NSPN 7100 Module 5A Exam Questions with Verified Solutions Graded A+
Onset of Labour - Answers Regular uterine contractions that increase in intensity, frequency,
and duration, leading to cervical effacement and dilation; often with bloody show or rupture of
membranes.
How Labour Begins - Answers Not fully understood; results from maternal uterine and cervical
changes, fetal/maternal hormones, and increased uterine irritability.
Maternal Preparation for Labour - Answers ↑ estrogen activates contractions; oxytocin +
prostaglandins ripen cervix; ↑ inflammation and oxytocin receptors; ↑ endorphins and
prolactin/oxytocin receptors promoting bonding.
Fetal Preparation for Labour - Answers Lung maturation, oxytocin neuroprotection, ↑
catecholamine receptors protecting against hypoxia, catecholamine surge aiding breathing and
heat regulation.
Normal Physiologic Labour - Answers Spontaneous, undisturbed labour supporting optimal
hormone release; enhances labour efficiency, calm, and bonding; fewer interventions and fetal
distress.
Medicalized Labour - Answers Interventions disturb natural hormone physiology, potentially
increasing complications and reducing benefits of normal labour.
Oxytocin (Natural) - Answers Posterior pituitary hormone that ripens cervix, triggers rhythmic
contractions, reduces fear/stress, promotes calm and bonding, and prevents PPH via uterine
involution.
Synthetic Oxytocin - Answers Used to induce/augment labour; linked to preventable adverse
outcomes and interference with hormonal balance.
Estrogen in Labour - Answers Stimulates uterine/breast growth, ↑ uterine blood flow, relaxes
smooth muscle, activates and regulates other pregnancy hormones.
Cortisol in Labour - Answers Rises late pregnancy and during labour; promotes contractions,
enhances oxytocin effects, aids maternal adaptation and fetal lung maturation.
Catecholamines (E, NE, Dopamine) - Answers Released from fear/stress; high levels inhibit
labour; late-labour surge aids neonatal BP, thermogenesis and transition.
Beta-Endorphins - Answers Natural opiates from posterior pituitary; relieve pain, suppress
immune response, and support prolactin release for breastfeeding.
True Labour vs False Labour - Answers True labour → regular, stronger contractions continuing
with activity + cervical change; false labour → irregular contractions that ease with movement
and no cervical change.
, 5 Ps of Labour - Answers Passenger (fetus + placenta), Powers (uterine contractions), Passage
(pelvis and soft tissues), Psyche (maternal coping and emotions), Position (maternal posture).
Passenger Definition - Answers Fetal size, presentation, lie, attitude and position affect how it
moves through pelvis.
Powers Definition - Answers Uterine contractions and maternal bearing-down efforts that push
the fetus through birth canal.
Passage Definition - Answers Maternal bony pelvis and soft tissues (cervix, pelvic floor, vagina)
forming the birth pathway.
Psyche Definition - Answers Maternal emotional state, beliefs, coping ability, fear and support
influencing labour progress.
Position Definition - Answers Maternal position that can facilitate descent and rotation through
gravity and pelvic diameter changes.
Cardinal Movements of Labour - Answers Engagement, Flexion, Descent, Internal Rotation,
Extension, Restitution + External Rotation, Expulsion.
Supportive Care Practices - Answers Upright positions and freedom of movement assist
descent and rotation with gravity.
First Stage of Labour - Answers Begins with regular contractions and cervical change; ends at
full dilation (10 cm).
Latent Phase (1st Stage) - Answers Regular painful contractions begin; effacement and early
dilation occur.
Active Phase (1st Stage) - Answers Stronger, more frequent contractions; cervix 6-10 cm;
occiput descends and rotates.
Contraction Pattern in 1st Stage - Answers Latent = every 2-30 min; Active = every 2-3 min;
duration 60-90 s.
Average Length of 1st Stage - Answers Nullipara ≈ 6-8 h latent + 3-6 h active; PSBC goal ≈ 0.5
cm/hr progress.
Nursing Role - 1st Stage - Answers 1:1 care; maternal VS hourly; fetal monitor q15-30 min;
assess contractions + coping continuously; Leopold's maneuvers.
Leopold's Maneuvers - Answers Abdominal palpations to determine fetal presentation, lie and
position; done on admission and as needed.
Second Stage of Labour - Answers Begins with full dilation; ends with birth of baby; includes
latent, passive and active pushing phases.
