NSPN 7100 Module 5B Exam Questions and Answers Already Passed
Labour Dystocia - Answers Lack of labour progress due to variance in the 5 Ps; common cause
of primary C-section. Some variances are anticipated (e.g., macrosomic fetus), others emerge
during labour (ineffective contractions).
Dysfunctional Labour - Answers Abnormal uterine contractions leading to slow cervical dilation,
fetal descent, or expulsion.
Intervention for Slowed Labour - Answers Assess the 5 Ps (Passenger, Passage, Powers,
Position, Psyche) and promote changes that encourage normal progress.
Risk Factors for Labour Dystocia - Answers Obesity, diabetes, multiparity, small or abnormal
pelvis, cephalopelvic disproportion, multifetal pregnancy, malpresentation or malposition, stress,
anxiety, restricted movement.
Passenger Variations - Answers Include fetal size, presentation, position, multifetal pregnancy,
and fetal anomalies; these affect labour progress.
Macrosomia - Answers Fetus > 90th percentile; large-for-gestational-age. Often indicated by
large SFH, no lightening, excessive maternal weight gain, or large partner.
Cephalopelvic Disproportion (CPD) - Answers Fetal head too large or malpositioned to pass
through the maternal pelvis; indicated by abnormal contraction patterns, fetal distress, or
excessive molding without descent.
Molding - Answers Normal overlapping of fetal skull bones to allow passage; excessive molding
with no descent may indicate CPD.
Caput Succedaneum - Answers Generalized edema of the scalp (usually occipital), crosses
suture lines, resolves in 3-4 days; worsening without descent may suggest CPD.
Cephalohematoma - Answers Collection of blood between skull and periosteum; does not cross
sutures, resolves in up to 8 weeks; risk of neonatal hyperbilirubinemia.
Shoulder Dystocia - Answers Obstetric emergency where head delivers but anterior shoulder is
stuck under pubic arch; may cause asphyxia or fractures.
McRoberts Maneuver - Answers Flex mother's legs onto abdomen to straighten sacrum and
widen pelvic angle; used to relieve shoulder dystocia.
Shoulder Dystocia Fetal Complications - Answers Asphyxia, clavicle or humerus fracture,
brachial plexus injury.
Shoulder Dystocia Maternal Complications - Answers Trauma, rectal injury, postpartum
hemorrhage.
, Malpresentation - Answers Fetal part other than head presents first (usually breech); may be
frank, complete, or footling.
Frank Breech - Answers Hips flexed, knees extended; buttocks present first.
Complete Breech - Answers Hips and knees both flexed.
Footling Breech - Answers One or both feet present before the buttocks.
External Cephalic Version (ECV) - Answers Manual abdominal maneuver done by an obstetrician
to turn fetus from breech to cephalic position.
Breech Presentation Cues - Answers Leopold's shows head at fundus, soft presenting part in
pelvis, meconium after ROM, or feet felt on vaginal exam.
Face or Brow Presentation - Answers Rare malpresentations; may result from increased parity,
prematurity, PROM, or CPD.
Safe Vaginal Birth Criteria for Breech - Answers Frank or complete breech, fetal weight 2000-
3800 g, flexed head, normal maternal pelvis, experienced provider.
Malposition - Answers Persistent occiput posterior (OP) position; rotation fails from OT → OA.
OP Assessment - Answers Difficult to locate fetal back, knees/feet felt anteriorly, "sunken belly,"
confirmed by vaginal exam.
OP Implications - Answers Longer, more painful labour with back pain; often requires epidural or
augmentation.
Maternal Positions to Correct OP - Answers Upright forward-leaning, lunging, rocking, birthing
ball, hands-and-knees; encourages rotation to OA.
Pain Relief for Posterior Labour - Answers Massage, counter-pressure, knee press, double hip
squeeze, sterile water injections.
Manual Rotation - Answers Provider may attempt to turn the fetal head anteriorly when cervix is
fully dilated, under continuous FHR monitoring.
Deflexed Head - Answers Fetal head partially extended, presenting wider diameter; leads to
slower labour.
Asynclitism - Answers Fetal head tilted sideways; sagittal suture not midline on exam.
Passage Components - Answers Bony pelvis, cervix, pelvic floor, vagina, and introitus;
genetically determined size and shape.
Pelvic Deformities - Answers Result from malnutrition, congenital issues, trauma, or spinal
disorders; cannot be corrected during labour.
