RNSG 1300 Test 1 OB question and answer

Question 1 The nurse explains to the patient that the obstetric conjugate measurement is important because: 1. This measurement determines the tilt of the pelvis. 2. This measurement determines the shape of the inlet. 3. The fetus passes under it during birth. 4. The size of this diameter determines whether the fetus can move down into the birth canal so that engagement can occur. Correct Answer: 4 Rationale 1: A change in the lumbar curve can increase or decrease the tilt of the pelvis. Rationale 2: The transverse diameter is the largest diameter of the inlet, and it helps determine its shape. Rationale 3: The fetus passes under the pubic arch, which is part of the pelvic outlet. Rationale 4: The obstetric conjugate extends from the middle of the sacral promontory to an area approximately 1 cm below the pubic crest. The fetus passes through the obstetric conjugate, and the size of this diameter determines whether the fetus can move down into the birth canal in order for engagement to occur. Question 2 A prenatal patient asks the nurse how the baby can possibly come out through her vagina, because a vagina is not nearly as big as a baby. How does the nurse best answer this patient's question? “The vagina: 1. “Usually tears as it stretches during childbirth.” 2. “Is designed to allow a baby come through.” 3. “Changes due to pregnancy hormones and stretches more.” 4. “Dilates and effaces in labor so the baby can get out.” Correct Answer: 3 Rationale 1: Vaginal tears are not routine in childbirth. The vagina stretches during childbirth because of hormonal changes, creating deeper rugae. Rationale 2: Although this is a true statement, it is not the best, most thorough response. Rationale 3: The hormones of pregnancy create deeper rugae of the vagina to facilitate stretching during birth. Rationale 4: The cervix, not the vagina, dilates and effaces. Global Rationale: Question 3 The OB-GYN nurse knows that the most common shape for the female pelvis is which of the following? Correct Answer: 1 Rationale 1: Gynecoid pelvis: The most common female pelvis is the gynecoid type. The inlet is rounded, with the anteroposterior diameter a little shorter than the transverse diameter. Rationale 2: Android pelvis: The normal male pelvis is the android type; however, it occasionally is seen in females. The inlet is heart-shaped. Rationale 3: Anthropoid pelvis: The inlet of an anthropoid pelvis is oval, with a long anteroposterior diameter and an adequate but rather short transverse diameter. Rationale 4: Platypelloid pelvis: The platypelloid type refers to the flat female pelvis. The inlet is a distinctly transverse oval with a short anteroposterior and extremely short transverse diameter