NUR 106 - MODULE C EXAM QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026

NUR 106 - MODULE C EXAM QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026 1. Passenger - size of fetal head, fetal presentation, lie, attitude, and position 2. Passageway - bony pelvis and shape 3. Powers - contractions and pushing efforts 4. Position - up-right or semi-fowlers - Answers What variables affect labor? - dilation - effacement - station - Answers What is determined in a cervical examination? dilation - Answers opening of the cervix; 1-10 cm effacement - Answers thinning of the cervix; documented in percentages 90% - 100% - Answers What is the goal of effacement closer to delivery? station - Answers relationship of fetal head to mother's pelvis; goes from negative to positive - Braxton hick's contractions (20+ weeks) - lightening (fetus drops) - urinary frequency - low backache - increased vaginal mucous - bloody show (active change) - cervical ripening - possible rupture of membranes - energy spurt - weight loss - Answers What are preceding signs of labor? - fetal and maternal hormonal changes - progressive uterine distention - changes in the uterus, cervix, and pituitary gland - Answers What occurs at the onset of labor? - Stage 1 = latent and active phase - Stage 2 = expulsion: descent of head and pushing phase - Stage 3 = placenta delivery - Answers What are the stages of labor? - purposeful - anticipated - intermittent - normal - Answers What is the nature of pain during birth? - relaxation and breathing techniques - effleurage and counterpressure - touch and massage - thermal stimulation - acupressure and acupuncture - TENS unit - hydrotherapy - intradermal water block - aromatherapy and music - hypnosis - positioning every 30-45 minutes - Answers What are non-pharmacologic ways to control pain for labor patients? - ambien - phenergan (excessive sedation) - reglan (potentiates effects of analgesics) - valium (significant amnesia) - Answers What sedatives are used in the early or latent stage of labor to promote rest? barbituates (tranquilizers) - Answers What sedatives are avoided in labor? - neonatal respiratory depression - reduction of gastric emptying - increase risk for aspiration - bladder and bowel elimination inhibition - sedation, altered mental status - tachycardia, hypotension - decreased FHR variability - allergic reaction - Answers What are adverse effects of analgesics? - monitor patient safety - monitor labor status before administering - antiemetics - monitor vitals, contraction pattern, and continuous FHR monitoring - Answers What nursing actions should be done for a patient on an analgesic? - phenergan - benadryl - atarx - vistaril - Answers What medications prolong the effects of opioids? no epidural is given - Answers If a patient's platelets are less than 100,000: episiotomy and laceration repairs - Answers What is local anesthesia used for? - broad ligament hematoma - compromise of maternal bearing down reflex - Answers What is a pudendal block used for? broad ligament hematoma - Answers What is a paracervical nerve block used for? - hypotension - fetal bradycardia - fever - itching - inability to feel the urge to void - urinary retention - prolonged second stage of labor - Answers What are the adverse effects of an epidural block? - hypotension - fetal bradycardia - possible spinal headache - risk for bladder and urinary atony - Answers What are the adverse effects of a spinal anesthesia block? - WBC - H&H - platelet count - Answers What must be reported before administering an epidural? - nausea - dizziness - Answers What are the main side effects of nitrous oxide? - maternal aspiration of gastric contents - respiratory depression - uterine relaxation - fetal respiratory depression - Answers What are the adverse effects of general anesthesia? - restrict PO intake - pre-operative medications - cricoid pressure - Answers How can we minimize maternal adverse effects of general anesthesia? - reduce time from induction of anesthesia to clamping of cord - maternal positioning - keep use of sedative medications at a minimum until cord is clamped - Answers How can we minimize fetal adverse effects of general anesthesia? bolus - Answers What is given before general anesthesia to prevent hypotension in the mother? if the mother can't feel anything or is not pushing well - Answers When is general anesthesia discontinued immediately? - bolus of IV fluids; maintain access - positioning - maternal vital signs every 2-3 minute - continuous monitoring of FHR and contraction pattern - patient safety - assess for bladder distention - discontinuation - Answers What preparation/administration