NUR 221 Exam 2 UPDATED ACTUAL
Exam Questions and CORRECT Answers
Preterm PROM - CORRECT ANSWER - rupture of membranes before 37 weeks
associated with 10% of all preterm births in America. most likely develops from pathologic
weakening of the amniotic membranes caused by inflammation, stress from uterine contractions,
or other factors that cause increased intrauterine pressure. infection of the urogenital tract is a
major risk leading to preterm PROM can be either a gush of liquid or a small leak
Non Pharmacological pain relief Cutaneous Stimulation strategies - CORRECT
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 - CORRECT ANSWER - Aromatherapy
Breathing techniques
Music
Imagery
Use of focal points
Non Pharmacological pain relief
,Cognitive strategies - CORRECT ANSWER - Childbirth education
Hypnosis
Biofeedback
cardinal movements of the mechanism of labor - CORRECT ANSWER - Engagement and
descent
Flexion
Internal rotation to occipitoanterior
position
Extension
External rotation beginning (restitution)
External rotation
expulsion
Engagement - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER -
Flexion - CORRECT 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 - CORRECT 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
Extension - CORRECT ANSWER - when the fetal head reaches the perineum for birth it
is deflected anteriorly by the perineum. the occiput passes under the lower border of the
symphysis of pubis first and the head emerges by extension. first the occiput then the face and
finally the chin
restitution and external rotation - CORRECT ANSWER - After head is born it rotates
briefly to the position it occupied when it was engaged in the inlet. this movement is referred to
as restitution. The 45-degree turn realigns the infants head with his or her back and shoulders. the
head can then be seen to rotate further. this external rotation occurs as the shoulders engage and
descend in maneuvers similar to those of the head. anterior shoulder descends first when it
reaches the outlet, it rotates to the midline and is delivered from under the pubic arch. the
posterior shoulder is guided over the perineum until it is free.
Expulsion - CORRECT ANSWER - After birth of the shoulders, the head and shoulders
are lifted up toward the mothers pubic bone, and the trunk of the the baby is born by flexing it
laterally in the direction of the symphysis pubis. when the baby has emerged completely birth is
complete and the second stage of labor ends.
preeclampsia etiology - CORRECT ANSWER - It occurs in approximately 2% to 7% of
healthy nulliparous pregnant women. The incidence and severity of preeclampsia is substantially
higher in women with multifetal gestation, a history of preeclampsia, chronic hypertension,
preexisting diabetes, and preexisting thrombophilias. Women with limited sperm exposure with
the same partner before conception also have a greater risk for developing preeclampsia. Paternal
factors also contribute to the risk for preeclampsia. Men who have fathered a preeclamptic
pregnancy are nearly twice as likely to father another preeclamptic pregnancy with a different
woman, regardless of whether the new partner has a history of a preeclamptic pregnancy .
Exam Questions and CORRECT Answers
Preterm PROM - CORRECT ANSWER - rupture of membranes before 37 weeks
associated with 10% of all preterm births in America. most likely develops from pathologic
weakening of the amniotic membranes caused by inflammation, stress from uterine contractions,
or other factors that cause increased intrauterine pressure. infection of the urogenital tract is a
major risk leading to preterm PROM can be either a gush of liquid or a small leak
Non Pharmacological pain relief Cutaneous Stimulation strategies - CORRECT
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 - CORRECT ANSWER - Aromatherapy
Breathing techniques
Music
Imagery
Use of focal points
Non Pharmacological pain relief
,Cognitive strategies - CORRECT ANSWER - Childbirth education
Hypnosis
Biofeedback
cardinal movements of the mechanism of labor - CORRECT ANSWER - Engagement and
descent
Flexion
Internal rotation to occipitoanterior
position
Extension
External rotation beginning (restitution)
External rotation
expulsion
Engagement - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER -
Flexion - CORRECT 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 - CORRECT 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
Extension - CORRECT ANSWER - when the fetal head reaches the perineum for birth it
is deflected anteriorly by the perineum. the occiput passes under the lower border of the
symphysis of pubis first and the head emerges by extension. first the occiput then the face and
finally the chin
restitution and external rotation - CORRECT ANSWER - After head is born it rotates
briefly to the position it occupied when it was engaged in the inlet. this movement is referred to
as restitution. The 45-degree turn realigns the infants head with his or her back and shoulders. the
head can then be seen to rotate further. this external rotation occurs as the shoulders engage and
descend in maneuvers similar to those of the head. anterior shoulder descends first when it
reaches the outlet, it rotates to the midline and is delivered from under the pubic arch. the
posterior shoulder is guided over the perineum until it is free.
Expulsion - CORRECT ANSWER - After birth of the shoulders, the head and shoulders
are lifted up toward the mothers pubic bone, and the trunk of the the baby is born by flexing it
laterally in the direction of the symphysis pubis. when the baby has emerged completely birth is
complete and the second stage of labor ends.
preeclampsia etiology - CORRECT ANSWER - It occurs in approximately 2% to 7% of
healthy nulliparous pregnant women. The incidence and severity of preeclampsia is substantially
higher in women with multifetal gestation, a history of preeclampsia, chronic hypertension,
preexisting diabetes, and preexisting thrombophilias. Women with limited sperm exposure with
the same partner before conception also have a greater risk for developing preeclampsia. Paternal
factors also contribute to the risk for preeclampsia. Men who have fathered a preeclamptic
pregnancy are nearly twice as likely to father another preeclamptic pregnancy with a different
woman, regardless of whether the new partner has a history of a preeclamptic pregnancy .
