Chapter 13 Prep U questions

C) ROA

A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus? A)LOA B)LOP C)ROA D) ROP

C) At the time of placental delivery

During which time is the nurse correct to document the end of the third stage of labor? A) Following fetal birth B) When pushing begins C) At the time of placental delivery D) When the mother is moved to the postpartum unit

D) crowning

The nurse notes that the fetal head is at the vaginal opening and does not regress between contractions. The nurse interprets this finding as which process? A) engagement B) Descent C) restitution D) crowning

A) Oxytocin B) Progesterone C) Prostaglandins

The nurse is instructing on maternal hormones which may impact the onset of labor hormones are included in the discussion? Select all the apply A)Insulin B)Thyroxin C)Progesterone D)Testorterone E)Oxytocin F)Prostaglandins

A) Radiates from the back to the front

A pregnant woman comes to the emergency department stating that she thinks she is in labor. Which assessment finding concerning the pain will the nurse interprets as confirmation that the client is in true labor? A) Radiates from the back to the front B)Slows when the woman changes position C) Occurs in an irregular pattern D) Lasts about 20 to 25 seconds

D) 8-10

The nurse has been monitoring a multipara client for several hours. She cries out that her contractions are getting harder and that she cannot do this. The nurse notes the client is very irritable, nauseated, annoyed, and doesn't want to be left alone. Based on the assessment the nurse predicts the cervix to be dilated how many centimeters? A) 0 to 2 B) 5 to 7 C) 3 to 4 D) 8 to 10

C) The fetus is in the true pelvis and engaged

The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which? A) The client is fully effaced. B)The fetus is floating high in the pelvis C) The fetus is in the true pelvis and engaged D) The fetus has descended down the birth canal

C) head elevated, grasping knees, breathing out Rationale: For the most effective pushing during the second stage of labor, a woman should wait to feel the urge to push even though a pelvic exam has revealed she is fully dilated. Pushing is usually best done from a semi-Fowler's position with legs raised against the abdomen, squatting, or on all fours rather than lying flat to allow gravity to aid the effort .Make sure the woman pushes with contractions and rests between them. She can use short pushes or long, sustained ones, whichever feels more comfortable. Holding the breath during a contraction could cause a Valsalva maneuver or temporarily impede blood return to her heart because of increased intrathoracic pressure, which could then also interfere with blood supply to the uterus. To prevent her from holding her breath during pushing, urge her to grunt or breathe out during a pushing effort (as tennis players do).

To give birth to her infant, a woman is asked to push with contractions. Which pushing technique is the most effective and safest? A) lying supine with legs in lithotomy stirrups B) squatting while holding her breath C) head elevated, grasping knees, breathing out D) lying on side, arms grasped on abdomen

A) "I feel pressure in my vagina when I have the contraction" Rationale: True labor is characterized by contractions occurring at regular intervals that increase in frequency, duration, and intensity. True labor contractions bring about progressive cervical dilation and effacement. True labor contractions are regular, becoming closer together, getting stronger with time with pressure in the vagina being felt. In contrast, false labor contractions are usually felt in the front of the abdomen, alternate in intensity (strong one followed by a weaker one), and diminish with activity, position changes, and drinking fluids.

A client calls the prenatal clinic and tells the nurse, "I think I am in labor." The nurse determines that the client is in true labor based on which client statement? A) "I feel pressure in my vagina when I have the contraction"

AP pain from the dilation (dilatation) or stretching of the cervix

A client is in the first stage of labor and asks the nurse what type of pain she should expect at this stage. What is the nurse's most appropriate response? A) pain from the dilation or stretching of the cervix B) Hypoxia of the contracting uterine muscles C) distention of the vagina and perineum D) pressure on the lower back, buttocks, and thighs

Shoulder Rationale:Shoulder presentations are the least likely to occur. They occur in less than 0.3% of all births. Approximately 97% of fetuses are in a cephalic presentation at the end of pregnancy. A longitudinal lie, in which the long axis of the fetus is parallel to the long axis of the mother, is the most common. When the fetus is in a transverse lie, the long axis of the fetus is perpendicular to the long axis of the woman. An oblique lie is in between the two.

The nurse is preparing to teach a group of soon-to-be new parents about the labor process. When detailing the differences between the various presentations, which one should the nurse point out seldom happens?