Chapter 19 Processes and Stages of Labor and Birth
1) How would the nurse best analyze the results from a clients sonogram that
shows the fetal shoulder as the presenting part?
1. Breech, transverse
2. Breech, longitudinal
3. Breech, frank
4. Vertex, transverse
Answer: 1
Explanation: 1. A shoulder presentation is one type of breech presentation,
and is also called a transverse lie.
Page Ref: 449, 450
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3.
Use skills of inquiry, analysis, and information literacy to address practice
issues. | NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 2 Examine the five critical factors that affect the labor
process.
MNL LO: 3.3.1 Describe the five processes of labor.
2) A clinic nurse is preparing diagrams of pelvic shapes. Which pelvic shapes
are considered least adequate for vaginal childbirth?
Note: Credit will be given only for all correct choices and no incorrect
choices.
Select all that apply.
1. Android
2. Anthropoid
3. Gynecoid
4. Platypelloid
,5. Lambdoidal suture
Answer: 1, 4
Explanation: 1. In the android and platypelloid types, the pelvic diameters are
diminished. Labor is more likely to be difficult (longer) and a cesarean birth
is more likely.
4. In the android and platypelloid types, the pelvic diameters are diminished.
Labor is more likely to be difficult (longer) and a cesarean birth is more
likely.
Page Ref: 446, 466
,Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3.
Use skills of inquiry, analysis, and information literacy to address practice
issues. | NLN Competencies: Knowledge and Science: Relationships
1
Copyright 2016 Pearson Education, Inc.
between knowledge/science and quality and safe patient care. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2 Examine the five critical factors that affect the labor
process.
MNL LO: 3.3.1 Describe the five processes of labor.
3) The nurse is caring for laboring clients. Which women are experiencing
problems related to a critical factor of labor?
Note: Credit will be given only for all correct choices and no incorrect
choices.
Select all that apply.
1. Woman at 7 cm, fetus in general flexion
2. Woman at 3 cm, fetus in longitudinal lie
3. Woman at 4 cm, fetus with transverse lie
4. Woman at 6 cm, fetus at -2 station, mild contractions
5. Woman at 5 cm, fetal presenting part is right shoulder
Answer: 3, 4, 5
Explanation: 3. A transverse lie occurs when the cephalocaudal axis of the fetal
spine is at a right angle to the womans spine and is associated with a shoulder
presentation and can lead to complications in the later stages of labor.
4. Station refers to the relationship of the presenting part to an imaginary line
drawn between the ischial spines of the maternal pelvis. If the presenting part
, is higher than the ischial spines, a negative number is assigned, noting
centimeters above zero station. A -2 station is high in the pelvis. Contractions
should be strong to cause fetal descent. Mild contractions will not move the
baby down or open the cervix. This client is experiencing a problem between
the maternal pelvis and the presenting part.
5. When the fetal shoulder is the presenting part, the fetus is in a transverse
lie and the acromion process of the scapula is the landmark. This type of
presentation occurs less than 1% of the time. This client is experiencing a
problem between the maternal pelvis and the presenting part.
Page Ref: 448, 449, 450, 451
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Quality and Safety: Communicate potential risk factors
and actual errors. | Nursing/Integrated Concepts: Nursing Process:
Assessment
Learning Outcome: 2 Examine the five critical factors that affect the labor
process.
MNL LO: 3.3.1 Describe the five processes of labor.
2
Copyright 2016 Pearson Education, Inc.
4) The charge nurse has received the shift change report. Which client
requires immediate intervention?
1. Woman at 6 cm undergoing induction of labor, strong contractions every 3
minutes
2. Woman at 4 cm whose fetus is in a longitudinal lie with a cephalic
presentation
3. Woman at 10 cm and fetus at +2 station experiencing a strong expulsion urge
4. Woman at 3 cm screaming in fear because her mother died during
childbirth
1) How would the nurse best analyze the results from a clients sonogram that
shows the fetal shoulder as the presenting part?
1. Breech, transverse
2. Breech, longitudinal
3. Breech, frank
4. Vertex, transverse
Answer: 1
Explanation: 1. A shoulder presentation is one type of breech presentation,
and is also called a transverse lie.
Page Ref: 449, 450
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3.
Use skills of inquiry, analysis, and information literacy to address practice
issues. | NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 2 Examine the five critical factors that affect the labor
process.
MNL LO: 3.3.1 Describe the five processes of labor.
2) A clinic nurse is preparing diagrams of pelvic shapes. Which pelvic shapes
are considered least adequate for vaginal childbirth?
Note: Credit will be given only for all correct choices and no incorrect
choices.
Select all that apply.
1. Android
2. Anthropoid
3. Gynecoid
4. Platypelloid
,5. Lambdoidal suture
Answer: 1, 4
Explanation: 1. In the android and platypelloid types, the pelvic diameters are
diminished. Labor is more likely to be difficult (longer) and a cesarean birth
is more likely.
4. In the android and platypelloid types, the pelvic diameters are diminished.
Labor is more likely to be difficult (longer) and a cesarean birth is more
likely.
Page Ref: 446, 466
,Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3.
Use skills of inquiry, analysis, and information literacy to address practice
issues. | NLN Competencies: Knowledge and Science: Relationships
1
Copyright 2016 Pearson Education, Inc.
between knowledge/science and quality and safe patient care. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2 Examine the five critical factors that affect the labor
process.
MNL LO: 3.3.1 Describe the five processes of labor.
3) The nurse is caring for laboring clients. Which women are experiencing
problems related to a critical factor of labor?
Note: Credit will be given only for all correct choices and no incorrect
choices.
Select all that apply.
1. Woman at 7 cm, fetus in general flexion
2. Woman at 3 cm, fetus in longitudinal lie
3. Woman at 4 cm, fetus with transverse lie
4. Woman at 6 cm, fetus at -2 station, mild contractions
5. Woman at 5 cm, fetal presenting part is right shoulder
Answer: 3, 4, 5
Explanation: 3. A transverse lie occurs when the cephalocaudal axis of the fetal
spine is at a right angle to the womans spine and is associated with a shoulder
presentation and can lead to complications in the later stages of labor.
4. Station refers to the relationship of the presenting part to an imaginary line
drawn between the ischial spines of the maternal pelvis. If the presenting part
, is higher than the ischial spines, a negative number is assigned, noting
centimeters above zero station. A -2 station is high in the pelvis. Contractions
should be strong to cause fetal descent. Mild contractions will not move the
baby down or open the cervix. This client is experiencing a problem between
the maternal pelvis and the presenting part.
5. When the fetal shoulder is the presenting part, the fetus is in a transverse
lie and the acromion process of the scapula is the landmark. This type of
presentation occurs less than 1% of the time. This client is experiencing a
problem between the maternal pelvis and the presenting part.
Page Ref: 448, 449, 450, 451
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Quality and Safety: Communicate potential risk factors
and actual errors. | Nursing/Integrated Concepts: Nursing Process:
Assessment
Learning Outcome: 2 Examine the five critical factors that affect the labor
process.
MNL LO: 3.3.1 Describe the five processes of labor.
2
Copyright 2016 Pearson Education, Inc.
4) The charge nurse has received the shift change report. Which client
requires immediate intervention?
1. Woman at 6 cm undergoing induction of labor, strong contractions every 3
minutes
2. Woman at 4 cm whose fetus is in a longitudinal lie with a cephalic
presentation
3. Woman at 10 cm and fetus at +2 station experiencing a strong expulsion urge
4. Woman at 3 cm screaming in fear because her mother died during
childbirth
