N326 Reproductive Health SFSU SPRING 2019 NCLEX
EVOLVE QUESTIONS QUIZ #1 RATED A+
Which sign does not precede the onset of labor?
A. A return of urinary frequency as a result of increased bladder pressure
B. Persistent low backache from relaxed pelvic joints
C. Stronger and more frequent uterine (Braxton Hicks) contractions
D. A decline in energy, as the body stores up for labor - ANSWER D:
A decline in energy, as the body stores up for labor
A surge of energy is a phenomenon that is common in the days preceding labor.
After lightening, a return of the frequent need to urinate occurs as the fetal
position causes increased pressure on the bladder. In the run-up to labor,
women often experience persistent low backache and sacroiliac distress as a
result of relaxation of the pelvic joints. Prior to the onset of labor, it is common
for Braxton Hicks contractions to increase in both frequency and strength;
bloody show may be passed.
Which position would the nurse suggest for second stage labor if the pelvic
outlet needs to be increased?
A.) Semirecumbent
B.)Sitting
C.)Squatting
D.)Side-lying - ANSWER C.) Squatting
Kneeling or squatting moves the uterus forward and aligns the fetus with the
pelvic inlet; this can facilitate the second stage of labor by increasing the pelvic
outlet. Sitting may assist with fetal descent, but like a semi-recumbent or side-
lying position, it does not increase the size of the pelvic outlet.
Concerning the third stage of labor, nurses should be aware that:
A.) The placenta eventually detaches itself from a flaccid uterus.
B.) The duration of the third stage may be as short as 3 to 5 minutes.
C.) It is important that the dark, roughened maternal surface of the placenta
appear before the shiny fetal surface.
,D.) The major risk for women during the third stage is a rapid heart rate. -
ANSWER B.) The duration of the third stage may be as short as 3 to 5 minutes.
The third stage of labor lasts from birth of the fetus until the placenta is
delivered. The duration may be as short as 3 to 5 minutes, although up to 1 hour
is considered within normal limits. The placenta cannot detach itself from a
flaccid (relaxed) uterus. Which surface of the placenta comes out first is not
clinically important. The major risk for women during the third stage of labor is
postpartum hemorrhage; the risk of hemorrhage increases as the length of the
third stage increases.
Which of the following findings would be a cause for concern for a nurse who is
monitoring an obstetric patient who is in early labor? [ALL THAT APPLY]
Biparietal diameter of less than 9.25 cm
Vertex presenting part
Transverse lie
General flexion attitude
Android pelvis - ANSWER Biparietal diameter of less than 9.25 cm
Transverse lie
Android pelvis
A biparietal diameter at term is typically noted as 9.25 cm, and the finding of a
smaller measurement would cause a concern related to the mode of delivery. A
transverse lie would also cause a concern relative to the mode of delivery
because a cesarean section would be indicated. An android pelvis would cause
a concern related to the mode of delivery. A vertex presenting part and a
general flexion attitude are normal findings and would not cause concern.
Fetal circulation can be affected by many factors during labor. Accurate
assessment of the laboring woman and fetus requires knowledge of these
expected adaptations. Which factor will not affect fetal circulation during labor?
A.) Fetal position
B.) Uterine contractions
C.) Blood pressure
,D.) Umbilical cord blood flow - ANSWER Fetal position
Maternal position may affect fetal circulation; however, fetal position is unlikely
to disturb umbilical blood flow. Uterine contractions during labor tend to
decrease circulation and subsequent perfusion. Most healthy fetuses are well
able to compensate for this stress and exposure to increased pressure while
moving passively through the birth canal during labor. Maternal blood pressure
is likely to have a significant effect on fetal circulation. Compression of the cord
and reduction of umbilical blood flow do affect fetal circulation.
With regard to primary and secondary powers, the maternity nurse should
understand that:
A.) Primary powers are responsible for effacement and dilation of the cervix.
B.) Effacement generally is well ahead of dilation in women giving birth for the
first time; they are more together in subsequent pregnancies.
C.) Scarring of the cervix caused by a previous infection or surgery may make
the delivery a bit more painful, but it should not slow or inhibit dilation.
D.) Pushing in the second stage of labor is more effective if the woman can
breathe deeply and control some of her involuntary needs to push, as the nurse
directs. - ANSWER A.) Primary powers are responsible for effacement and
dilation of the cervix.
The primary powers are responsible for dilation and effacement; secondary
powers are concerned with expulsion of the fetus. Effacement is generally well
ahead of dilation in first-timers; the two are more concurrent in subsequent
pregnancies. Scarring of the cervix may slow dilation. Pushing is more effective
and less fatiguing when the woman begins to push only after she has the urge to
do so.
