NCLEX: Labor and Delivery

Question 1

four P’s

Answer 1

Powers: uterine contraction

Passageway:

Passenger: fetus, membranes, and placenta

Psyche: emotional structure, response to labor, physio-physcho function (anxiety or fear)

Question 2

cephalic presentation (4)

Answer 2

vertex, military, brow, and face

Question 3

breech (3)

Answer 3

frank, full, footling

Question 4

weight loss of 1-3 lbs about 24-48 hours before onset of labor….

Answer 4

results from fluid shifts produced by the changes of progesterone and estrogen

Question 5

true labor

Answer 5

contractions occur regularly, become stronger, last o=longer, and occur closer together.
cervical dilation and effacement are progressive
the fetus usually becomes engaged in the pelvis and begins to descend

Question 6

false labor

Answer 6

does not produce dilation, effacement or descent
contractions are irregular, without progression
activity such as walking often relieves false labor

Question 7

engagement… lightening or dropping

Answer 7

fetus nestle into pelvis

Question 8

descent

Answer 8

journey through the pelvis. assessed by the measurement of station (-2, -1, 0, +1, +2…)

Question 9

flexion

Answer 9

nodding fetal head forward toward the fetal chest

Question 10

internal rotation

Answer 10

most commonly occurs, occupototransverse position to occipitoanterior

Question 11

extension

Answer 11

enables the head to emerge when in cephalic position
begins after the head crowns
extension is complete when head passes under the symphysis pubis and occiput, and the anterior fontanel, brow, face, and chin pass over the sacrum and coccyx and are over the perineum

Question 12

resistitution

Answer 12

realignment of head and body

Question 13

expulsion

Answer 13

birth

Question 14

interventions for late decelerations include

Answer 14

improving placental blood flow and fetal oxygenation

Question 15

nonreassuring FHR patterns

Answer 15

bradycardia
tachycardia
late decelerations
prolonged decelerations 
hypertonic uterine activity
decreased or absent variability
variable decelerations falling to less than 70 beats/min for longer than 60 seconds.

Question 16

actions to take for a nonreassuring FHR

Answer 16

identify cause
discontinue oxytocin (pictocin) infusion
change the mother’s position
administer oxygen by face mask at 8-10 L/min and infuse IV fluids as prescribed
prepare to initiate continuous electronic fetal monitoring with internal devices if not contraindicated
prepare for C section delivery if necessary
document the event, actions taken, and the mother’s response.

Question 17

variable decelerations

Answer 17

occur if the umbilical cord becomes compressed, reducing blood flow between the placenta and the fetus

Question 18

C section position

Answer 18

supine position with a wedge under the right hip

Question 19

accelerations/transient/episodic

Answer 19

sign of fetal well being