chapter 16-labour and birth processes

Question 1

A new mother asks the nurse when the “soft spot” on her son’s head will go away. The nurse’s answer is based on the knowledge that the anterior fontanel closes how many months after birth?
a. 2 months
b. 8 months
c. 12 months
d. 18 months

Answer 1

d

Question 2

What is the term for the relationship of the fetal body parts to one another?
a. Lie
b. Presentation
c. Attitude
d. Position

Answer 2

c

Question 3

The nurse has received a report about a woman in labour. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?
a. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines.
b. The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
c. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines.
d. The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.

Answer 3

b

Question 4

Which position would be least effective when gravity is needed to assist in fetal descent?
a. Lithotomy
b. Kneeling
c. Sitting
d. Walking

Answer 4

a

Question 5

Which position would the nurse suggest for second-stage labour if the pelvic outlet needs to be increased?
a. Semirecumbent
b. Sitting
c. Squatting
d. Semi-Fowler’s

Answer 5

c

Question 6

To adequately care for a labouring woman, the nurse should know that which stage of labour varies most in length?
a. First
b. Second
c. Third
d. Fourth

Answer 6

a

Question 7

The nurse would expect which maternal cardiovascular finding during labour?
a. Increased cardiac output
b. Decreased pulse rate
c. Decreased white blood cell (WBC) count
d. Decreased blood pressure

Answer 7

A

Question 8

Which represents one of the factors that affect the process of labour and birth, known commonly as the five P’s?
a. Pelvic diameters
b. Position
c. Powers
d. Pressure

Answer 8

C

Question 9

What is the term for the slight overlapping of cranial bones or shaping of the fetal head during labour?
a. Lightening
b. Moulding
c. Ferguson reflex
d. Valsalva manoeuvre

Answer 9

B

Question 10

Which presentation is described accurately in terms of both presenting part and frequency of occurrence?
a. Cephalic: occiput; at least 95%
b. Breech: sacrum; 10 to 15%
c. Shoulder: scapula; 10 to 15%
d. Cephalic: cranial; 80 to 85%

Answer 10

A

Question 11

Which is true with regard to factors that affect how the fetus moves through the birth canal?
a. The fetal attitude describes the angle at which the fetus exits the uterus.
b. Of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother.
c. The normal attitude of the fetus is called general flexion.
d. The transverse lie is preferred for vaginal birth.

Answer 11

C

Question 12

What should the nurse be aware of with regard to fetal positioning during labour?
a. Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal.
b. Birth is imminent when the presenting part is at +4 to +5 cm, below the spine.
c. The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter.
d. Engagement is the term used to describe the beginning of labour.

Answer 12

B

Question 13

Which basic type of pelvis includes the correct description and percentage of occurrence in women?
a. Gynecoid: classic female; heart shaped; 75%
b. Android: resembling the male; wider oval; 15%
c. Anthropoid: resembling the ape; narrower; 10%
d. Platypelloid: flattened, wide, shallow; 3%

Answer 13

D

Question 14

What should the nurse know with regard to primary and secondary powers?
a. Primary and secondary powers are responsible for effacement and dilation of the cervix.
b. Effacement generally is well ahead of dilation in women giving birth for the first time; effacement and dilation are more together in subsequent pregnancies.
c. Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation.
d. Pushing in the second stage of labour is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs.

Answer 14

B

Question 15

What should the nurse teach the woman about her position during labour?
a. The supine position increases blood flow.
b. The “all fours” position, on her hands and knees, is hard on her back.
c. Frequent changes in position will help relieve her fatigue and increase her comfort.
d. In a sitting or squatting position her abdominal muscles will have to work harder.

Answer 15

C

Question 16

Which description of the four stages of labour is correct for both definition and duration?
a. First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 18 hours
b. Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
c. Third state: active pushing to birth; 20 minutes (multipara), 50 minutes (primipara)
d. Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

Answer 16

A

Question 17

What should nurses be aware of with regard to the turns and other adjustments of the fetus during the birth process?
a. The seven critical movements must progress in a more or less orderly sequence.
b. Asynclitism sometimes is achieved by means of the Leopold manoeuvre.
c. The effects of the forces determining descent are modified by the shape of the woman’s pelvis and the size of the fetal head.
d. At birth the baby is said to achieve “restitution” (i.e., a return to the C-shape of the womb).

Answer 17

C

Question 18

What should the nurse be aware of to accurately assess the health of the mother during labour?
a. The woman’s blood pressure will increase during contractions and fall back to prelabour normal between contractions.
b. Use of the Valsalva manoeuvre is encouraged during the second stage of labour to relieve fetal hypoxia.
c. Having the woman point her toes will reduce leg cramps.
d. The endogenous endorphins released during labour will raise the woman’s pain threshold and produce sedation.

Answer 18

D

Question 19

Which may be a sign that precedes labour?
a. Lightening
b. Exhaustion
c. Weight gain
d. Decreased fetal movement

Answer 19

A

Question 20

Which factor influences cervical dilation?
a. The size of the fetus
b. The diameters of the bony pelvis
c. The size of the female
d. The pressure applied by the amniotic sac

Answer 20

D