Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
A.
1. With regard to primary and
secondary powers, the ma- Rationale: The primary powers are responsible for dilation and ef-
ternity nurse should under- facement; secondary powers are concerned with expulsion of the
stand that: fetus. Ettacement is generally well ahead of dilation in first-timers;
the two are more concurrent in subsequent pregnancies. Scarring
A. Primary powers are re-
of the cervix may slow dilation. Pushing is more ettective and less
sponsible for effacement
fatiguing when the woman begins to push only after she has the
and dilation of the cervix.
urge to do so.
B. Effacement generally is
well ahead of dilation in
women giving birth for the
first time; they are more to-
gether in subsequent preg-
nancies.
C. Scarring of the cervix
caused by a previous infec-
tion or surgery may make
the delivery a bit more
painful, but it should not
slow or inhibit dilation.
D. Pushing in the second
stage of labor is more ef-
fective if the woman can
breathe deeply and con-
trol some of her involuntary
needs to push, as the nurse
directs.
2. D.
, Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
Which sign does not precede Rationale: A surge of energy is a phenomenon that is common in
the onset of labor? the days preceding labor. After lightening, a return of the frequent
need to urinate occurs as the fetal position causes increased
A. A return of urinary fre- pressure on the bladder. In the run-up to labor, women often
quency as a result of in- experience persistent low backache and sacroiliac distress as a
creased bladder pressure result of relaxation of the pelvic joints. Prior to the onset of labor,
it is common for Braxton Hicks contractions to increase in both
B. Persistent low backache frequency and strength; bloody show may be passed.
from relaxed pelvic joints
C. Stronger and more
frequent uterine (Braxton
Hicks) contractions
D. A decline in energy, as the
body stores up for labor
3. In order to accurately as- D.
sess the health of the moth-
er accurately during labor, Rationale: In addition, physiologic anesthesia of the perineal tis-
the nurse should be aware sues, caused by the pressure of the presenting part, decreases
that: the mother's perception of pain. Blood pressure increases during
contractions but remains somewhat elevated between them. Use
A. The woman's blood pres- of the Valsalva maneuver is discouraged during second-stage
sure increases during con- labor because of a number of unhealthy outcomes, including
tractions and falls back to fetal hypoxia. Pointing the toes can cause leg cramps, as can the
prelabor normal between process of labor itself.
contractions.
B. Use of the Valsalva ma-
neuver is encouraged dur-
ing the second stage of labor
to relieve fetal hypoxia.
, Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
C. Having the woman
point her toes reduces leg
cramps.
D. The endogenous endor-
phins released during la-
bor raise the woman's pain
threshold and produce seda-
tion.
4. The nurse knows that the B.
second stage of labor, the
descent phase, has begun Rationale: The second stage of labor begins with full cervical
when: dilation. During the active pushing phase of the second stage of
labor, the woman may experience an increase in the urge to bear
A. The amniotic membranes down. Rupture of membranes has no significance in determining
rupture. the stage of labor. Many women may have an urge to bear down
when the presenting part is below the level of the ischial spines.
B. The cervix cannot be felt This can occur during the first stage of labor, as early as at 5 cm
during a vaginal examina- dilation.
tion.
C. The woman experiences a
strong urge to bear down.
D. The presenting part is be-
low the ischial spines.
5. Which statement is inaccu- B.
rate with regard to normal
labor? Rationale: Although the amount of time varies with each woman,
a normal uncomplicated labor is usually completed within 18
, Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
A. A single fetus presents by hours. In normal labor, a single fetus presents by vertex. A regular
vertex. progression of contractions, ettacement, dilation, and descent is
the trajectory that the nurse expects for a woman experiencing a
B. It is completed within 8 normal labor, which usually occurs with no complications.
hours.
C. A regular progression of
contractions, effacement, di-
lation, and descent occurs.
D. No complications are in-
volved.
6. Nurses can help their clients B.
by keeping them informed
about the distinctive stages Rationale: The latent phase is characterized by mild to moderate,
of labor. What description of irregular contractions; dilation up to 3 cm; brownish to pale pink
the phases of the first stage mucus; and a duration of 6 to 8 hours. No oflcial lull phase exists
of labor is accurate? in the first stage. The transition phase is characterized by strong
to very strong, regular contractions; 8 to 10 cm dilation; and a
A. Latent: mild, regular con- duration of 20 to 40 minutes.
tractions; no dilation; bloody
show; duration of 2 to 4
hours
B. Active: moderate, regular
contractions; 4 to 7 cm dila-
tion; duration of 3 to 6 hours
C. Lull: no contractions; dila-
tion stable; duration of 20 to
60 minutes
Exam Study Guide Test.
A.