Which statement is inaccurate with regard to normal labor?
A.) A single fetus presents by vertex.
B.) It is completed within 8 hours.
C.) A regular progression of contractions, effacement, dilation, and descent
occurs.
D.) No complications are involved. - ANSWER B.) It is completed within 8 hours.
Although the amount of time varies with each woman, a normal uncomplicated
labor is usually completed within 18 hours. In normal labor, a single fetus
, presents by vertex. A regular progression of contractions, effacement, dilation,
and descent is the trajectory that the nurse expects for a woman experiencing a
normal labor, which usually occurs with no complications.
The nurse knows that the second stage of labor, the descent phase, has begun
when:
A.) The amniotic membranes rupture.
B.) The cervix cannot be felt during a vaginal examination.
C.) The woman experiences a strong urge to bear down.
D.) The presenting part is below the ischial spines. - ANSWER B.) The cervix
cannot be felt during a vaginal examination.
The second stage of labor begins with full cervical dilation. During the active
pushing phase of the second stage of labor, the woman may experience an
increase in the urge to bear down. Rupture of membranes has no significance in
determining the stage of labor. Many women may have an urge to bear down
when the presenting part is below the level of the ischial spines. This can occur
during the first stage of labor, as early as at 5 cm dilation.
In order to accurately assess the health of the mother accurately during labor,
the nurse should be aware that:
A.) The woman's blood pressure increases during contractions and falls back to
prelabor normal between contractions.
B.) Use of the Valsalva maneuver is encouraged during the second stage of
labor to relieve fetal hypoxia.
C.) Having the woman point her toes reduces leg cramps.
D.) The endogenous endorphins released during labor raise the woman's pain
threshold and produce sedation. - ANSWER D.) The endogenous endorphins
released during labor raise the woman's pain threshold and produce sedation.
In addition, physiologic anesthesia of the perineal tissues, caused by the
pressure of the presenting part, decreases the mother's perception of pain.
Blood pressure increases during contractions but remains somewhat elevated
between them. Use of the Valsalva maneuver is discouraged during second-
stage labor because of a number of unhealthy outcomes, including fetal hypoxia.
Pointing the toes can cause leg cramps, as can the process of labor itself.
EVOLVE QUESTIONS QUIZ #1 RATED A+
Which sign does not precede the onset of labor?
A. A return of urinary frequency as a result of increased bladder pressure
B. Persistent low backache from relaxed pelvic joints
C. Stronger and more frequent uterine (Braxton Hicks) contractions
D. A decline in energy, as the body stores up for labor - ANSWER D:
A decline in energy, as the body stores up for labor
A surge of energy is a phenomenon that is common in the days preceding labor.
After lightening, a return of the frequent need to urinate occurs as the fetal
position causes increased pressure on the bladder. In the run-up to labor,
women often experience persistent low backache and sacroiliac distress as a
result of relaxation of the pelvic joints. Prior to the onset of labor, it is common
for Braxton Hicks contractions to increase in both frequency and strength;
bloody show may be passed.
Which position would the nurse suggest for second stage labor if the pelvic
outlet needs to be increased?
A.) Semirecumbent
B.)Sitting
C.)Squatting
D.)Side-lying - ANSWER C.) Squatting
Kneeling or squatting moves the uterus forward and aligns the fetus with the
pelvic inlet; this can facilitate the second stage of labor by increasing the pelvic
outlet. Sitting may assist with fetal descent, but like a semi-recumbent or side-
lying position, it does not increase the size of the pelvic outlet.
Concerning the third stage of labor, nurses should be aware that:
A.) The placenta eventually detaches itself from a flaccid uterus.
B.) The duration of the third stage may be as short as 3 to 5 minutes.
C.) It is important that the dark, roughened maternal surface of the placenta
appear before the shiny fetal surface.
,D.) The major risk for women during the third stage is a rapid heart rate. -
ANSWER B.) The duration of the third stage may be as short as 3 to 5 minutes.
The third stage of labor lasts from birth of the fetus until the placenta is
delivered. The duration may be as short as 3 to 5 minutes, although up to 1 hour
is considered within normal limits. The placenta cannot detach itself from a
flaccid (relaxed) uterus. Which surface of the placenta comes out first is not
clinically important. The major risk for women during the third stage of labor is
postpartum hemorrhage; the risk of hemorrhage increases as the length of the
third stage increases.
