NM 704 EXAM 4 2026 QUESTIONS WITH
VERIFIED ANSWERS
◉ Epidural Complications. Answer: Cesearan birth for fetal distress,
augmentation of labor with oxytocin, prolonged second stage,
urinary retention, hypotension, fever, and continued motor blockage
after birth
◉ Epidural effects on labor. Answer: Prolonged second stage,
increased oxytocin augmentation and operative vaginal births
◉ Demerol (meperidine). Answer: Long half-life and active
metabolites = high risk of neonatal respiratory depression, fetal
exposure highest 1-4 hours after administration, decreases FHR
variability
◉ Morphine. Answer: Most often used to treat prolonged latent
labor, decreases uterine activity prior to active labor; has active
metabolites that can cause maternal/newborn depression,
contraindicated in later stage of labor
◉ Nubain (nalbuphine). Answer: Contraindicated for use by women
who have a history of drug abuse/addiction because antagonist
effect can cause withdrawal symptoms
, ◉ Fentanyl (Sublimaze). Answer: Fewer side effects than morphine,
good if woman is in active labor, short half life, not associated with
neonatal respiratory depression; causes transient decreased FHR
variability or psuedo-sinusoidal pattern
◉ Ultiva (remifentanil). Answer: Shortest-active opioid, no active
metabolites, fewer side effects and neonatal effects, can cause
significant maternal respirtory depression, use is controversial, dose
at beginning of uterine ctx to maximize peak effect; used only in PCA
infusions
◉ Traditional 2nd Stage. Answer: Begins with complete dilation of
the cervix and ends with the birth of the baby
Stage of expulsion
Push only when complete
Requires vaginal exam for diagnosis, provider focuses
◉ Alternative 2nd stage. Answer: Begins with onset of involuntary,
expulsive efforts (urge to push) and ends with birth of baby
Cervical dilation is not relevant, woman follows her body's cues and
pushes when she must, with an urge
◉ Ferguson's reflex. Answer: Stimulation of the nerve plexus that
generates an urge to push via a surge of oxytocin, occurs as
VERIFIED ANSWERS
◉ Epidural Complications. Answer: Cesearan birth for fetal distress,
augmentation of labor with oxytocin, prolonged second stage,
urinary retention, hypotension, fever, and continued motor blockage
after birth
◉ Epidural effects on labor. Answer: Prolonged second stage,
increased oxytocin augmentation and operative vaginal births
◉ Demerol (meperidine). Answer: Long half-life and active
metabolites = high risk of neonatal respiratory depression, fetal
exposure highest 1-4 hours after administration, decreases FHR
variability
◉ Morphine. Answer: Most often used to treat prolonged latent
labor, decreases uterine activity prior to active labor; has active
metabolites that can cause maternal/newborn depression,
contraindicated in later stage of labor
◉ Nubain (nalbuphine). Answer: Contraindicated for use by women
who have a history of drug abuse/addiction because antagonist
effect can cause withdrawal symptoms
, ◉ Fentanyl (Sublimaze). Answer: Fewer side effects than morphine,
good if woman is in active labor, short half life, not associated with
neonatal respiratory depression; causes transient decreased FHR
variability or psuedo-sinusoidal pattern
◉ Ultiva (remifentanil). Answer: Shortest-active opioid, no active
metabolites, fewer side effects and neonatal effects, can cause
significant maternal respirtory depression, use is controversial, dose
at beginning of uterine ctx to maximize peak effect; used only in PCA
infusions
◉ Traditional 2nd Stage. Answer: Begins with complete dilation of
the cervix and ends with the birth of the baby
Stage of expulsion
Push only when complete
Requires vaginal exam for diagnosis, provider focuses
◉ Alternative 2nd stage. Answer: Begins with onset of involuntary,
expulsive efforts (urge to push) and ends with birth of baby
Cervical dilation is not relevant, woman follows her body's cues and
pushes when she must, with an urge
◉ Ferguson's reflex. Answer: Stimulation of the nerve plexus that
generates an urge to push via a surge of oxytocin, occurs as