Onset of Labour - Answers Regular uterine contractions that increase in intensity, frequency,
and duration, leading to cervical effacement and dilation; often with bloody show or rupture of
membranes.
How Labour Begins - Answers Not fully understood; results from maternal uterine and cervical
changes, fetal/maternal hormones, and increased uterine irritability.
Maternal Preparation for Labour - Answers ↑ estrogen activates contractions; oxytocin +
prostaglandins ripen cervix; ↑ inflammation and oxytocin receptors; ↑ endorphins and
prolactin/oxytocin receptors promoting bonding.
Fetal Preparation for Labour - Answers Lung maturation, oxytocin neuroprotection, ↑
catecholamine receptors protecting against hypoxia, catecholamine surge aiding breathing and
heat regulation.
Normal Physiologic Labour - Answers Spontaneous, undisturbed labour supporting optimal
hormone release; enhances labour efficiency, calm, and bonding; fewer interventions and fetal
distress.
Medicalized Labour - Answers Interventions disturb natural hormone physiology, potentially
increasing complications and reducing benefits of normal labour.
Oxytocin (Natural) - Answers Posterior pituitary hormone that ripens cervix, triggers rhythmic
contractions, reduces fear/stress, promotes calm and bonding, and prevents PPH via uterine
involution.
Synthetic Oxytocin - Answers Used to induce/augment labour; linked to preventable adverse
outcomes and interference with hormonal balance.
Estrogen in Labour - Answers Stimulates uterine/breast growth, ↑ uterine blood flow, relaxes
smooth muscle, activates and regulates other pregnancy hormones.
Cortisol in Labour - Answers Rises late pregnancy and during labour; promotes contractions,
enhances oxytocin effects, aids maternal adaptation and fetal lung maturation.
Catecholamines (E, NE, Dopamine) - Answers Released from fear/stress; high levels inhibit
labour; late-labour surge aids neonatal BP, thermogenesis and transition.
Beta-Endorphins - Answers Natural opiates from posterior pituitary; relieve pain, suppress
immune response, and support prolactin release for breastfeeding.
True Labour vs False Labour - Answers True labour → regular, stronger contractions continuing
with activity + cervical change; false labour → irregular contractions that ease with movement
and no cervical change.
, 5 Ps of Labour - Answers Passenger (fetus + placenta), Powers (uterine contractions), Passage
(pelvis and soft tissues), Psyche (maternal coping and emotions), Position (maternal posture).
Passenger Definition - Answers Fetal size, presentation, lie, attitude and position affect how it
moves through pelvis.
Powers Definition - Answers Uterine contractions and maternal bearing-down efforts that push
the fetus through birth canal.
Passage Definition - Answers Maternal bony pelvis and soft tissues (cervix, pelvic floor, vagina)
forming the birth pathway.
Psyche Definition - Answers Maternal emotional state, beliefs, coping ability, fear and support
influencing labour progress.
Position Definition - Answers Maternal position that can facilitate descent and rotation through
gravity and pelvic diameter changes.
Cardinal Movements of Labour - Answers Engagement, Flexion, Descent, Internal Rotation,
Extension, Restitution + External Rotation, Expulsion.
Supportive Care Practices - Answers Upright positions and freedom of movement assist
descent and rotation with gravity.
First Stage of Labour - Answers Begins with regular contractions and cervical change; ends at
full dilation (10 cm).
Latent Phase (1st Stage) - Answers Regular painful contractions begin; effacement and early
dilation occur.
Active Phase (1st Stage) - Answers Stronger, more frequent contractions; cervix 6-10 cm;
occiput descends and rotates.
Contraction Pattern in 1st Stage - Answers Latent = every 2-30 min; Active = every 2-3 min;
duration 60-90 s.
Average Length of 1st Stage - Answers Nullipara ≈ 6-8 h latent + 3-6 h active; PSBC goal ≈ 0.5
cm/hr progress.
Nursing Role - 1st Stage - Answers 1:1 care; maternal VS hourly; fetal monitor q15-30 min;
assess contractions + coping continuously; Leopold's maneuvers.
Leopold's Maneuvers - Answers Abdominal palpations to determine fetal presentation, lie and
position; done on admission and as needed.
Second Stage of Labour - Answers Begins with full dilation; ends with birth of baby; includes
latent, passive and active pushing phases.
