1|Page
NM 704 FINAL EXAM LATEST 2026-2027 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
What are the major muscles of the pelvic floor and perineum ?
Varney's Midwifery pp. 316-21 - ANSWER-Pelvic ligaments
Pelvic floor (contains levator ani, endopelvic fascia, pelvic
diaphragm, perineal diaphragm, superficial perineal muscles)
Inspection of the cervix, vagina, and perineum - ANSWER-Should
be done when greater than normal bleeding happens with a firm
uterus
If a laceration extends into the uterus from the cervix, transfer to a
MD for repair must be done.
If the cervx is bleeding from a cervical laceration, place a ring
forceps on either side of the laceration to stop significant bleeding
Less than 2cm do not need repair
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What is a placental calcification? - ANSWER-gritty white areas of
calcification
Quantity is not of significant importance
What is a succenturiate placenta? - ANSWER-one or more
accessory lobes connected to the body of the placenta by blood
vessels
What do we know about pain meds in second stage of labor? -
ANSWER-They prolong 2nd stage labor
Increase the likelihood of operative vaginal deliveries
Studies are unclear whether they increase or do not increase the
rate of csection
Which pain med is short acting and has very few side effects
compared to morphine? - ANSWER-Fentanyl
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Do epidurals increase the length of 3rd stage labor? - ANSWER-
no, false
Direted or coached pushing is known to decrease the length of
2nd stage labor by up to an hour compared to spontaneous
pushing - ANSWER-False. Coached oushing can decrease the
amount of oxygen for the parent and the child and make them
acidotic
What is more likely to occur with prolonged second stage labor? -
ANSWER-MAternal morbidity rises
neonatal outcomes are unclear
fever, fistulas, choreoamnionitis
When does the fetal ejection reflex (ferguson reflex/urge to push)
occur? What precipitates it? - ANSWER-The stretch receptors on
the pelvic floor are activated by downward progression of the
fetus and signals a positive feedback loop to continue to push the
fetus out
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The nerves send a message to the brain, the brain makes more
oxytocin, oxytocin makes contractions stronger which emphasizes
increased pressure and stretch. this occurs until fetus is expelled
what are the outcomes of water birth compared to traditional? -
ANSWER-outcomes are similar across both types of births
What are the signs of placental separation? - ANSWER-1. fresh
flow of blood from vagina
2. umbilical cord lengthens outside vagina
3. uterine fundus rises up
4. uterus goes from discoid and becomes firm and globular
How do we avoid 3rd stage complications? - ANSWER-do not pull
on the cord
do not massage the fundus
What is expectant management of 3rd stage labor? (use SDM) -
ANSWER-Expectant management of third stage in the context of
a physiological labor and birth is a more recent topic of research.
NM 704 FINAL EXAM LATEST 2026-2027 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
What are the major muscles of the pelvic floor and perineum ?
Varney's Midwifery pp. 316-21 - ANSWER-Pelvic ligaments
Pelvic floor (contains levator ani, endopelvic fascia, pelvic
diaphragm, perineal diaphragm, superficial perineal muscles)
Inspection of the cervix, vagina, and perineum - ANSWER-Should
be done when greater than normal bleeding happens with a firm
uterus
If a laceration extends into the uterus from the cervix, transfer to a
MD for repair must be done.
If the cervx is bleeding from a cervical laceration, place a ring
forceps on either side of the laceration to stop significant bleeding
Less than 2cm do not need repair
,2|Page
What is a placental calcification? - ANSWER-gritty white areas of
calcification
Quantity is not of significant importance
What is a succenturiate placenta? - ANSWER-one or more
accessory lobes connected to the body of the placenta by blood
vessels
What do we know about pain meds in second stage of labor? -
ANSWER-They prolong 2nd stage labor
Increase the likelihood of operative vaginal deliveries
Studies are unclear whether they increase or do not increase the
rate of csection
Which pain med is short acting and has very few side effects
compared to morphine? - ANSWER-Fentanyl
,3|Page
Do epidurals increase the length of 3rd stage labor? - ANSWER-
no, false
Direted or coached pushing is known to decrease the length of
2nd stage labor by up to an hour compared to spontaneous
pushing - ANSWER-False. Coached oushing can decrease the
amount of oxygen for the parent and the child and make them
acidotic
What is more likely to occur with prolonged second stage labor? -
ANSWER-MAternal morbidity rises
neonatal outcomes are unclear
fever, fistulas, choreoamnionitis
When does the fetal ejection reflex (ferguson reflex/urge to push)
occur? What precipitates it? - ANSWER-The stretch receptors on
the pelvic floor are activated by downward progression of the
fetus and signals a positive feedback loop to continue to push the
fetus out
, 4|Page
The nerves send a message to the brain, the brain makes more
oxytocin, oxytocin makes contractions stronger which emphasizes
increased pressure and stretch. this occurs until fetus is expelled
what are the outcomes of water birth compared to traditional? -
ANSWER-outcomes are similar across both types of births
What are the signs of placental separation? - ANSWER-1. fresh
flow of blood from vagina
2. umbilical cord lengthens outside vagina
3. uterine fundus rises up
4. uterus goes from discoid and becomes firm and globular
How do we avoid 3rd stage complications? - ANSWER-do not pull
on the cord
do not massage the fundus
What is expectant management of 3rd stage labor? (use SDM) -
ANSWER-Expectant management of third stage in the context of
a physiological labor and birth is a more recent topic of research.
