NUR 221 PATHOPHYSIOLOGY EXAM 2
COMPLETE STUDY GUIDE WITH DETAILED
SOLUTIONS 2026
● Non Pharmacological pain relief Cutaneous Stimulation strategies
Answer: Counter pressure
Effleurage (light massage)
Therapeutic touch and massage
Walking
Rocking
Changing positions
Application of heat or cold
Transcutaneous electrical nerve stimulation (TENS)
Accupressure
Water therapy i.e. baths, showers, whirlpools
Intradermal water block
● Non Pharmacological pain relief
Sensory Stimulation strategies Answer: Aromatherapy
Breathing techniques
Music
,Imagery
Use of focal points
● Non Pharmacological pain relief
Cognitive strategies Answer: Childbirth education
Hypnosis
Biofeedback
● cardinal movements of the mechanism of labor Answer: Engagement
and descent
Flexion
Internal rotation to occipitoanterior
position
Extension
External rotation beginning (restitution)
External rotation
expulsion
● Engagement Answer: when the fetus moves their head past the pelvic
inlet, the head is said to be engaged. occurs before active labor, while
abdominal muscles are more relaxed.
, ● Asynclitism Answer: Oblique presentation of the fetal head at the
superior strait of the pelvis; the pelvic planes and those of the fetal head
are not parallel
● Descent Answer: refers to the progress of the presenting part through
the pelvis. depends on 4 forces. 1. pressure exerted by the amniotic fluid.
2. direct pressure exerted by the contracting fundus on the fetus. 3. Force
of the contraction of the maternal diaphragm and the abdominal muscles
in the second stage of labor. 4. extension and straightening of the fetal
body
● Stations of descent Answer:
● Flexion Answer: as soon as the head reaches resistance from the
cervix, pelvic wall or pelvic floor. it normally flexes so the chin makes
contact with the fetal chest
● Internal Rotation Answer: The maternal pelvic inlet is widest in the
transverse diameter, therefore the fetal head passes the inlet into the true
pelvis in the occipitotransverse position. for the fetus to exit the head
must rotate. internal rotation begins at the level of the ischial spines but
is not complete until the presenting part reaches the lower pelvis. as the
occiput rotates anteriorly the face rotates posteriorly. with each
contraction the pelvic bones and muscles guide the fetal head. almost
always rotated by the time it reaches pelvic floor
COMPLETE STUDY GUIDE WITH DETAILED
SOLUTIONS 2026
● Non Pharmacological pain relief Cutaneous Stimulation strategies
Answer: Counter pressure
Effleurage (light massage)
Therapeutic touch and massage
Walking
Rocking
Changing positions
Application of heat or cold
Transcutaneous electrical nerve stimulation (TENS)
Accupressure
Water therapy i.e. baths, showers, whirlpools
Intradermal water block
● Non Pharmacological pain relief
Sensory Stimulation strategies Answer: Aromatherapy
Breathing techniques
Music
,Imagery
Use of focal points
● Non Pharmacological pain relief
Cognitive strategies Answer: Childbirth education
Hypnosis
Biofeedback
● cardinal movements of the mechanism of labor Answer: Engagement
and descent
Flexion
Internal rotation to occipitoanterior
position
Extension
External rotation beginning (restitution)
External rotation
expulsion
● Engagement Answer: when the fetus moves their head past the pelvic
inlet, the head is said to be engaged. occurs before active labor, while
abdominal muscles are more relaxed.
, ● Asynclitism Answer: Oblique presentation of the fetal head at the
superior strait of the pelvis; the pelvic planes and those of the fetal head
are not parallel
● Descent Answer: refers to the progress of the presenting part through
the pelvis. depends on 4 forces. 1. pressure exerted by the amniotic fluid.
2. direct pressure exerted by the contracting fundus on the fetus. 3. Force
of the contraction of the maternal diaphragm and the abdominal muscles
in the second stage of labor. 4. extension and straightening of the fetal
body
● Stations of descent Answer:
● Flexion Answer: as soon as the head reaches resistance from the
cervix, pelvic wall or pelvic floor. it normally flexes so the chin makes
contact with the fetal chest
● Internal Rotation Answer: The maternal pelvic inlet is widest in the
transverse diameter, therefore the fetal head passes the inlet into the true
pelvis in the occipitotransverse position. for the fetus to exit the head
must rotate. internal rotation begins at the level of the ischial spines but
is not complete until the presenting part reaches the lower pelvis. as the
occiput rotates anteriorly the face rotates posteriorly. with each
contraction the pelvic bones and muscles guide the fetal head. almost
always rotated by the time it reaches pelvic floor
