Chapter 15: Nursing Care During Labor and Birth -
Exam Question and Answer
1. The nurse is preparing to perform Leopold's maneuvers. Why are
Leopold's maneuvers used by practitioners?
a. To determine the status of the membranes
b. To determine cervical dilation and effacement
c. To determine the best location to assess the fetal heart rate
d. To determine whether the fetus is in the posterior position correct
answer: ANS correct answer: C
Leopold's maneuvers are often performed before assessing the fetal heart rate (FHR). These maneuvers
help identify the best location to obtain the FHR. A Nitrazine or ferning test can be performed to
determine the status of the fetal membranes. Dilation and ettacement are best determined by vaginal
examination. Assessment of fetal position is more accurate with vaginal examination.
2. Which comfort measure should a nurse use to assist a laboring
woman to relax?
a. Recommend frequent position changes.
b. Palpate her filling bladder every 15 minutes.
c. Offer warm wet cloths to use on the client's face and neck.
d. Keep the room lights lit so the client and her coach can see
everything. correct answer: ANS correct answer: A Frequent maternal position
changes reduce the discomfort from constant pressure and promote fetal descent. A full bladder
intensifies labor pain. The bladder should be emptied every 2 hours. Women in labor get hot and
perspire. Cool cloths are much better. Soft indirect lighting is more soothing than irritating bright
lights.
3. Which assessment finding could indicate hemorrhage in the
postpartum patient?
a. Elevated pulse rate
b. Elevated blood pressure
c. Firm fundus at the midline
d. Saturation of two perineal pads in 4 hours correct answer: ANS correct
, answer: A
An increasing pulse rate is an early sign of excessive blood loss. If the blood volume were diminishing,
the blood pressure would decrease. A firm fundus indicates that the uterus is contracting and
compressing the open blood vessels at the placental site. Saturation of one pad within the first hour is
the maximum normal amount of lochial flow. Two pads within 4 hours is within normal limits.
4. Which is an essential part of nursing care for a laboring client?
a. Helping the woman manage the pain
, b. Eliminating the pain associated with labor
c. Feeling comfortable with the predictable nature of intrapartal care
d. Sharing personal experiences regarding labor and birth to
decrease her anxiety correct answer: ANS correct answer: A
Helping a client manage the pain is an essential part of nursing care because pain is an expected part of
normal labor and cannot be fully relieved. Labor pain cannot be fully relieved. The labor nurse should
always be assessing for unpredictable occurrences. Decreasing anxiety is important, but managing pain
is a top priority.
5. A client at 40 weeks' gestation should be instructed to go to a
hospital or birth center for evaluation when she experiences correct
answer:
a. fetal movement.
b. irregular contractions for 1 hour.
c. a trickle of fluid from the vagina.
d. thick pink or dark red vaginal mucus. correct answer: ANS correct
answer: C
A trickle of fluid from the vagina may indicate rupture of the membranes, requiring evaluation for
infection or cord compression. The lack of fetal movement needs further assessment. Irregular
contractions are a sign of false labor and do not require further assessment. Bloody show may occur
before the onset of true labor. It does not require professional assessment unless the bleeding is
pronounced.
6. Which client at term should go to the hospital or birth center the
soonest after labor begins?
a. Gravida 2, para 1, who lives 10 minutes away
b. Gravida 1, para 0, who lives 40 minutes away
c. Gravida 2, para 1, whose first labor lasted 16 hours
d. Gravida 3, para 2, whose longest previous labor was 4 hours
correct answer: ANS correct answer: D Multiparous women usually have shorter labors
than do nulliparous women. The woman described in option D is multiparous with a history of rapid
labors, increasing the likelihood that her infant might be born in uncontrolled circumstances. A
gravida 2 would be expected to have a longer labor than the gravida in option C. The fact that she
,ives close to the hospital allows her to stay home for a longer period of time. A gravida 1 will be expected
to have the longest labor. The gravida 2 would be expected to have a longer labor than the gravida 3,
especially because her first labor was 16 hours.
