Question 1

To identify the duration of a contraction, the nurse would:

Accepted Answer

To identify the duration of a contraction, the nurse should time from the beginning of one contraction to the completion of the same contraction. This will give a clear idea of how long the contraction lasts. Timing between the beginning of one contraction and the beginning of the next contraction would give the frequency of contractions, not the duration. Palpating for the strength of the contraction at its peak is not relevant to identifying the duration of the contraction. Timing from the beginning of the contraction to the peak of the same contraction would give the time to peak, not the duration of the contraction.

Question 2

A primigravida patient arrives in the labor and delivery unit and describes her contractions as occurring every 10-12 minutes, lasting 30 seconds. She is smiling and very excited about the possibility of being in labor. On exam, her cervix is dilated 2 cm, 100% effaced, and -2 station. What best describes this labor?

Accepted Answer

Based on the given information, the patient is experiencing contractions every 10-12 minutes lasting 30 seconds, indicating the latent phase of labor. Additionally, the cervical examination findings show that the patient is only 2cm dilated, 100% effaced, and -2 station, which are also consistent with the latent phase of labor. The second phase, active phase, and transition phase require higher levels of cervical dilation and effacement and stronger contractions.

Question 3

A clinic nurse is preparing diagrams of pelvic shapes. Which pelvic shapes are considered least adequate for vaginal childbirth?

Accepted Answer

The android and platypelloid pelvic shapes are considered least adequate for vaginal childbirth due to their narrow dimensions and shape, which can complicate the passage of the baby through the birth canal.

Question 4

A patient is admitted to the labor and delivery unit with contractions that are 2 minutes apart, lasting 60 seconds. She reports that she had bloody show earlier that morning. A vaginal exam reveals that her cervix is 100 percent effaced and 8 cm dilated. The nurse knows that the patient is in which phase of labor?

Accepted Answer

The patient is in the transition phase of labor, which is characterized by 100 percent effacement and dilation of 8-10 cm. The contractions are typically strong and close together. The bloody show is also a sign of cervical change and progression of labor. The active phase of labor is typically 4-7 cm dilation, and the latent phase is 0-3 cm dilation. The fourth stage of labor is after delivery of the baby and expulsion of the placenta.

Question 5

The primiparous patient in early labor asks the nurse what the contractions are like as labor progresses. The nurse responds, "In normal labor, as the uterine contractions become stronger, they usually also become:

Accepted Answer

As labor progresses and the contractions become stronger, they typically become longer in duration. This allows for the cervix to continue to efface and dilate, ultimately leading to the birth of the baby. Contractions may also become more frequent and more painful as labor progresses. However, they would not become less frequent or less painful as the nurse suggests in options A and B. Contractions also would not typically become shorter in duration as labor progresses, as this would not allow for adequate cervical effacement and dilation.

Question 6

A woman who is 40 weeks pregnant calls the labor suite to ask whether she should be evaluated. Which statements by the patient indicate she is likely in labor?

Accepted Answer

The answer of A woman who is 40 weeks pregnant...

Question 7

A patient is admitted to the labor unit with contractions 1-2 minutes apart lasting 60-90 seconds. The patient is apprehensive and irritable. This patient is most likely in what phase of labor?

Accepted Answer

The patient's contractions are frequent and long-lasting, and she is exhibiting signs of discomfort and irritability, which are typical of the transition phase of labor. During this phase, the cervix opens up to 10cm and is accompanied by strong contractions. In this phase, women often experience increased anxiety, agitation, and physical discomfort.

Question 8

The primiparous patient at 40 weeks' gestation reports to the nurse that she has had increased pelvic pressure and increased urinary frequency. Which response by the nurse is best?

Accepted Answer

These symptoms are indicative of the baby's head descending further into the pelvis, a common occurrence as labor approaches, known as lightening or dropping. This can increase pelvic pressure and urinary frequency due to the baby's head pressing more against the bladder.

Question 9

A nurse needs to evaluate the progress of a woman's labor. The nurse obtains the following data: cervical dilatation 6 cm; contractions mild in intensity, occurring every 5 minutes, with a duration of 30-40 seconds. Which clue in this data does not fit the pattern suggested by the rest of the clues?

