Question 1

A nurse is teaching a group of primigravidas that during delivery,pressure on the fetal skull may produce changes in the shape of the skull.What is the reshaping of the skull called?

Accepted Answer

The reshaping of the skull bones in response to pressure is called molding.

Question 2

The patient's membranes have just ruptured.What is the first priority of the nurse?

Accepted Answer

The FHR should be assessed immediately after rupture of the membranes to determine the well-being of the baby.

Question 3

Why is the size and shape of the true pelvis more important than that of the false pelvis?

Accepted Answer

The size and shape of the true pelvis is more important than the false pelvis because the fetal head must be able to pass through for vaginal delivery to occur.

Question 4

A patient arrives at the hospital having contractions.How should the nurse determine that the patient is in true labor?

Accepted Answer

One sign of true labor is when the cervix has softened and effaced.True labor contractions are regular and rhythmic.

Question 5

Which type of monitor will assesses the intensity of contractions?

Accepted Answer

Internal monitoring is used to monitor the intensity of contractions,the frequency and duration of contractions,and the resting tone of uterine contractions.An external monitor is used to monitor the fetal heart rate and uterine activity.

Question 6

Using Leopold maneuvers to assess fetal position,the nurse finds a soft rounded prominence at the level of the fundus,a hard round prominence just above the symphysis pubis,and nodulations on the left side of the uterus.How should the nurse document the fetal position?

Accepted Answer

Fetal position can be determined by the Leopold maneuver,which defines the relationship of the presenting part to the maternal pelvis quadrant.A soft rounded prominence at the level of the fundus,a hard round prominence just above the symphysis pubis,and nodulations on the left side of the uterus indicate a right occiput anterior (ROA),vertex positioning.

Question 7

How do Braxton-Hicks contractions,which may begin in the first trimester and become increasingly stronger during the pregnancy,differ from labor contractions?

Accepted Answer

Braxton-Hicks contractions do not dilate the cervix.Braxton-Hicks contractions remain irregular,can range from mild to moderate in severity,and increase in duration as the pregnancy progresses.

Question 8

What is the largest diameter of the fetal skull?

Accepted Answer

The largest transverse diameter of the fetal skull is the biparietal measurement.If this is too large,the skull may not be able to enter the mother's pelvis.

Question 9

A nurse is assessing the printout from the fetal monitor.What is the legal responsibility of the nurse?

Accepted Answer

Nurses are responsible for the timely notification of the primary caregiver in the event of an abnormal fetal heart rate (FHR)pattern.The nurse cannot write a medication order.

Question 10

A mother is in early labor and asks the nurse how long the labor will last.The nurse explains that the first stage of labor lasts from the beginning of regular contractions until when?

Accepted Answer

The first stage of labor begins with regular contractions and ends with complete dilation of the cervix.

Question 11

When trying to differentiate false labor from true labor,the nurse realizes which of the following statements regarding true labor is correct?

Accepted Answer

Contractions get stronger with ambulation in true labor.True labor is also marked by the onset of regular,rhythmic contractions.

Question 12

What is the ideal attitude for the fetal body during labor?

Accepted Answer

The ideal attitude for the fetal body is flexion.

Question 13

A woman who is 38 weeks' pregnant tells the nurse that the baby has dropped and she is having urinary frequency again.What do these symptoms describe?

Accepted Answer

The symptoms of lightening are a return of urinary frequency,and the patient is able to breathe more normally.

Question 14

The first-time mother has been told by the nurse that the first stage of labor is the longest.What would be an appropriate nursing intervention for comfort during this time?

Accepted Answer

Backache in the sacral area is a common complaint during the first stage of labor.The keyword is "comfort" in the question.Providing a backrub is providing comfort to the laboring patient.

Question 15

When observing the fetal heart monitor,the nurse recognizes the fetal heart rate (FHR)decreases to 120 beats/min at the beginning of a contraction and returns to a baseline of 155 beats/min at the end of the contraction.What should this indicate to the nurse?

Accepted Answer

This indicates early decelerations because of head compression.

Question 16

During the second stage of labor,how often should the nurse should monitor the fetal heart rate?

Accepted Answer

Fetal heart rate should be assessed every 5 minutes during the second stage of labor.

Question 17

The nurse is alarmed as she assesses a protruding umbilical cord from the vagina.What immediate action should the nurse take?

Accepted Answer

The knee-chest position reduces the pressure on the prolapsed cord.The charge nurse will need to be notified,and the contractions will need to be monitored.However,the priority is reducing the pressure on the prolapsed cord.

Question 18

A woman is admitted in active labor,and the nurse assesses the fetal heart rate (FHR)at 124 beats/min.What action should the nurse take based on the assessment?

Accepted Answer

The normal FHR is 120 to 160 beats/min.No interventions are required.

Question 19

What area of the uterus provides the force during a contraction?

Accepted Answer

The upper portion of the uterus provides the force during contractions.

Question 20

What method is used to visualize soft tissue and to determine adequacy of the pelvis with no detrimental effects to the fetus?

Accepted Answer

In more than 20 years of use,ultrasonography has had no detrimental effects on the fetus.Pelvimetry and x-ray uses radiation to visualize bony prominences.Pelvimetry is not used in the pregnant patient due to detrimental effects to the fetus.Palpation does not allow for visualization of soft tissue.

Quiz 27: Labor and Delivery