Test 2 OB

Question 1

When determining the frequency of contractions, the nurse would measure which period of time?
a) Start of one contraction to the start of the next contraction
b) Beginning of one contraction to the end of the same contraction
c) Peak of one contraction to the peak of the next contraction
d) End of one contraction to the beginning of the next contraction

Answer 1

a) Start of one contraction to the start of the next contraction

Question 2

Which fetal lie is most conducive to a spontaneous vaginal birth?
a) Transverse
b) Longitudinal
c) Perpendicular
d) Oblique

Answer 2

b) Longitudinal

Question 3

Which observation would suggest that placental separation is occurring?
a) Uterus stops contracting altogether.
b) Umbilical cord pulsations stop.
c) Uterine shape changes to globular.
d) Maternal blood pressure drops.

Answer 3

c) Uterine shape changes to globular.

Question 4

As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is
a) discomfort level is greater with false labor.
b) progressive cervical changes occur in true labor.
c) there is a feeling of nausea with false labor.
d) there is more fetal movement with true labor.

Answer 4

b) progressive cervical changes occur in true labor.

Question 5

The most intense time during labor is during the
a. Latent phase
b. Active phase
c. Transition phase
d. Placental expulsion phase

Answer 5

c. Transition phase

Question 6

A laboring woman is admitted to the labor and birth suite at 4-cm dilation. She would be in which phase of labor?
a) Latent
b) Active
c) Late
d) Early

Question 7

Which assessment would indicate that a woman is in true labor?
a) Membranes are ruptured and fluid is clear.
b) Presenting part is engaged and not floating.
c) Cervix is 4 cm dilated, 90% effaced.
d) Contractions last 30 seconds every 5 to 10 minutes.

Answer 7

c) Cervix is 4 cm dilated, 90% effaced.

Question 8

Which interventions are underutilized in promoting a normal birth? Select all that apply.
a) Oral nutrition and fluids in labor
b) Open-glottis pushing in the second stage of labor
c) Skin-to-skin contact after birth for infant bonding
d) Routine artificial rupture of membranes (amniotomy)
e) Labor induction with intravenous Pitocin
f) Routine episiotomy to shorten labor length

Answer 8

a) Oral nutrition and fluids in labor
b) Open-glottis pushing in the second stage of labor
c) Skin-to-skin contact after birth for infant bonding

Question 9

Physiologic preparation for labor would be demonstrated by
a) a decrease in Braxton Hicks contractions felt by mother.
b) weight gain and an increase in appetite by mother.
c) lightening, when the fetus drops into true pelvis.
d) fetal heart rate accelerations and increased movements.

Answer 9

c) lightening, when the fetus drops into true pelvis.

Question 10

Evidence-based practice applied to the clinical setting improves
a) communication between health care professionals.
b) client care and overall better outcomes.
c) cost-effectiveness of therapeutic treatments.
d) ability to carry out a research study by nurses.

Answer 10

b) client care and overall better outcomes.

Question 11

How often do you assess the fetal heart rate during latent labor?

During Active Labor?

The general principle being what?

Answer 11

30-60 minutes during latent

15-30 minutes during active

As the frequency/duration of contractions increases, and circulation is reduced during contractions, we need to make sure the fetus is tolerating it well.

Question 12

How often do you assess the birthing parent’s vitals during labor?

Answer 12

Temperature is every 4 hours during the first stage of labor, every 2 hours after the water breaks

B/P, HR, RR every hour during latent phase, every 30 min during active/transition

Question 13

How often do you assess contractions during labor?

Answer 13

30-60 during latent, so do it and the FHR together

15-30 during active

15 min during transition

Question 14

A nurse is explaining the use of effleurage as a pain relief measure during labor. Which
statement would the nurse most likely use when explaining this measure?
A. “This technique focuses on manipulating body tissues.”
B. “The technique requires focusing on a specific stimulus.”
C. “This technique redirects energy fields that lead to pain.”
D. “The technique involves light stroking of the abdomen with breathing.”

Answer 14

Effleurage involves light stroking of the abdomen in rhythm with breathing.

Question 15

When palpating the fundus during a contraction, the nurse notes that it feels like a chin. The
nurse interprets this finding as indicating which type of contraction?
A. intense
B. strong
C. moderate
D. mild

Answer 15

C. moderate

Question 16

A client’s membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next?
A. Check the fetal heart rate.
B. Perform a vaginal exam.
C. Notify the primary care provider immediately.
D. Change the linen saver pad.

Answer 16

A. Check the fetal heart rate.

Question 17

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she is not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?
A. “I’m feeling contractions mostly in my back.”
B. “My contractions are about 6 minutes apart and regular.”
C. “The contractions slow down when I walk around.”
D. “If I try to talk to my partner during a contraction, I can’t.”