Labour Dystocia - Answers Lack of labour progress due to variance in the 5 Ps; common cause
of primary C-section. Some variances are anticipated (e.g., macrosomic fetus), others emerge
during labour (ineffective contractions).
Dysfunctional Labour - Answers Abnormal uterine contractions leading to slow cervical dilation,
fetal descent, or expulsion.
Intervention for Slowed Labour - Answers Assess the 5 Ps (Passenger, Passage, Powers,
Position, Psyche) and promote changes that encourage normal progress.
Risk Factors for Labour Dystocia - Answers Obesity, diabetes, multiparity, small or abnormal
pelvis, cephalopelvic disproportion, multifetal pregnancy, malpresentation or malposition, stress,
anxiety, restricted movement.
Passenger Variations - Answers Include fetal size, presentation, position, multifetal pregnancy,
and fetal anomalies; these affect labour progress.
Macrosomia - Answers Fetus > 90th percentile; large-for-gestational-age. Often indicated by
large SFH, no lightening, excessive maternal weight gain, or large partner.
Cephalopelvic Disproportion (CPD) - Answers Fetal head too large or malpositioned to pass
through the maternal pelvis; indicated by abnormal contraction patterns, fetal distress, or
excessive molding without descent.
Molding - Answers Normal overlapping of fetal skull bones to allow passage; excessive molding
with no descent may indicate CPD.
Caput Succedaneum - Answers Generalized edema of the scalp (usually occipital), crosses
suture lines, resolves in 3-4 days; worsening without descent may suggest CPD.
Cephalohematoma - Answers Collection of blood between skull and periosteum; does not cross
sutures, resolves in up to 8 weeks; risk of neonatal hyperbilirubinemia.
Shoulder Dystocia - Answers Obstetric emergency where head delivers but anterior shoulder is
stuck under pubic arch; may cause asphyxia or fractures.
McRoberts Maneuver - Answers Flex mother's legs onto abdomen to straighten sacrum and
widen pelvic angle; used to relieve shoulder dystocia.
Shoulder Dystocia Fetal Complications - Answers Asphyxia, clavicle or humerus fracture,
brachial plexus injury.
Shoulder Dystocia Maternal Complications - Answers Trauma, rectal injury, postpartum
hemorrhage.
, Malpresentation - Answers Fetal part other than head presents first (usually breech); may be
frank, complete, or footling.
Frank Breech - Answers Hips flexed, knees extended; buttocks present first.
Complete Breech - Answers Hips and knees both flexed.
Footling Breech - Answers One or both feet present before the buttocks.
External Cephalic Version (ECV) - Answers Manual abdominal maneuver done by an obstetrician
to turn fetus from breech to cephalic position.
Breech Presentation Cues - Answers Leopold's shows head at fundus, soft presenting part in
pelvis, meconium after ROM, or feet felt on vaginal exam.
Face or Brow Presentation - Answers Rare malpresentations; may result from increased parity,
prematurity, PROM, or CPD.
Safe Vaginal Birth Criteria for Breech - Answers Frank or complete breech, fetal weight 2000-
3800 g, flexed head, normal maternal pelvis, experienced provider.
Malposition - Answers Persistent occiput posterior (OP) position; rotation fails from OT → OA.
OP Assessment - Answers Difficult to locate fetal back, knees/feet felt anteriorly, "sunken belly,"
confirmed by vaginal exam.
OP Implications - Answers Longer, more painful labour with back pain; often requires epidural or
augmentation.
Maternal Positions to Correct OP - Answers Upright forward-leaning, lunging, rocking, birthing
ball, hands-and-knees; encourages rotation to OA.
Pain Relief for Posterior Labour - Answers Massage, counter-pressure, knee press, double hip
squeeze, sterile water injections.
Manual Rotation - Answers Provider may attempt to turn the fetal head anteriorly when cervix is
fully dilated, under continuous FHR monitoring.
Deflexed Head - Answers Fetal head partially extended, presenting wider diameter; leads to
slower labour.
Asynclitism - Answers Fetal head tilted sideways; sagittal suture not midline on exam.
Passage Components - Answers Bony pelvis, cervix, pelvic floor, vagina, and introitus;
genetically determined size and shape.
Pelvic Deformities - Answers Result from malnutrition, congenital issues, trauma, or spinal
disorders; cannot be corrected during labour.
