Relias Shoulder Dystocia Questions and
Answers | Update | 100% Correct.
1. Shoulder dystocia drills should promote which of the following behaviors for
team members?
Select 2 answers.
• Using medical terminology to avoid alarming the patient and family
• Remaining calm during the emergency
• Being deliberate in actions
• Requesting assistance from as few personnel as possible to not stretch staffing
Explanation:
In emergencies like shoulder dystocia, remaining calm ensures coordinated action and reduces
panic. Being deliberate helps prevent rushed or harmful maneuvers. Clear communication is
critical—even if non-medical language is used to reassure the patient—and appropriate
assistance should always be summoned.
2. During a vaginal birth, the baby's head emerges, then suddenly retracts back
against the mother's perineum. The nurse recognizes this as the "turtle sign,"
which indicates:
Select 2 answers.
• Birth is imminent
• The baby's anterior shoulder is caught on the mother's pubic bone
• The baby's posterior shoulder is caught on the mother's sacrum
• There is a possible shoulder dystocia
Explanation:
The "turtle sign" is a classic indication of shoulder dystocia. It occurs when the anterior shoulder
becomes impacted behind the pubic bone, preventing the rest of the body from delivering. This is
a true obstetric emergency.
,3. Which maternal complications can arise related to a shoulder dystocia
delivery?
Select all that apply.
• Fourth-degree laceration
• Postpartum hemorrhage
• Uterine rupture
• Uterine prolapse
Explanation:
Shoulder dystocia deliveries often involve forceful maneuvers that can cause serious perineal
trauma (like fourth-degree lacerations), significant blood loss (postpartum hemorrhage), and
even uterine rupture. Uterine prolapse is not typically a direct result of shoulder dystocia.
4. Why is careful, comprehensive, and precise documentation following a
shoulder dystocia delivery important?
Select all that apply.
• The medical records department may audit your chart.
• This documentation will be key in the defense against charges of malpractice in
a lawsuit following a neonatal injury.
• A well-written note following a shoulder dystocia delivery can demonstrate
expertise in handling a shoulder dystocia delivery.
• Accurate notes describing all aspects of a shoulder dystocia delivery can be
useful in learning more about handling future shoulder dystocia deliveries.
Explanation:
Shoulder dystocia cases are high-risk and often result in legal scrutiny. Proper documentation
serves both legal protection and educational purposes. It shows professional competence and
contributes to institutional learning.
5. A nurse is assisting a patient in getting up to the bathroom for the first time
after a birth complicated by shoulder dystocia. The patient cries out due to pain
from the front and back of the pelvis and states she cannot walk. What maternal
injury related to shoulder dystocia should the nurse be considering the most
likely reason that the patient is having difficulty ambulating?
• Sacral dislocation
• Uterine artery hematoma
, • Symphyseal ligament tear
• Femoral nerve damage
Explanation:
A symphyseal ligament tear can occur during shoulder dystocia due to excessive pressure or
manipulation. This injury causes pain in the pelvic girdle and makes walking difficult. Though
femoral nerve damage can cause leg weakness, it’s less commonly associated with this specific
presentation.
6. Which of the following is an appropriate initial response to a fetal shoulder
dystocia?
• Provide increasing downward traction on the fetal head
• Second attempt at shoulder delivery while having mother push
• Apply fundal pressure with an attempt at shoulder delivery
• Communicate to staff and patient of the presence of shoulder dystocia
Explanation:
Immediate clear communication is crucial. Alerting the team and preparing for coordinated
maneuvers ensures a safe and structured response. Excess traction or fundal pressure can worsen
the situation.
7. Which of the following are goals for debriefing?
Select 3 answers.
• Evaluate team performance
• Determine fault if injury occurs
• Discuss safety concerns
• Identify areas for improvement
Explanation:
Debriefing is a non-punitive learning opportunity. It aims to assess performance, improve
future responses, and reinforce patient safety—not to assign blame.
8. According to the American College of Obstetricians and Gynecologists
(ACOG), a planned cesarean birth may be offered to a mother with diabetes and
an estimated fetal weight of:
Answers | Update | 100% Correct.
1. Shoulder dystocia drills should promote which of the following behaviors for
team members?
Select 2 answers.
• Using medical terminology to avoid alarming the patient and family
• Remaining calm during the emergency
• Being deliberate in actions
• Requesting assistance from as few personnel as possible to not stretch staffing
Explanation:
In emergencies like shoulder dystocia, remaining calm ensures coordinated action and reduces
panic. Being deliberate helps prevent rushed or harmful maneuvers. Clear communication is
critical—even if non-medical language is used to reassure the patient—and appropriate
assistance should always be summoned.
2. During a vaginal birth, the baby's head emerges, then suddenly retracts back
against the mother's perineum. The nurse recognizes this as the "turtle sign,"
which indicates:
Select 2 answers.
• Birth is imminent
• The baby's anterior shoulder is caught on the mother's pubic bone
• The baby's posterior shoulder is caught on the mother's sacrum
• There is a possible shoulder dystocia
Explanation:
The "turtle sign" is a classic indication of shoulder dystocia. It occurs when the anterior shoulder
becomes impacted behind the pubic bone, preventing the rest of the body from delivering. This is
a true obstetric emergency.
,3. Which maternal complications can arise related to a shoulder dystocia
delivery?
Select all that apply.
• Fourth-degree laceration
• Postpartum hemorrhage
• Uterine rupture
• Uterine prolapse
Explanation:
Shoulder dystocia deliveries often involve forceful maneuvers that can cause serious perineal
trauma (like fourth-degree lacerations), significant blood loss (postpartum hemorrhage), and
even uterine rupture. Uterine prolapse is not typically a direct result of shoulder dystocia.
4. Why is careful, comprehensive, and precise documentation following a
shoulder dystocia delivery important?
Select all that apply.
• The medical records department may audit your chart.
• This documentation will be key in the defense against charges of malpractice in
a lawsuit following a neonatal injury.
• A well-written note following a shoulder dystocia delivery can demonstrate
expertise in handling a shoulder dystocia delivery.
• Accurate notes describing all aspects of a shoulder dystocia delivery can be
useful in learning more about handling future shoulder dystocia deliveries.
Explanation:
Shoulder dystocia cases are high-risk and often result in legal scrutiny. Proper documentation
serves both legal protection and educational purposes. It shows professional competence and
contributes to institutional learning.
5. A nurse is assisting a patient in getting up to the bathroom for the first time
after a birth complicated by shoulder dystocia. The patient cries out due to pain
from the front and back of the pelvis and states she cannot walk. What maternal
injury related to shoulder dystocia should the nurse be considering the most
likely reason that the patient is having difficulty ambulating?
• Sacral dislocation
• Uterine artery hematoma
, • Symphyseal ligament tear
• Femoral nerve damage
Explanation:
A symphyseal ligament tear can occur during shoulder dystocia due to excessive pressure or
manipulation. This injury causes pain in the pelvic girdle and makes walking difficult. Though
femoral nerve damage can cause leg weakness, it’s less commonly associated with this specific
presentation.
6. Which of the following is an appropriate initial response to a fetal shoulder
dystocia?
• Provide increasing downward traction on the fetal head
• Second attempt at shoulder delivery while having mother push
• Apply fundal pressure with an attempt at shoulder delivery
• Communicate to staff and patient of the presence of shoulder dystocia
Explanation:
Immediate clear communication is crucial. Alerting the team and preparing for coordinated
maneuvers ensures a safe and structured response. Excess traction or fundal pressure can worsen
the situation.
7. Which of the following are goals for debriefing?
Select 3 answers.
• Evaluate team performance
• Determine fault if injury occurs
• Discuss safety concerns
• Identify areas for improvement
Explanation:
Debriefing is a non-punitive learning opportunity. It aims to assess performance, improve
future responses, and reinforce patient safety—not to assign blame.
8. According to the American College of Obstetricians and Gynecologists
(ACOG), a planned cesarean birth may be offered to a mother with diabetes and
an estimated fetal weight of:
