized by:
A. Gradual onset and a shallow decrease in heart rate
B. Sharp, abrupt decreases in heart rate
C. A pattern that mirrors contractions
D. A gradual return to baseline over time
B. Sharp, abrupt decreases in heart rate
What is the primary purpose of monitoring fetal accelerations during labor?
A. To confirm fetal sleep patterns
B. To ensure fetal heart rate remains steady
C. To assess fetal oxygenation and neurological well-being
D. To measure contraction strength
C. To assess fetal oxygenation and neurological well-being
Spontaneous rupture of membranes (SROM) requires the nurse to assess all of the following EXCEPT:
A. Color
B. Amount
C. Cervical dilation
D. Odor
C. Cervical dilation
Artificial rupture of membranes (AROM) is typically performed when:
A. The fetus is in a transverse position
B. The fetal head is well engaged in the pelvis
C. There is a need to confirm SROM
D. Labor has already reached the second stage
B. The fetal head is well engaged in the pelvis
Which of the following is NOT a non-pharmacological pain management technique during labor?
A. Aromatherapy
B. Epidural anesthesia
C. Hydrotherapy
D. Counterpressure
B. Epidural anesthesia
Epidural anesthesia in labor requires careful monitoring, particularly for:
A. Hypertension
B. Hypotension
C. Hypoglycemia
D. Hyperthermia
B. Hypotension
The second stage of labor, or “pushing” stage, begins when:
A. The cervix reaches 10 cm dilation and 100% effacement
B. The fetal head begins to crown
C. Contractions become mild and irregular
D. The placenta detaches
A. The cervix reaches 10 cm dilation and 100% effacement
During the latent phase of the first stage of labor, a typical contraction pattern is:
A. 5-20 minutes apart, mild intensity
B. 3-5 minutes apart, moderate-strong intensity
C. 2-3 minutes apart, strong intensity
D. 10 minutes apart, mild intensity
A. 5-20 minutes apart, mild intensity
In the third stage of labor, which of the following is a sign that the placenta has separated?
A. Contractions cease completely
B. Cord appears to lengthen and fundus rises
C. Blood flow from the introitus slows
D. Uterus becomes soft and uncontracted
B. Cord appears to lengthen and fundus rises
Immediate newborn care after birth often includes:
A. Applying general anesthesia to the birthing parent
B. Skin-to-skin contact and assessment
C. Administering antibiotics to the newborn
D. Immediate transport to the nursery
B. Skin-to-skin contact and assessment
In the fourth stage of labor, which assessment is typically performed every 15 minutes?
A. Fundal height and firmness
B. Cervical dilation
C. Maternal oxygen saturation
D. Fetal heart rate
A. Fundal height and firmness
A Foley bulb is used in labor primarily to:
A. Provide pain relief
B. Dilate the cervix mechanically
C. Increase fetal heart rate variability
D. Prevent preterm labor
B. Dilate the cervix mechanically
A common reason for performing an episiotomy is to:
A. Speed up the delivery of the fetus
B. Allow more room for instrument-assisted delivery
C. Reduce the risk of postpartum hemorrhage
D. Facilitate quicker healing post-delivery
B. Allow more room for instrument-assisted delivery
An important consideration when administering Pitocin to augment labor is to monitor:
A. Contraction pattern and intensity
B. Fetal presentation
C. Maternal appetite
D. Blood glucose levels
A. Contraction pattern and intensity
During an assisted vaginal delivery, the healthcare provider may use:
A. Foley catheter and speculum
B. Forceps or vacuum
C. Oxygen and nasal cannula
D. Pitocin and a sedative
B. Forceps or vacuum
The primary function of the ovaries in the female reproductive system is to:
A. Produce and release eggs
B. Support fetal development
C. Maintain uterine lining
D. Facilitate fertilization
Answer: A. Produce and release eggs
Which hormone is primarily responsible for maintaining pregnancy by stabilizing the uterine lining?
A. Estrogen
B. Progesterone
C. Oxytocin
D. Prolactin
Answer: B. Progesterone
Estrogen plays a key role in reproduction by:
A. Stimulating milk production
B. Causing uterine contractions
C. Promoting follicle development and preparing the endometrium
D. Stabilizing the placenta
Answer: C. Promoting follicle development and preparing the endometrium
The bony pelvis includes all of the following structures EXCEPT:
A. Ilium
B. Ischium
C. Clavicle
D. Pubis
Answer: C. Clavicle
The narrowest portion of the pelvic inlet, critical in the birthing process, is the:
A. Sacral promontory
B. Ischial spines
C. Coccyx
D. Iliac crest
Answer: B. Ischial spines
The pubic symphysis plays a role in childbirth by:
A. Expanding to widen the birth canal
B. Supporting fetal head rotation
C. Anchoring the umbilical cord
D. Preventing uterine prolapse
Answer: A. Expanding to widen the birth canal
