NSG 432 OB Exam 1 Study Guide with Complete
Solution | Latest 2026–2027 Update Graded A+
Mechanisms of Labor:
• The baby's adaptation through the birth canal to prepare for labor and delivery
• Lightening or dropping occurs when the fetus descends into the pelvis about 2 weeks
before birth
• Vaginal discharge increases
• Brownish or blood-tinged cervical mucus is passed
• Mother has a sudden burst of energy ("nesting") often 24-48 hours before onset of labor
• Weight loss of 1-3 lbs as a result from the fluid shifts about 24-48 hours before onset of
labor
• Consists of the Seven Cardinal Movements
• Engagement: When the biparietal diameter of the head passes the pelvic inlet
• Descent: Refers to the progress of the presenting part through the pelvis; degree of
descent is measured by the station of the presenting part
• Flexion: Head flexes so that the chin is brought into closer contact with the fetal chest as
soon as the head meets resistance from the cervix, pelvic wall, or pelvic floor
• Internal Rotation: With each contraction, the fetal head is guided by the bony pelvis and
the muscles of the pelvic floor
• Extension: Occiput passes under the lower border of the symphysis pubis first and then the
head emerges by extension
• Restitution (External Rotation): Head rotates briefly to the position it occupied when it was
engaged in the inlet. The 45-dedgree turn realigns the infant's head with the back and
shoulders
• Expulsion: Baby comes out
Process of Labor:
5 P's of Labor:
• Powers: Uterine Contractions
• Forces acting to expel the fetus
• Effacement & dilation occur with these powers
• Passageway: The mother's rigid bony pelvis and the soft tissues of the cervix, pelvic floor,
vagina, and introitus
• Passenger: The fetus, membranes, and placenta
• Psyche: A woman's emotional structure that can determine her entire response to labor and
influence physiological and psychological functioning; mother may experience anxiety or fear
• Position (of mother)
Leopold's Maneuvers:
• Methods of palpation to determine presentation and position of the fetus and aid in location of
fetal heart sounds
, • If head is in the fundus, a hard, round, movable object is felt. Buttocks feel soft and have an
irregular shape and more difficult to move.
• The fetus's back is a smooth, hard surface and should be felt on one side of the abdomen
• Irregular knobs and lumps are the hands, feet, elbows, and knees on the opposite side of the
abdomen
Stages of Labor: Latent: - - Placenta normally
Perform assessments separates with third
Stage 1 Stage 2
- Encourage Q5 or fourth uterine
Effacement and Pushing stage minutes contraction after
dilation of cervix mother/partner infant is born
to participate
Assess for dilation in - Provide
by doing a vaginal mother with care Uterus is contracting a
exam using two
encourageme lot in this stage b/c
fingers
nt and praise you want the
Phase 1: - Begins at 10cm to the and provide rest placenta to get out
Early/latent: 0- birth of the baby - Comfort between
5cm contractions
- Takes about 6-8 - Mother measures,
has intense hours to get changes of -
concentration on through Maintain privacy
pushing with contractions position,
- Mom should be walking ambulation -
around, Early/latent phase: ice Optimal
chips, and fetus continues to positions:
frequent voiding descend passively Positions that - Assess maternal VS
is to be expected though the birth promote
canal and rotate to an Stage 3 - Assess uterine status
-She is talkative anterior position as
Separation/expulsion
a and excited in this result of ongoing - Patient education
of placenta
phase uterine contractions about expulsion of
placenta
Phase 2: Active pushing phase:
Active: 6-10cm Woman has strong - Examine placenta to
- Mom is serious urges to bear down ensure that it is
as and becomes less the presenting part - Starts at birth of intact
of talkative, restless the fetus descends baby and ends when Stage 4
and as labor and presses on the the placenta is Recovery stage
stretch contractions receptors of the delivered
pelvic
intensify floor
, - BP returns to prelabor level Key interventions in - Assess vital
this stage: Massage signs Q15 mins for the
- Period 1-4 hours after birth the fundus so that the first hour, 30 minutes
uterus remains for 1 hour, and hourly
contracted and assess for 2 hours post-