Which of the following findings would be a cause for concern for a nurse who is
monitoring an obstetric patient who is in early labor? [ALL THAT APPLY]
Biparietal diameter of less than 9.25 cm
Vertex presenting part
Transverse lie
General flexion attitude
Android pelvis - ANSWER Biparietal diameter of less than 9.25 cm
Transverse lie
Android pelvis
A biparietal diameter at term is typically noted as 9.25 cm, and the finding of a
smaller measurement would cause a concern related to the mode of delivery. A
transverse lie would also cause a concern relative to the mode of delivery
because a cesarean section would be indicated. An android pelvis would cause
a concern related to the mode of delivery. A vertex presenting part and a
general flexion attitude are normal findings and would not cause concern.
Fetal circulation can be affected by many factors during labor. Accurate
assessment of the laboring woman and fetus requires knowledge of these
expected adaptations. Which factor will not affect fetal circulation during labor?
A.) Fetal position
B.) Uterine contractions
C.) Blood pressure
,D.) Umbilical cord blood flow - ANSWER Fetal position
Maternal position may affect fetal circulation; however, fetal position is unlikely
to disturb umbilical blood flow. Uterine contractions during labor tend to
decrease circulation and subsequent perfusion. Most healthy fetuses are well
able to compensate for this stress and exposure to increased pressure while
moving passively through the birth canal during labor. Maternal blood pressure
is likely to have a significant effect on fetal circulation. Compression of the cord
and reduction of umbilical blood flow do affect fetal circulation.
With regard to primary and secondary powers, the maternity nurse should
understand that:
A.) Primary powers are responsible for effacement and dilation of the cervix.
B.) Effacement generally is well ahead of dilation in women giving birth for the
first time; they are more together in subsequent pregnancies.
C.) Scarring of the cervix caused by a previous infection or surgery may make
the delivery a bit more painful, but it should not slow or inhibit dilation.
D.) Pushing in the second stage of labor is more effective if the woman can
breathe deeply and control some of her involuntary needs to push, as the nurse
directs. - ANSWER A.) Primary powers are responsible for effacement and
dilation of the cervix.
The primary powers are responsible for dilation and effacement; secondary
powers are concerned with expulsion of the fetus. Effacement is generally well
ahead of dilation in first-timers; the two are more concurrent in subsequent
pregnancies. Scarring of the cervix may slow dilation. Pushing is more effective
and less fatiguing when the woman begins to push only after she has the urge to
do so.
Which statement is inaccurate with regard to normal labor?
A.) A single fetus presents by vertex.
B.) It is completed within 8 hours.
C.) A regular progression of contractions, effacement, dilation, and descent
occurs.
D.) No complications are involved. - ANSWER B.) It is completed within 8 hours.
Although the amount of time varies with each woman, a normal uncomplicated
labor is usually completed within 18 hours. In normal labor, a single fetus
, presents by vertex. A regular progression of contractions, effacement, dilation,
and descent is the trajectory that the nurse expects for a woman experiencing a
normal labor, which usually occurs with no complications.
The nurse knows that the second stage of labor, the descent phase, has begun
when:
A.) The amniotic membranes rupture.
B.) The cervix cannot be felt during a vaginal examination.
C.) The woman experiences a strong urge to bear down.
D.) The presenting part is below the ischial spines. - ANSWER B.) The cervix
cannot be felt during a vaginal examination.
The second stage of labor begins with full cervical dilation. During the active
pushing phase of the second stage of labor, the woman may experience an
increase in the urge to bear down. Rupture of membranes has no significance in
determining the stage of labor. Many women may have an urge to bear down
when the presenting part is below the level of the ischial spines. This can occur
during the first stage of labor, as early as at 5 cm dilation.
In order to accurately assess the health of the mother accurately during labor,
the nurse should be aware that:
A.) The woman's blood pressure increases during contractions and falls back to
prelabor normal between contractions.
B.) Use of the Valsalva maneuver is encouraged during the second stage of
labor to relieve fetal hypoxia.
C.) Having the woman point her toes reduces leg cramps.
D.) The endogenous endorphins released during labor raise the woman's pain
threshold and produce sedation. - ANSWER D.) The endogenous endorphins
released during labor raise the woman's pain threshold and produce sedation.
In addition, physiologic anesthesia of the perineal tissues, caused by the
pressure of the presenting part, decreases the mother's perception of pain.
Blood pressure increases during contractions but remains somewhat elevated
between them. Use of the Valsalva maneuver is discouraged during second-
stage labor because of a number of unhealthy outcomes, including fetal hypoxia.
Pointing the toes can cause leg cramps, as can the process of labor itself.