1. With regard to primary and
secondary powers, the ma- Rationale: The primary powers are responsible for dilation and ef-
ternity nurse should under- facement; secondary powers are concerned with expulsion of the
stand that: fetus. Ettacement is generally well ahead of dilation in first-timers;
the two are more concurrent in subsequent pregnancies. Scarring
A. Primary powers are re-
of the cervix may slow dilation. Pushing is more ettective and less
sponsible for effacement
fatiguing when the woman begins to push only after she has the
and dilation of the cervix.
urge to do so.
B. Effacement generally is
well ahead of dilation in
women giving birth for the
first time; they are more to-
gether in subsequent preg-
nancies.
C. Scarring of the cervix
caused by a previous infec-
tion or surgery may make
the delivery a bit more
painful, but it should not
slow or inhibit dilation.
D. Pushing in the second
stage of labor is more ef-
fective if the woman can
breathe deeply and con-
trol some of her involuntary
needs to push, as the nurse
directs.
2. D.
, Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
Which sign does not precede Rationale: A surge of energy is a phenomenon that is common in
the onset of labor? the days preceding labor. After lightening, a return of the frequent
need to urinate occurs as the fetal position causes increased
A. A return of urinary fre- pressure on the bladder. In the run-up to labor, women often
quency as a result of in- experience persistent low backache and sacroiliac distress as a
creased bladder pressure result of relaxation of the pelvic joints. Prior to the onset of labor,
it is common for Braxton Hicks contractions to increase in both
B. Persistent low backache frequency and strength; bloody show may be passed.
from relaxed pelvic joints
C. Stronger and more
frequent uterine (Braxton
Hicks) contractions
D. A decline in energy, as the
body stores up for labor
3. In order to accurately as- D.
sess the health of the moth-
er accurately during labor, Rationale: In addition, physiologic anesthesia of the perineal tis-
the nurse should be aware sues, caused by the pressure of the presenting part, decreases
that: the mother's perception of pain. Blood pressure increases during
contractions but remains somewhat elevated between them. Use
A. The woman's blood pres- of the Valsalva maneuver is discouraged during second-stage
sure increases during con- labor because of a number of unhealthy outcomes, including
tractions and falls back to fetal hypoxia. Pointing the toes can cause leg cramps, as can the
prelabor normal between process of labor itself.
contractions.
B. Use of the Valsalva ma-
neuver is encouraged dur-
ing the second stage of labor
to relieve fetal hypoxia.
, Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
C. Having the woman
point her toes reduces leg
cramps.
D. The endogenous endor-
phins released during la-
bor raise the woman's pain
threshold and produce seda-
tion.
4. The nurse knows that the B.
second stage of labor, the
descent phase, has begun Rationale: The second stage of labor begins with full cervical
when: dilation. During the active pushing phase of the second stage of
labor, the woman may experience an increase in the urge to bear
A. The amniotic membranes down. Rupture of membranes has no significance in determining
rupture. the stage of labor. Many women may have an urge to bear down
when the presenting part is below the level of the ischial spines.
B. The cervix cannot be felt This can occur during the first stage of labor, as early as at 5 cm
during a vaginal examina- dilation.
tion.
C. The woman experiences a
strong urge to bear down.
D. The presenting part is be-
low the ischial spines.
5. Which statement is inaccu- B.
rate with regard to normal
labor? Rationale: Although the amount of time varies with each woman,
a normal uncomplicated labor is usually completed within 18
, Lowdermilk Ch. 16, 17, 18, 19, 32 Labor, Birth, & Fetus 52 Final
Exam Study Guide Test.
A. A single fetus presents by hours. In normal labor, a single fetus presents by vertex. A regular
vertex. progression of contractions, ettacement, dilation, and descent is
the trajectory that the nurse expects for a woman experiencing a
B. It is completed within 8 normal labor, which usually occurs with no complications.
hours.
C. A regular progression of
contractions, effacement, di-
lation, and descent occurs.
D. No complications are in-
volved.
6. Nurses can help their clients B.
by keeping them informed
about the distinctive stages Rationale: The latent phase is characterized by mild to moderate,
of labor. What description of irregular contractions; dilation up to 3 cm; brownish to pale pink
the phases of the first stage mucus; and a duration of 6 to 8 hours. No oflcial lull phase exists
of labor is accurate? in the first stage. The transition phase is characterized by strong
to very strong, regular contractions; 8 to 10 cm dilation; and a
A. Latent: mild, regular con- duration of 20 to 40 minutes.
tractions; no dilation; bloody
show; duration of 2 to 4
hours
B. Active: moderate, regular
contractions; 4 to 7 cm dila-
tion; duration of 3 to 6 hours
C. Lull: no contractions; dila-
tion stable; duration of 20 to
60 minutes
