Chapter 13: Labor and Birth Processes – Questions and Answers

Chapter 13: Labor and Birth Processes – Questions and Answers. A new mother asks the nurse when the “soft spot” on her son’s head will go away. The nurse’s answer is based on the knowledge that the anterior fontanel closes after birth by _____ months. a. 2 c. 12 b. 8 d. 18 ANS: D The larger of the two fontanels, the anterior fontanel, closes by 18 months after birth. PTS: 1 DIF: Cognitive Level: Knowledge REF: 342 OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal: a. Lie. c. Attitude. b. Presentation. d. Position. ANS: C Attitude is the relation of the fetal body parts to one another. Lie is the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother. Presentation refers to the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor at term. Position is the relation of the presenting part to the four quadrants of the mother’s pelvis. PTS: 1 DIF: Cognitive Level: Knowledge REF: 344 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother’s right side close to midline. What is the likely position of the fetus? a. ROA c. RSA b. LSP d. LOA ANS: C The fetus is positioned anteriorly in the right side of the maternal pelvis with the sacrum as the presenting part. RSA is the correct three-letter abbreviation to indicate this fetal position. The first letter indicates the presenting part in either the right or left side of the maternal pelvis. The second letter indicates the anatomic presenting part of the fetus. The third letter stands for thelocationofthepresentingpartinrelationtotheanterior,posterior,ortransverseportionof 4. The nurse has received report regarding her patient in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and ?2-2. The nurse’s interpretation of this assessment is that: a. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines. b. The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines. c. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines. d. The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines. ANS: B The correct description of the vaginal examination for this woman in labor is the cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines. The sterile vaginal examination is recorded as centimeters of cervical dilation, percentage of cervical dilation, and the relationship of the presenting part to the ischial spines (either above or below). PTS: 1 DIF: Cognitive Level: Comprehension REF: 347 OBJ: Nursing Process: Assessment, Planning MSC: Client Needs: Health Promotion and Maintenance 5. To care for a laboring woman adequately, the nurse understands that the __________ stage of labor varies the most in length? a. First c. Third b. Second d. Fourth ANS: A The first stage of labor is considered to last from the onset of regular uterine contractions to full dilation of the cervix. The first stage is much longer than the second and third stages combined. In a first-time pregnancy the first stage of labor can take up to 20 hours. The second stage of labor lasts from the time the cervix is fully dilated to the birth of the fetus. The average length is 20 minutes for a multiparous woman and 50 minutes for a nulliparous woman. The third stage of labor lasts from the birth of the fetus until the placenta is delivered. This stage may be as short as 3 minutes or as long as 1 hour. The fourth stage of labor, recovery, lasts about 2 hours after delivery of the placenta. PTS: 1 DIF: Cognitive Level: Knowledge REF: 351 OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 6. The nurse would expect which maternal cardiovascular finding during labor? During each contraction, 400 mL of blood is emptied from the uterus into the maternal vascular system. This increases cardiac output by about 51% above baseline pregnancy values at term. The heart rate increases slightly during labor. The WBC count can increase during labor. During the first stage of labor, uterine contractions cause systolic readings to increase by about 10 mm Hg. During the second stage, contractions may cause systolic pressures to increase by 30 mm Hg and diastolic readings to increase by 25 mm Hg. PTS: 1 DIF: Cognitive Level: Comprehension REF: 353 OBJ: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance 7. The factors that affect the process of labor and birth, known commonly as the five Ps, include all except: a. Passenger. c. Powers. b. Passageway. d. Pressure. ANS: D The five Ps are passenger (fetus and placenta), passageway (birth canal), powers (contractions), position of the mother, and psychologic response. PTS: 1 DIF: Cognitive Level: Knowledge REF: 342 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 8. The slight overlapping of cranial bones or shaping of the fetal head during labor is called: a. Lightening. c. Ferguson reflex. b. Molding. d. Valsalva maneuver. ANS: B Fetal head formation is called molding. Molding also permits adaptation to various diameters of the maternal pelvis. Lightening is the mother’s sensation of decreased abdominal distention, which usually occurs the week before labor. The Ferguson reflex is the contraction urge of the uterus after stimulation of the cervix. The Valsalva maneuver describes conscious pushing during the second stage of labor. PTS: 1 DIF: Cognitive Level: Comprehension REF: 343 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 9. Which presentation is described accurately in terms of both presenting part and frequency of occurrence? a. Cephalic: occiput; at least 95% c. Shoulder: scapula; 10% to 15% b. Breech: sacrum; 10% to 15% d. Cephalic: cranial; 80% to 85%. We offer online tutoring and help with assignments for all majors with a guaranteed pass. For assistance contact Tutor Lucas: +1 (775) 766-9089