Practice Exam Topics

Question 1

Type of contraction:

irregular, stops with activity or sleep, no change in duration, frequency, and intensity, no cervical dilation, and occurs only in the abdomen.

Answer 1

False contractions

Question 2

Where are true contractions felt?

Answer 2

Lower back and abdomen

Question 3

Describes a preliminary sign of labor; caused by an increase in epinephrine that comes from labor.

Answer 3

Increase in energy

Question 4

Lightening, increase in energy, backaches, braxton hicks contractions, and ripening of the cervix

are signs of what?

Answer 4

preliminary signs of labor

Question 5

Descent, flexion, internal rotation, extension, external rotation, birth

Answer 5

6 cardinal movements

Question 6

Type of deceleration that is typically sporadic and does not follow a pattern.

Answer 6

Variable decelerations

Question 7

Type of deceleration that starts after the peak of contractions.

Answer 7

Late decelerations

Question 8

What do variable decelerations imply?

Answer 8

Umbilical cord compression

Question 9

What is the cause of early deceleration FHR?

Answer 9

fetal head compression

Question 10

What is the cause of late deceleration in FHR?

Answer 10

uteroplacental insufficiency

Question 11

How many hours prior to birth must opioids be given?

Answer 11

3 hours prior to birth

Question 12

formulated in 1965 by a neurobiologist and a psychologist who wanted to propose that spinal nerves act as gates to let pain travel through to reach the brain — or close these gates and prevent pain messages from getting through at all.

Answer 12

Gate control theory of pain

Question 13

A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client’s umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?

Answer 13

breech

With a frank breech presentation, the fetal heart is generally above the level of the client’s umbilicus.

Question 14

A nurse is preparing a sterile field. Which of the following actions should the nurse perform when opening the sterile pack?

• Place the pack on a sterile work surface.
• Reach around the pack and open the top flap away from the body.
• Open the right flap with the left hand.
• Move to the opposite side of the pack to open the fourth flap.

Answer 14

Reach around the pack and open the top flap away from the body.

The nurse should pull the uppermost flap away from her body, grasping it from the side to avoid reaching over the sterile field and contaminating it

Question 15

A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

• Early decelerations
• Accelerations
• Late decelerations
• Variable decelerations

Answer 15

Variable decelerations

Variable decelerations occur when the umbilical cord becomes compressed and disrupts the flow of oxygen to the fetus.

Question 16

A nurse in the labor and delivery unit is caring for a client who is undergoing external fetal monitoring. The nurse observes that the fetal heart rate begins to slow after the start of a contraction and the lowest rate occurs after the peak of the contraction. Which of the following actions should the nurse take first?

• Place the client in the lateral position.
• Increase the rate of maintenance IV infusion.
• Elevate the client’s legs.
• Administer oxygen using a nonrebreather mask.

Answer 16

Place the client in the lateral position.

This is a late deceleration and is associated with fetal hypoxemia due to insufficient placental perfusion. Placing the client in the lateral position is the first action the nurse should take.

Question 17

Beth has requested to have an epidural and the nurse has informed anesthesia of the request. What are two risks that are potentially associated with an epidural?

Answer 17

Hypotension and prolonged second stage of labor can occur

Question 18

The nurse is caring for a client who is in active labor. The client reports dizziness and numbness in her hands. What action should the nurse take?

a. Help her breathe into her cupped hands

b. Initiate oxygen at 2 liters.

c. Place her flat on her back.

d. notify her doctor

Answer 18

Help her breathe into her cupped hands.

Question 19

A nurse on the labor and delivery unit is caring for a client who is having a difficult, prolonged labor with severe backache. Which of the following contributing causes should the nurse identify?

• Fetal attitude is in general flexion
• Fetal lie is longitudinal.
• Maternal pelvis is gynecoid.
• Fetal position is persistent occiput posterior.

Answer 19

Fetal position is persistent occiput posterior.

The persistent occiput posterior position of the fetus is a common cause of prolonged, difficult labor with severe back pain as spinal nerves are being compressed. Counter pressure or a hands-and-knees position can offer pain relief.

Question 20

A nurse is caring for a client who is at 39.2 weeks of gestation and experiencing contractions every 2-4 minutes and getting stronger. A vaginal exam reveals that the client’s cervix is 4 cm dilated, 75% effaced, and 0 station. The clients asks for pain medication. Which of the following actions should the nurse take?
(Select all that apply)

• Provide ice chips.
• Help client to the bathroom.
• Administer opioid analgesic medication.
• Suggest application of cold.
• Encourage the use of box breathing pattern.

Answer 20

• Administer opioid analgesic medication.
• Suggest application of cold.
• Encourage the use of box breathing pattern.

Question 21

A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding?

Answer 21

Variable decelerations are due to umbilical cord compression.

Variable decelerations are decreases in the fetal heart rate with an abrupt onset, followed by a gradual return to baseline.

Variable decelerations coincide with umbilical cord compression, which decreases the oxygen supply to the fetus.