Exam 2: NUR230/ NUR 230 (Latest 2026/ 2027 Update) Childbearing Child Caring Family Nursing: OB/Mother-Baby Review| Test Bank| Grade A| 100% Correct (Verified Solutions) – Galen

INSTANT PDF DOWNLOAD — This official test bank for NUR 230 Exam 2 at Galen College of Nursing covers Childbearing Child Caring Family Nursing (OB/Mother-Baby) for the 2026/2027 academic year second examination. It contains verified questions and answers with detailed rationales in multiple-choice, select-all-that-apply (SATA), ordered response, and clinical scenario formats aligned with nursing program standards. INTRAPARTUM CARE (LABOR AND DELIVERY) Stages and Phases of Labor Stage 1: Cervical Dilation (Onset of True Labor to Full Dilation at 10 cm) – Subdivided into three phases: Latent Phase (0-6 cm) – Cervical dilation 0-6 cm, effacement 0-40% (primip) or 0-80% (multip). Contractions: mild to moderate intensity, frequency q5-30 minutes (irregular initially, becoming more regular), duration 15-45 seconds. Duration: nulliparous average 6-12 hours (up to 20 hours may be normal), multiparous average 4-8 hours (up to 14 hours may be normal). Nursing interventions: encourage rest and relaxation (save energy for active labor), upright positions and ambulation if no contraindications (promotes descent, improves contractions, increases comfort), comfort measures (back rub, breathing techniques, position changes, warm shower/bath if membranes intact and not contraindicated), hydration and light snacks (clear liquids, broth, juice, popsicles, hard candy) if not at risk for aspiration and anesthesia not imminent (depends on facility policy), encourage voiding q2h (full bladder impedes descent, can cause uterine atony, postpartum hemorrhage). Encourage partner/support person involvement (coach breathing, comfort measures, advocate). Provide education on labor process, what to expect, when to return to hospital (if early labor admitted, latent phase may be slow; discuss options). Active Phase (6-8 cm) – Cervical dilation 6-8 cm, effacement 40-80% (primip) or 80% complete (multip). Contractions: moderate to strong intensity, frequency q3-5 minutes, duration 45-60 seconds. Duration: nulliparous average 2-4 hours, multiparous average 1-3 hours. Nursing interventions: provide continuous labor support (one-to-one nurse or doula support reduces cesarean delivery, operative vaginal delivery, use of analgesia/anesthesia, shorter labor, higher satisfaction scores – ACOG recommendation), encourage position changes (upright positions, side-lying, hands-knees, squatting, pelvic rocking – gravity aids descent, improves pelvic outlet diameters, reduces back pain), encourage voiding q1-2 hours, pain management options (non-pharmacologic: hydrotherapy, massage, counterpressure, sterile water papules for back labor, TENS unit, aromatherapy, relaxation, breathing techniques, positioning; pharmacologic: IV opioids (fentanyl, morphine, meperidine (Demerol) – less commonly used now due to neuroactive metabolite normeperidine (can cause seizures, CNS excitation, accumulates with repeated doses, crosses placenta rapidly, may cause neonatal respiratory depression, sedation (avoid within 2-4 hours of delivery), monitor maternal respiratory rate (12 → hold dose, may need reversal with naloxone if severe), epidural analgesia (most effective pain relief, does not increase cesarean delivery rate, may increase operative vaginal delivery rate, increases duration of second stage, can cause maternal hypotension (preload with IV fluids, position lateral, monitor BP frequently, treat hypotension with fluids, ephedrine, phenylephrine), fever (38°C or higher, associated with increased neonatal sepsis evaluation, but may not represent true infection – monitor fetal HR, maternal WBC, consider antibiotics), urinary retention, pruritus (opioids in epidural – treat with diphenhydramine, nalbuphine), headache (post-dural puncture headache – risk factors: young age, female, lower BMI, larger gauge needle, traumatic insertion, multiple attempts; treatment: epidural blood patch, caffeine, hydration, bedrest), respiratory depression (rare with low-dose epidural, monitor). FHR monitoring: continuous electronic fetal monitoring (EFM) or intermittent auscultation (depending on risk status, facility policy). Encourage support person to assist with comfort measures, advocate for patient. Monitor for signs of transition (increased anxiety, irritability, restlessness, feeling of loss of control, nausea/vomiting, increased rectal pressure, shaking legs, increased bloody show, irritability with touch). Transition Phase (8-10 cm) – Cervical dilation 8-10 cm, effacement complete (100%). Cont