OB PREP U: CHAPTER 13 EXAM WITH
COMPLETE SOLUTION
The nurse assesses a client in labor and finds that the fetal long axis is longitudinal to
the maternal long axis. The nurse documents this finding as which of the following?
a) Attitude
b) Lie
c) Position
d) Presentation - ANSWER b) Lie
Rationale:
The nurse is assessing fetal lie, the relationship of the fetal long axis to the maternal
long axis. When the fetal long axis is longitudinal to the maternal long axis, the lie is said
to longitudinal. Presentation is the portion of the fetus that overlies the maternal pelvic
inlet. Attitude is the relationship of the different fetal parts to one another. Position is the
relationship of the fetal denominator to the different sides of the maternal pelvis.
The skull is the most important factor in relation to the labor and birth process. The fetal
skull must be small enough to travel through the bony pelvis. What feature of the fetal
skull helps to make this passage possible?
a) Vertex presentation
b) Caput succedaneum
c) Molding
d) Cephalohematoma - ANSWER c) Molding
Rationale:
The cartilage between the bones allows the bones to overlap during labor, a process
called molding that elongates the fetal skull thereby reducing the diameter of the head.
The nurse should initially implement which intervention when a nulliparous woman
telephones the hospital to report that she is in labor.
a) Emphasize that food and fluid should stop or be light
b) Tell the woman to stay home until her membranes rupture
, c) Ask the woman to describe why she believes that she is in labor
d) Arrange for the woman to come to the hospital for labor evaluation - ANSWER c) Ask
the woman to describe why she believes that she is in labor
Rationale:
The nurse needs further information to assist in determining if the woman is in true or
false labor. She will need to ask the patient questions to seek further assessment and
triage information. Having her wait until membranes rupture may be dangerous, as she
may give birth before reaching the hospital. She should continue fluid intake until it is
determined whether or not she is in labor. She may be in false labor, and more
information should be obtained before she is brought to the hospital.
When going through the transition phase of labor women often feel out of control. What
do women in the transition phase of labor need?
a) Their significant other beside them
b) Intense nursing care
c) Just to be left alone
d) Positive reinforcement - ANSWER d) Positive reinforcement
Rationale:
Any women, even ones who have had natural childbirth classes, have a difficult time
maintaining positive coping strategies during this phase of labor. Many women describe
feeling out of control during this phase of labor. A woman in transition needs support,
encouragement, and positive reinforcement.
The initial descent of the fetus into the pelvis to zero station is which one of the cardinal
movements of labor?
a) Engagement
b) Felxion
c) Extension
d) Expulsion - ANSWER a) Engagement
Rationale:
The movement of the fetus into the pelvis from the upper uterus is engagement. This is
the first cardinal movement of the fetus in preparation for the spontaneous vaginal
delivery. Flexion occurs as the fetus encounters resistance from the soft tissues and
muscles of the pelvic floor. Extension is the state in which the fetal head is well flexed
with the chin on the chest as the fetus travels through the birth canal. Expulsion occurs
, after delivery of the anterior and posterior shoulders.
When teaching a group of nursing students about uterine contractions, which of the
following would the instructor include as a typical feature?
a) Retracting of the lower segment
b) Pulling down of the cervical portion
c) Thinning out of the upper segment
d) Contracting stronger in the lower segment - ANSWER a) Retracting of the lower
segment
Rationale:
The nurse should identify retraction of the lower segment of the uterus as a feature of
typical uterine contractions. As labor progresses the uterine contractions become
stronger. The upper segment of the uterus contracts more actively than the lower
segment. The lower segment retracts, pulling up the cervix. The upper segment
thickens with time and the lower segment thins.
One of the theories about the onset of labor is the prostaglandin theory. While not being
conclusively proven that the action of prostaglandins initiate labor, it is known that
prostaglandins do play a role in labor. What is an action of prostaglandins?
a) Stimulates uterine muscle to relax
b) Softens cervix
c) Initiates relaxation of perineum
d) Initiates cervical dilation - ANSWER b) Softens cervix
Rationale:
The prostaglandin theory is another theory of labor initiation. Prostaglandins influence
labor in several ways, which include softening the cervix and stimulating the uterus to
contract. However, evidence supporting the theory that prostaglandins are the agents
that trigger labor to begin is inconclusive.