Accepted Answer

Cervical dilatation of 6 cm typically indicates active labor, during which contractions are expected to be more intense and longer in duration than described.

Question 10

The charge nurse has received the shift change report. Which patient requires immediate intervention?

Accepted Answer

The primip at 3 cm who is screaming in fear due to her mother dying during childbirth requires immediate intervention to address her emotional needs and provide support. The other patients are in varying stages of labor and do not require immediate intervention.

Question 11

The primiparous patient has asked the nurse why her cervix has only changed from 1 to 2 cm in 3 hours of contractions occurring every 5 minutes. The best response by the nurse is:

Accepted Answer

Effacement, or thinning of the cervix, is also considered progress in labor. The nurse can explain this to the patient to help her understand that even though the cervical dilation may be slower than expected, her body is still making progress towards delivery.

Question 12

A patient who is having false labor most likely would have:

Accepted Answer

The answer of A patient who is having false labor...

Question 13

A patient is being admitted to the labor and delivery suite. The nurse will need to report the patient's progress to the primary healthcare practitioner. Which findings should the nurse report?

Accepted Answer

Fetal heart rate, contraction pattern, and vital signs are critical parameters that need to be monitored and reported to the primary healthcare practitioner during labor to ensure the well-being of both the mother and the fetus.

Question 14

The nurse is preparing a patient education handout on the differences between false labor and true labor. What information is most important for the nurse to include?

Accepted Answer

The answer of The nurse is preparing a patient education...

Question 15

How would the nurse best analyze the results from a patient's sonogram that shows the fetal shoulder as the presenting part?

Accepted Answer

The fetal shoulder presenting indicates a transverse lie, where the baby is positioned horizontally in the uterus, which is a type of breech presentation. This is different from the more common head-down (vertex) position.

Question 16

The nurse is teaching a prenatal class about false labor. The nurse should teach patients that false labor most likely will include which of the following?

Accepted Answer

False labor is characterized by contractions that do not intensify with activity (A) and pain that is typically felt in the abdomen and does not radiate (D).

Question 17

The primiparous patient at 39 weeks' gestation calls the clinic and reports increased bladder pressure but easier breathing and irregular, mild contractions. She also states that she just cleaned the entire house. Which statement should the nurse make?

Accepted Answer

Increased bladder pressure, easier breathing, and mild contractions are all signs of early labor. The fact that the patient cleaned the house may be a sign of "nesting," which can also occur in early labor. The nurse should encourage the patient to monitor her symptoms and come to the clinic if they become stronger or more frequent. Option A is judgmental and not helpful. Option B is incorrect because these symptoms are commonly experienced in the last weeks of pregnancy. Option D is not reassuring and does not provide clear guidance.

Question 18

Four minutes after the birth of a baby, there is a sudden gush of blood from the mother's vagina and about 8 inches of umbilical cord slides out. What action should the nurse take first?

Accepted Answer

The sudden gush of blood and the appearance of the umbilical cord indicates a possible premature separation of the placenta from the uterine wall. The nurse should watch for the emergence of the placenta, as it could result in hemorrhage if not delivered promptly. The other actions are not necessary at this time.

Question 19

A primigravida calls the labor and delivery unit and tells the nurse that she is 39 weeks pregnant and that over the last 4 or 5 days, she has noticed that although her breathing has become easier, she is having leg cramps, a slight amount of edema in her lower legs, and an increased amount of vaginal secretions. The nurse tells the patient that she has experienced what is commonly called:

Accepted Answer

The patient has likely experienced "lightening," which occurs when the fetus descends into the pelvis in preparation for birth, relieving pressure on the diaphragm and making breathing easier. This can also cause leg cramps and mild edema in the lower legs. Increased vaginal secretions are also common as the body prepares for labor. Quickening refers to the first movements felt by the mother during pregnancy, dilation is the opening of the cervix during labor, and Braxton Hicks contractions are mild contractions that can occur throughout pregnancy.

Question 20

The nurse is caring for laboring patients. Which women are experiencing problems related to a critical factor of labor?

Accepted Answer

The answer of The nurse is caring for laboring patients....

Quiz 22: Processes and Stages of Labor and Birth