for bladder distension partum
Solution | Latest 2026–2027 Update Graded A+
Mechanisms of Labor:
• The baby's adaptation through the birth canal to prepare for labor and delivery
• Lightening or dropping occurs when the fetus descends into the pelvis about 2 weeks
before birth
• Vaginal discharge increases
• Brownish or blood-tinged cervical mucus is passed
• Mother has a sudden burst of energy ("nesting") often 24-48 hours before onset of labor
• Weight loss of 1-3 lbs as a result from the fluid shifts about 24-48 hours before onset of
labor
• Consists of the Seven Cardinal Movements
• Engagement: When the biparietal diameter of the head passes the pelvic inlet
• Descent: Refers to the progress of the presenting part through the pelvis; degree of
descent is measured by the station of the presenting part
• Flexion: Head flexes so that the chin is brought into closer contact with the fetal chest as
soon as the head meets resistance from the cervix, pelvic wall, or pelvic floor
• Internal Rotation: With each contraction, the fetal head is guided by the bony pelvis and
the muscles of the pelvic floor
• Extension: Occiput passes under the lower border of the symphysis pubis first and then the
head emerges by extension
• Restitution (External Rotation): Head rotates briefly to the position it occupied when it was
engaged in the inlet. The 45-dedgree turn realigns the infant's head with the back and
shoulders
• Expulsion: Baby comes out
Process of Labor:
5 P's of Labor:
• Powers: Uterine Contractions
• Forces acting to expel the fetus
• Effacement & dilation occur with these powers
• Passageway: The mother's rigid bony pelvis and the soft tissues of the cervix, pelvic floor,
vagina, and introitus
• Passenger: The fetus, membranes, and placenta
• Psyche: A woman's emotional structure that can determine her entire response to labor and
influence physiological and psychological functioning; mother may experience anxiety or fear
• Position (of mother)
Leopold's Maneuvers:
• Methods of palpation to determine presentation and position of the fetus and aid in location of
fetal heart sounds
, • If head is in the fundus, a hard, round, movable object is felt. Buttocks feel soft and have an
irregular shape and more difficult to move.
• The fetus's back is a smooth, hard surface and should be felt on one side of the abdomen
• Irregular knobs and lumps are the hands, feet, elbows, and knees on the opposite side of the
abdomen
Stages of Labor: Latent: - - Placenta normally
Perform assessments separates with third
Stage 1 Stage 2
- Encourage Q5 or fourth uterine
Effacement and Pushing stage minutes contraction after
dilation of cervix mother/partner infant is born
to participate
Assess for dilation in - Provide
by doing a vaginal mother with care Uterus is contracting a
exam using two
encourageme lot in this stage b/c
fingers
nt and praise you want the
Phase 1: - Begins at 10cm to the and provide rest placenta to get out
Early/latent: 0- birth of the baby - Comfort between
5cm contractions
- Takes about 6-8 - Mother measures,
has intense hours to get changes of -
concentration on through Maintain privacy
pushing with contractions position,
- Mom should be walking ambulation -
around, Early/latent phase: ice Optimal
chips, and fetus continues to positions:
frequent voiding descend passively Positions that - Assess maternal VS
is to be expected though the birth promote
canal and rotate to an Stage 3 - Assess uterine status
-She is talkative anterior position as
Separation/expulsion
a and excited in this result of ongoing - Patient education
of placenta
phase uterine contractions about expulsion of
placenta
Phase 2: Active pushing phase:
Active: 6-10cm Woman has strong - Examine placenta to
- Mom is serious urges to bear down ensure that it is
as and becomes less the presenting part - Starts at birth of intact
of talkative, restless the fetus descends baby and ends when Stage 4
and as labor and presses on the the placenta is Recovery stage
stretch contractions receptors of the delivered
pelvic
intensify floor
, - BP returns to prelabor level Key interventions in - Assess vital
this stage: Massage signs Q15 mins for the
- Period 1-4 hours after birth the fundus so that the first hour, 30 minutes
uterus remains for 1 hour, and hourly
contracted and assess for 2 hours post-
for bladder distension partum