is done before pharmacological pain management? - repositioning - increase IV fluids - administer O2 - assess for fetal distress - ephedrine 5-10 mg IVP (vasoconstricts if fetus is in distress and pushes blood back into the placenta) - Answers What nursing interventions are done for patients during pharmacological pain management? enable clinicians to assess adequacy of fetal oxygenation during labor - Answers What is the primary goal of intrapartum fetal surveillance? - uterine activity - fetal response - fetal compromise - Answers What are the basis for monitoring? increment - Answers the building up phase of a contraction; longest part acme - Answers the peak of a contraction; shortest and most intense phase decrement - Answers letting up phase of a contraction; diminishing nadir - Answers resting phase of a contraction; uteroplacental reoxygenation acme period - Answers What phase of a contraction are IV meds pushed? contraction frequency - Answers from onset of one contraction to onset of the next contraction; documented in minutes rounded to the nearest half contraction duration - Answers measure from beginning of increment to end of decrement contraction strength - Answers strength if contraction during acme palpation as mild, moderate, or strong - Answers How is external contraction strength measured by? mm Hg (MVUs) - Answers How is internal contraction strength measured by? contraction resting tone - Answers tone when uterus is at rest average is 10 mm Hg but should not exceed 25 - Answers What should the internal resting tone of the uterus be? soft - Answers What should the external resting tone of the uterus be? 45-60 seconds - Answers What is the average contraction relaxation time? 100-250 - Answers 1st stage MVUs: 300-400 - Answers 2nd stage MVUs: hands-on fetal monitoring - Answers fetal monitoring that consists of a doppler and fetoscope; only gives you the now electronic fetal monitoring - Answers continuous fetal monitoring - availability and cost - non-invasive - outcomes - atmosphere/mobility - 1:1 nursing care - water births - Answers What are the benefits of hands-on fetal monitoring? - difficult to perform in some situations - patient may be intolerant of clinician's touch during contraction - no visual record of the FHR or UA - intermittent, unable to assess patterns or early detection on compromise - unable to determine UA intensity objectively - not recommended for high-risk pregnancies - Answers What are the limitations of hands-on fetal monitoring? tocotransducer - Answers external monitoring instrument that measures uterine activity transabdominally; it is placed over the fundus - non-invasive, easy to apply - may be used during both the antepartum and intrapartum period - sometimes used with telemetry - does not require ruptured membranes or cervical dilation - no known risks to the woman or fetus - provides continuous recording of FHR and UA - Answers What are the benefits of ultrasounds and tocotransducers? - limits maternal mobility - frequent repositioning of transducers - may double-count; may half-count heart rate - maternal heart rate may be recorded if monitor placed over maternal arterial vessels, such as the aorta - unable to assess strength or intensity of UA - obese women and preterm or multifetal gestations may be difficult to monitor - Answers What are the limitations of ultrasounds and tocotransducers? fetal scalp electrode - Answers small electrode attached to the fetal scalp that senses the potential differences created by the depolarization of the fetal heart - capable of accurately displaying some fetal cardiac arrythmias when linked to ECG recorder - accurately displays FHR between 30 and 240 bpm - maternal position changes do usually affect quality of FHR tracing - Answers What are the benefits of fetal scalp electrodes? - requires ruptured membranes - cervix must be dilated sufficiently to allow placement - improper insertion can cause maternal trauma such as vaginal lacerations - presenting part must be accessible and identifiable - may record maternal heart rate in presence of fetal demise - may not have adequate ECG conduction when excessive fetal hair is present - possible increased risk for infection - Answers What are the limitations of fetal scalp electrodes? patients with herpes, placenta previa, or group B strep (unless 2 antibiotics are given) - Answers Who cannot get a fetal calp electrode placed? nurse or doctor - Answers Who can place a fetal scalp electrode? intrauterine pressure catheter - Answers a catheter that can be placed through the cervix into the uterus to measure uterine pressure during labor - only true accurate measure of all UA