Answer 17

C. “The contractions slow down when I walk around.”

Question 18

When assessing cervical effacement of a client in labor, the nurse assesses which
characteristic?
A. extent of opening to its widest diameter
B. degree of thinning
C. passage of the mucous plug
D. fetal presenting part

Answer 18

B. degree of thinning

Question 19

A woman telephones the prenatal clinic and reports that her water just broke. Which
suggestion by the nurse would be most appropriate?
A. “Call us back when you start having contractions.”
B. “Come to the clinic or emergency department for an evaluation.”
C. “Drink 3 to 4 glasses of water and lie down.”
D. “Come in as soon as you feel the urge to push.”

Answer 19

B. “Come to the clinic or emergency department for an evaluation.”

Question 20

A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which event
has most likely occurred?
A. cervical dilation
B. lightening
C. bloody show
D. Braxton Hicks contractions

Answer 20

B. lightening

Question 21

What is the order of fetal movement in labor?

Answer 21

Descent, engagement, flexion, internal rotation, extension, external rotation, expulsion

Question 22

A nurse is preparing a presentation for a group of pregnant people about the labor
experience. Which factors would the nurse include when discussing measures to promote coping for a positive labor experience? Select all that apply.
A. presence of a support partner
B. view of birth as a stressor
C. low anxiety level
D. fear of loss of control
E. participation in a pregnancy exercise program

Answer 22

A, C, E

Question 23

A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as the major change occurring during this stage?
A. regular contractions
B. cervical dilation (dilatation)
C. fetal movement through the birth canal
D. placental separation

Answer 23

B. cervical dilation (dilatation)

Question 24

Which action is a priority when caring for a woman during the fourth stage of labor?
A. assessing the uterine fundus
B. offering fluids as indicated
C. encouraging the woman to void
D. assisting with perineal care

Answer 24

A. assessing the uterine fundus

Question 25

Which positions would be most appropriate for the nurse to suggest as a comfort measure to a woman who is in the first stage of labor? Select all that apply.
A. walking with partner support
B. straddling with forward leaning over a chair
C. closed knee–chest position
D. rocking back and forth with foot on chair
E. supine with legs raised at a 90-degree angle

Answer 25

Answer: A, B, D

Question 26

Which suggestion by the nurse about pushing would be most appropriate to a woman in the second stage of labor?
A. “Lying flat with your head elevated on two pillows makes pushing easier.”
B. “Choose whatever method you feel most comfortable with for pushing
C. “Let me help you decide when it is time to start pushing.”
D. “Bear down like you’re having a bowel movement with every contraction.”

Answer 26

B. “Choose whatever method you feel most comfortable with for pushing

Question 27

A nurse is assisting with the birth of a newborn. The fetal head has just emerged. Which action would be performed next?

A. suctioning of the mouth and nose
B. clamping of the umbilical cord
C. checking for the cord around the neck
D. drying of the newborn

Answer 27

C. checking for the cord around the neck

Question 28

A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client’s fundus. Which finding would the nurse identify as expected?
A. two fingerbreadths above the umbilicus
B. at the level of the umbilicus
C. two fingerbreadths below the umbilicus
D. four fingerbreadths below the umbilicus

Answer 28

B. at the level of the umbilicus

Question 29

When the nurse is assessing a postpartum client approximately 6 hours after birth, which
finding would warrant further investigation?
A. deep red, fleshy-smelling lochia
B. voiding of 350 cc
C. blood pressure 90/50 mm Hg
D. profuse sweating

Answer 29

C. blood pressure 90/50 mm Hg

Question 30

A postpartum client who is bottle feeding her newborn asks, “When should my period return?” Which response by the nurse would be most appropriate?
A. “It’s difficult to say, but it will probably return in about 2 to 3 weeks.”
B. “It varies, but you can estimate it returning in about 7 to 9 weeks”
C. “You won’t have to worry about it returning for at least 3 months.”
D. “You don’t have to worry about that now. It’ll be quite a while.”

Answer 30

B. “It varies, but you can estimate it returning in about 7 to 9 weeks”

Question 31

Bradycardia lasts for how long postpartum?

Answer 31

About 2 weeks

Question 32

Which factor in a client’s history would alert the nurse to an increased risk for postpartum
hemorrhage?
A. multiparity, age of mother, operative birth
B. size of placenta, small baby, operative birth
C. uterine atony, placenta previa, operative procedures
D. prematurity, infection, length of labor

Answer 32

C. uterine atony, placenta previa, operative procedures

Risk factors for postpartum hemorrhage include precipitous labor, uterine atony, placenta previa or abruption, labor induction or augmentation, operative
procedures such as vacuum extraction, forceps, or cesarean birth, retained placental fragments,
prolonged third stage of labor greater than 30 minutes, multiparity and uterine overdistention
such as from a large infant, twins, or hydramnios

Question 33

A nurse is developing a teaching plan about sexuality and contraception for a postpartum
woman who is breastfeeding. Which information would the nurse most likely include? Select all
that apply.
A. resumption of sexual intercourse about two weeks after birth
B. possible experience of fluctuations in sexual interest
C. use of a water-based lubricant to ease vaginal discomfort
D. use of combined hormonal contraceptives for the first three weeks
E. possibility of increased breast sensitivity during sexual activity

Answer 33

b,c, e