7. A woman who is gravida 3, para 2, enters the intrapartum unit.
The most important nursing assessments are correct answer:
Exam Question and Answer
1. The nurse is preparing to perform Leopold's maneuvers. Why are
Leopold's maneuvers used by practitioners?
a. To determine the status of the membranes
b. To determine cervical dilation and effacement
c. To determine the best location to assess the fetal heart rate
d. To determine whether the fetus is in the posterior position correct
answer: ANS correct answer: C
Leopold's maneuvers are often performed before assessing the fetal heart rate (FHR). These maneuvers
help identify the best location to obtain the FHR. A Nitrazine or ferning test can be performed to
determine the status of the fetal membranes. Dilation and ettacement are best determined by vaginal
examination. Assessment of fetal position is more accurate with vaginal examination.
2. Which comfort measure should a nurse use to assist a laboring
woman to relax?
a. Recommend frequent position changes.
b. Palpate her filling bladder every 15 minutes.
c. Offer warm wet cloths to use on the client's face and neck.
d. Keep the room lights lit so the client and her coach can see
everything. correct answer: ANS correct answer: A Frequent maternal position
changes reduce the discomfort from constant pressure and promote fetal descent. A full bladder
intensifies labor pain. The bladder should be emptied every 2 hours. Women in labor get hot and
perspire. Cool cloths are much better. Soft indirect lighting is more soothing than irritating bright
lights.
3. Which assessment finding could indicate hemorrhage in the
postpartum patient?
a. Elevated pulse rate
b. Elevated blood pressure
c. Firm fundus at the midline
d. Saturation of two perineal pads in 4 hours correct answer: ANS correct
, answer: A
An increasing pulse rate is an early sign of excessive blood loss. If the blood volume were diminishing,
the blood pressure would decrease. A firm fundus indicates that the uterus is contracting and
compressing the open blood vessels at the placental site. Saturation of one pad within the first hour is
the maximum normal amount of lochial flow. Two pads within 4 hours is within normal limits.
4. Which is an essential part of nursing care for a laboring client?
a. Helping the woman manage the pain
, b. Eliminating the pain associated with labor
c. Feeling comfortable with the predictable nature of intrapartal care
d. Sharing personal experiences regarding labor and birth to
decrease her anxiety correct answer: ANS correct answer: A
Helping a client manage the pain is an essential part of nursing care because pain is an expected part of
normal labor and cannot be fully relieved. Labor pain cannot be fully relieved. The labor nurse should
always be assessing for unpredictable occurrences. Decreasing anxiety is important, but managing pain
is a top priority.
5. A client at 40 weeks' gestation should be instructed to go to a
hospital or birth center for evaluation when she experiences correct
answer:
a. fetal movement.
b. irregular contractions for 1 hour.
c. a trickle of fluid from the vagina.
d. thick pink or dark red vaginal mucus. correct answer: ANS correct
answer: C
A trickle of fluid from the vagina may indicate rupture of the membranes, requiring evaluation for
infection or cord compression. The lack of fetal movement needs further assessment. Irregular
contractions are a sign of false labor and do not require further assessment. Bloody show may occur
before the onset of true labor. It does not require professional assessment unless the bleeding is
pronounced.
6. Which client at term should go to the hospital or birth center the
soonest after labor begins?
a. Gravida 2, para 1, who lives 10 minutes away
b. Gravida 1, para 0, who lives 40 minutes away
c. Gravida 2, para 1, whose first labor lasted 16 hours
d. Gravida 3, para 2, whose longest previous labor was 4 hours
correct answer: ANS correct answer: D Multiparous women usually have shorter labors
than do nulliparous women. The woman described in option D is multiparous with a history of rapid
labors, increasing the likelihood that her infant might be born in uncontrolled circumstances. A
gravida 2 would be expected to have a longer labor than the gravida in option C. The fact that she
,ives close to the hospital allows her to stay home for a longer period of time. A gravida 1 will be expected
to have the longest labor. The gravida 2 would be expected to have a longer labor than the gravida 3,
especially because her first labor was 16 hours.
7. A woman who is gravida 3, para 2, enters the intrapartum unit.
The most important nursing assessments are correct answer:
