NURS 3730 EXAM 2 QUESTIONS AND ANSWERS | NURS 3730
STUDY GUIDE & PRACTICE TEST 2026/2027
factors affecting labor/delivery process- 5p's - ANS ✔✔passenger, passage, position, powers, psyche
5p's - *passenger* - ANS ✔✔Fetal Size- Big baby, not going to go through pelvis correctly, difficult. Small
baby- may not be in right position
Anomalies- conjoined twins
Head- large or missing skull
Presentation
Lie
Attitude
Position
fetal presentation - ANS ✔✔Vertex- occiput, back of head presenting. Chin to chest. IDEAL POSITION
Brow- head more extended, brows first
Face- head all the way back. Will feel nares, mouth, etc w/ vag exam
Breech- booty first
Shoulder- baby is side lying
fetal lie - ANS ✔✔mom's long axis (spine) in relation to baby's long axis (spine)
- want them to be aligned. Do not want a transverse lie
- transverse increases risk for uterine rupture and prolapsed cord!!
fetal head attitude - ANS ✔✔Head position: flexion is ideal
Suboccipitobregmatic- smallest diameter. Ideal position
occipitomental- largest diameter
fetal position - ANS ✔✔Presenting baby part in relationship to maternal pelvis
Occiput-anterior: baby's occiput is facing moms anterior pelvis
R occiput anterior: baby's occiput is facing moms anterior but is a little to the right
L occiput transverse- facing directly to side. Occiput to L
Breech- sacrum
Chin- mentum
IDEAL: ANTERIOR
fetal station - ANS ✔✔Ischial spine= 0
Anything above= negative
Below= positive
5p's - passageway - ANS ✔✔True pelvis: pelvic brim
False pelvis: up above, floating
,Cervix and soft tissues
Trauma to cervix? Condition of tissues
Episiotomy? Scar tissue?
Gynecoid- most popular/common in female pelvis
Anthropoid- a/p diameter is wider, more narrow. Most babies end up in occiput posterior position
Android- male pelvis. Very difficult to deliver, baby will get stuck in pelvic brim
Platypelloid- very narrow. Cant even get into pelvis, end up with c section
5p's - powers - ANS ✔✔-Uterine Contractions-force generated by the myometrium (from oxytocin).
Helps open cervix and push baby down into pelvis
-Measured by palpation, tocotransducer or IUPC
---Feel uterus, document
---Tocotransducer to tell frequency and duration
---IUPC- monitors intensity in mmHg
-Adequate? If cervical changes are occurring- adequate. If no changes, can only tell with IUPC
-Frequency, duration and intensity
---Start of one, to start of next- frequency
---Duration- how long they last, avg.... 2-5 minutes (in general)
-Primary and secondary
---Ferguson reflex- involuntary urge to push
---Primary- involuntary uterine contractions
---Secondary- mom is VOLUNTARILY pushing down
5p's- maternal position - ANS ✔✔Can use gravity, standing around, walking to help baby get into correct
position
Can change during 1st stage of labor, as well as in pushing phase. Difficult w/ epidural but possible
5p's - psyche - ANS ✔✔-Maternal history- anything can affect labor process. Anxiety, stressful response-
can slow labor process!! Body just kind of shuts down...Bad experiences, sexual abuse, etc.
-Maternal Catecholamine's
-Support- BUILD RAPPORT
-Doulas common for this reason
signs preceding labor - ANS ✔✔-Lightening: engagement, baby descends into maternal pelvis. Drop in
fundal height. Mostly only in first time moms before labor begins
-Backache: kind of like period pains
-Contractions: more Braxton hicks, etc.
-Energy: nesting. Feels like she needs to clean house, wash clothes for baby, pack bags
-Increased vaginal discharge: increased leukorrhea, more watery and increased amount. Might be
mistaken for amniotic fluid!!!
onset of labor - ANS ✔✔Caused by multiple factors including hormonal, mechanical, aging placenta.
Placenta ages, as term comes near, placenta function declines
Increased estrogen and prostaglandins decreased progesterone....Prostaglandins help ripen cervix
*Not completely understood*
false labor - ANS ✔✔discomfort, but mom can still move around and function without a problem
, frequency and intensity- contractions stay spaced out, constant
contractions may slow down with ambulation
baby may be facing posterior
cervix will be firm, not many changes occurring.
true labor - ANS ✔✔mom will be very uncomfortable, and increases more over time
frequency and intensity w/ contractions gradually increase
ambulation does not stop contractions, they continue
baby may be facing anterior
cervix changes- dilation, effacement, soft
first stage of labor - ANS ✔✔3 phases- start contracting, dilating. Stops when 10cm dilated
Latent
Active
Transition
second stage of labor consists of.. - ANS ✔✔pushing and birth of infant- 2 phases
latent
active
third stage of labor - ANS ✔✔birth of the placenta
fourth stage of labor - ANS ✔✔first 1-2hrs after birth
fetal adaptations to labor - ANS ✔✔-Fetal Heart Rate (FHR)- accelerations and early decels are normal
response to fetal movement, vaginal examinations, fundal pressure, contractions, palpation and head
compression.
-Fetal Circulation
---Decreased with contractions
---Most fetuses are able to compensate
---Cord compression- early decelerations
-But if underlying problem w/ fetus or mom, may not be able to compensate as well as normal baby
-Fetal Respiration- fluid cleared from lungs during expulsion
maternal adaptations to labor - ANS ✔✔-Cardiac output increases/HR increases- pain
STUDY GUIDE & PRACTICE TEST 2026/2027
factors affecting labor/delivery process- 5p's - ANS ✔✔passenger, passage, position, powers, psyche
5p's - *passenger* - ANS ✔✔Fetal Size- Big baby, not going to go through pelvis correctly, difficult. Small
baby- may not be in right position
Anomalies- conjoined twins
Head- large or missing skull
Presentation
Lie
Attitude
Position
fetal presentation - ANS ✔✔Vertex- occiput, back of head presenting. Chin to chest. IDEAL POSITION
Brow- head more extended, brows first
Face- head all the way back. Will feel nares, mouth, etc w/ vag exam
Breech- booty first
Shoulder- baby is side lying
fetal lie - ANS ✔✔mom's long axis (spine) in relation to baby's long axis (spine)
- want them to be aligned. Do not want a transverse lie
- transverse increases risk for uterine rupture and prolapsed cord!!
fetal head attitude - ANS ✔✔Head position: flexion is ideal
Suboccipitobregmatic- smallest diameter. Ideal position
occipitomental- largest diameter
fetal position - ANS ✔✔Presenting baby part in relationship to maternal pelvis
Occiput-anterior: baby's occiput is facing moms anterior pelvis
R occiput anterior: baby's occiput is facing moms anterior but is a little to the right
L occiput transverse- facing directly to side. Occiput to L
Breech- sacrum
Chin- mentum
IDEAL: ANTERIOR
fetal station - ANS ✔✔Ischial spine= 0
Anything above= negative
Below= positive
5p's - passageway - ANS ✔✔True pelvis: pelvic brim
False pelvis: up above, floating
,Cervix and soft tissues
Trauma to cervix? Condition of tissues
Episiotomy? Scar tissue?
Gynecoid- most popular/common in female pelvis
Anthropoid- a/p diameter is wider, more narrow. Most babies end up in occiput posterior position
Android- male pelvis. Very difficult to deliver, baby will get stuck in pelvic brim
Platypelloid- very narrow. Cant even get into pelvis, end up with c section
5p's - powers - ANS ✔✔-Uterine Contractions-force generated by the myometrium (from oxytocin).
Helps open cervix and push baby down into pelvis
-Measured by palpation, tocotransducer or IUPC
---Feel uterus, document
---Tocotransducer to tell frequency and duration
---IUPC- monitors intensity in mmHg
-Adequate? If cervical changes are occurring- adequate. If no changes, can only tell with IUPC
-Frequency, duration and intensity
---Start of one, to start of next- frequency
---Duration- how long they last, avg.... 2-5 minutes (in general)
-Primary and secondary
---Ferguson reflex- involuntary urge to push
---Primary- involuntary uterine contractions
---Secondary- mom is VOLUNTARILY pushing down
5p's- maternal position - ANS ✔✔Can use gravity, standing around, walking to help baby get into correct
position
Can change during 1st stage of labor, as well as in pushing phase. Difficult w/ epidural but possible
5p's - psyche - ANS ✔✔-Maternal history- anything can affect labor process. Anxiety, stressful response-
can slow labor process!! Body just kind of shuts down...Bad experiences, sexual abuse, etc.
-Maternal Catecholamine's
-Support- BUILD RAPPORT
-Doulas common for this reason
signs preceding labor - ANS ✔✔-Lightening: engagement, baby descends into maternal pelvis. Drop in
fundal height. Mostly only in first time moms before labor begins
-Backache: kind of like period pains
-Contractions: more Braxton hicks, etc.
-Energy: nesting. Feels like she needs to clean house, wash clothes for baby, pack bags
-Increased vaginal discharge: increased leukorrhea, more watery and increased amount. Might be
mistaken for amniotic fluid!!!
onset of labor - ANS ✔✔Caused by multiple factors including hormonal, mechanical, aging placenta.
Placenta ages, as term comes near, placenta function declines
Increased estrogen and prostaglandins decreased progesterone....Prostaglandins help ripen cervix
*Not completely understood*
false labor - ANS ✔✔discomfort, but mom can still move around and function without a problem
, frequency and intensity- contractions stay spaced out, constant
contractions may slow down with ambulation
baby may be facing posterior
cervix will be firm, not many changes occurring.
true labor - ANS ✔✔mom will be very uncomfortable, and increases more over time
frequency and intensity w/ contractions gradually increase
ambulation does not stop contractions, they continue
baby may be facing anterior
cervix changes- dilation, effacement, soft
first stage of labor - ANS ✔✔3 phases- start contracting, dilating. Stops when 10cm dilated
Latent
Active
Transition
second stage of labor consists of.. - ANS ✔✔pushing and birth of infant- 2 phases
latent
active
third stage of labor - ANS ✔✔birth of the placenta
fourth stage of labor - ANS ✔✔first 1-2hrs after birth
fetal adaptations to labor - ANS ✔✔-Fetal Heart Rate (FHR)- accelerations and early decels are normal
response to fetal movement, vaginal examinations, fundal pressure, contractions, palpation and head
compression.
-Fetal Circulation
---Decreased with contractions
---Most fetuses are able to compensate
---Cord compression- early decelerations
-But if underlying problem w/ fetus or mom, may not be able to compensate as well as normal baby
-Fetal Respiration- fluid cleared from lungs during expulsion
maternal adaptations to labor - ANS ✔✔-Cardiac output increases/HR increases- pain