Which of the following would be least effective in promoting a positive birth outcome for
a woman in labor?
a) Promoting the woman's feelings of control
b) Providing clear information about procedures
c) Encouraging the woman to use relaxation techniques
d) Allowing the woman time to be alone - ANSWER d) Allowing the woman time to be
COMPLETE SOLUTION
The nurse assesses a client in labor and finds that the fetal long axis is longitudinal to
the maternal long axis. The nurse documents this finding as which of the following?
a) Attitude
b) Lie
c) Position
d) Presentation - ANSWER b) Lie
Rationale:
The nurse is assessing fetal lie, the relationship of the fetal long axis to the maternal
long axis. When the fetal long axis is longitudinal to the maternal long axis, the lie is said
to longitudinal. Presentation is the portion of the fetus that overlies the maternal pelvic
inlet. Attitude is the relationship of the different fetal parts to one another. Position is the
relationship of the fetal denominator to the different sides of the maternal pelvis.
The skull is the most important factor in relation to the labor and birth process. The fetal
skull must be small enough to travel through the bony pelvis. What feature of the fetal
skull helps to make this passage possible?
a) Vertex presentation
b) Caput succedaneum
c) Molding
d) Cephalohematoma - ANSWER c) Molding
Rationale:
The cartilage between the bones allows the bones to overlap during labor, a process
called molding that elongates the fetal skull thereby reducing the diameter of the head.
The nurse should initially implement which intervention when a nulliparous woman
telephones the hospital to report that she is in labor.
a) Emphasize that food and fluid should stop or be light
b) Tell the woman to stay home until her membranes rupture
, c) Ask the woman to describe why she believes that she is in labor
d) Arrange for the woman to come to the hospital for labor evaluation - ANSWER c) Ask
the woman to describe why she believes that she is in labor
Rationale:
The nurse needs further information to assist in determining if the woman is in true or
false labor. She will need to ask the patient questions to seek further assessment and
triage information. Having her wait until membranes rupture may be dangerous, as she
may give birth before reaching the hospital. She should continue fluid intake until it is
determined whether or not she is in labor. She may be in false labor, and more
information should be obtained before she is brought to the hospital.
When going through the transition phase of labor women often feel out of control. What
do women in the transition phase of labor need?
a) Their significant other beside them
b) Intense nursing care
c) Just to be left alone
d) Positive reinforcement - ANSWER d) Positive reinforcement
Rationale:
Any women, even ones who have had natural childbirth classes, have a difficult time
maintaining positive coping strategies during this phase of labor. Many women describe
feeling out of control during this phase of labor. A woman in transition needs support,
encouragement, and positive reinforcement.
The initial descent of the fetus into the pelvis to zero station is which one of the cardinal
movements of labor?
a) Engagement
b) Felxion
c) Extension
d) Expulsion - ANSWER a) Engagement
Rationale:
The movement of the fetus into the pelvis from the upper uterus is engagement. This is
the first cardinal movement of the fetus in preparation for the spontaneous vaginal
delivery. Flexion occurs as the fetus encounters resistance from the soft tissues and
muscles of the pelvic floor. Extension is the state in which the fetal head is well flexed
with the chin on the chest as the fetus travels through the birth canal. Expulsion occurs
, after delivery of the anterior and posterior shoulders.
When teaching a group of nursing students about uterine contractions, which of the
following would the instructor include as a typical feature?
a) Retracting of the lower segment
b) Pulling down of the cervical portion
c) Thinning out of the upper segment
d) Contracting stronger in the lower segment - ANSWER a) Retracting of the lower
segment
Rationale:
The nurse should identify retraction of the lower segment of the uterus as a feature of
typical uterine contractions. As labor progresses the uterine contractions become
stronger. The upper segment of the uterus contracts more actively than the lower
segment. The lower segment retracts, pulling up the cervix. The upper segment
thickens with time and the lower segment thins.
One of the theories about the onset of labor is the prostaglandin theory. While not being
conclusively proven that the action of prostaglandins initiate labor, it is known that
prostaglandins do play a role in labor. What is an action of prostaglandins?
a) Stimulates uterine muscle to relax
b) Softens cervix
c) Initiates relaxation of perineum
d) Initiates cervical dilation - ANSWER b) Softens cervix
Rationale:
The prostaglandin theory is another theory of labor initiation. Prostaglandins influence
labor in several ways, which include softening the cervix and stimulating the uterus to
contract. However, evidence supporting the theory that prostaglandins are the agents
that trigger labor to begin is inconclusive.
Which of the following would be least effective in promoting a positive birth outcome for
a woman in labor?
a) Promoting the woman's feelings of control
b) Providing clear information about procedures
c) Encouraging the woman to use relaxation techniques
d) Allowing the woman time to be alone - ANSWER d) Allowing the woman time to be
