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Maternity Chapter 15 Exam Questions with Answers
1. Which of the following would be a danger signal of labor for a woman in labor?:
Meconium-stained amniotic fluid
2. The first stage of labor is often a time of introspection. In light of this, which
information would guide the nurse's planning of nursing care?: A woman may spend time thinking about what is happening to her
3. A nurse is conducting an in-service program for staff nurses working in the labor
and birth unit. The nurse is discussing ways to promote a positive birth outcome for the woman in labor. The nurse determines that additional teaching is necessary when the group identifies which measure?: Allowing the woman time to be alone
4. When caring for a client in the third stage of labor, the nurse notices that the
expulsion of the placenta has not occurred within 5 minutes after birth of the infant. What should the nurse do?: Nothing. Normal time for stage three is 5 to 30 minutes
5. When teaching a group of nursing students about the stages of labor, the nurse
explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation?: effacement
6. After delivery of the placenta, a patient's uterus is sluggish to contract. What should
the nurse prepare to do to assist the patient at this time?: Administer oxytocin (pitocin) as prescribed
7. A pregnant client in labor has to undergo a sonogram to confirm the fetal position of
a shoulder presentation. For which condition associated with shoulder presentation during a vaginal birth should the nurse assess?: Fetal anomalies
8. A client calls the clinic asking to come in to be evaluated. She states that when
she went to bed last night the fetus was high in the abdomen, but this morning the fetus feels like it has dropped down. After asking several questions, the nurse explains this is probably due to:: Lightening
9. The nurse is assisting the health care provider with the pelvic assessment of a
pregnant client. The nurse concludes that the obstetric conjugate will be how long if the distance between the symphysis pubis and sacral promontary is 13 cm?: 11 cm
10. When going through the transition phase of labor, women often feel out of control.
What do women in the transition phase of labor need the most?: Pos- itive reinforcement
11. A woman is in the second stage of labor and is crowning. Which diameter of the
fetal skull that is smallest should align with the anteroposterior diameter of the mother's pelvis, which is the narrowest diameter at the pelvic inlet?: - transverse (biparietal)
contractions is every 5 minutes
18. The new parents are spending time with their newborn. However, they are
concerned with the edema and ecchymosis on the baby's scalp. How should the nurse explain this to the parents after noting the baby was ROA in labor?: Ecchymosis with edema on the scalp is where the infant was pushed out of the canal.
19. Which changes in the female body occur to allow the passage of the fetus down the
birth canal? Select all that apply.: Vaginal rugae stretch and smooth out, cervix dilates to 10cm and cervix softens
20. Assessment reveals that the fetus of a client in labor is in the vertex
presentation. The nurse determines that which part is presenting?: occiput
21. A client in labor has been admitted to the labor and birth suite. The nurse
assessing her notes that the fetus is in a cephalic presentation. Which description should the nurse identify by the term presentation?: part of the fetal body entering the maternal pelvis first
22. During the active stage of labor, a patient's membranes spontaneously rupture.
Which action should the nurse do first after this occurs?: Assess fetal heart rate for fetal safety
23. The nurse is determining how often contractions occur measuring from the
beginning of the one contraction to the beginning of the next contraction. The nurse documents this finding as:: frequency
24. A pregnant woman at 37 weeks gestation calls the clinic to say she thinks that she
is in labor. The nurse instructs the woman to go to the health care facility based on the client's report of contractions that are:: occurring about every 5 minutes
25. Assessment of a woman in labor reveals that the scapula of the fetus is the
presenting part. The nurse interprets this finding as indicating which fetal presentation?: Shoulder
26. A 37-year-old primigravida client at 40 weeks' gestation is seen in the clinic for a
scheduled prenatal visit. The nurse predicts the woman is close to labor based on which assessment finding?: Nesting
27. A primigravida client at 39 weeks' gestation calls the OB unit questioning the nurse
about being in labor. Which response should the nurse prioritize?- : Ask the woman to describe why she believes that she is in labor
28. The nurse identifies from a client's prenatal record that she has a doc- umented
gynecoid pelvis. Upon the client entering the labor and delivery department, which nursing action is best?: Take no extra measures; prepare for a standard labor
29. Which physical characteristic of the neonate is typically present in the neonate
of a primigravid mother?: Significant head molding
between contractions during labor?: restoration of blood flow to uterus and placenta
36. The nurse is teaching a prenatal class on the difference between true and false
labor contractions. The nurse determines the session is successful when the class correctly chooses which factor as an indication of true labor contraction?: increase even if relaxing and taking a shower
37. The community health nurse is conducting a presentation on labor and delivery.
When illustrating the birth process, the nurse should point out zero station refers to which sign?: "The presenting part is at the true pelvis and is engaged."
38. The nursing instructor is illustrating the various positions the fetus may utilize
during the passage through the vaginal canal at birth. The instructor determines the session is successful when the students correctly identify the ROA position, indicating which presentation by the fetus?: Facing the right anterior pelvic quadrant
39. A primigravidia client at 38 weeks' gestation calls the clinic and reports, "My baby
is lower and it is more difficult to walk." Which response should the nurse prioritize?: "The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."
40. When teaching a group of soon-to-be parents about the structures of
the fetal skull, the nurse describes the anterior fontanelle. Which description would the nurse include?: Approximately 2-3cm in size
41. The nurse is reviewing the laboratory test results of a client in labor. Which finding
would the nurse consider normal?: Increase WBC
42. A nurse performs an initial assessment of a laboring woman and reports the
following findings to the primary care provider: fetal heart rate is 152 bpm, cervix is 100% effaced and 5 cm dilated, membranes are intact, and presenting part is well applied to the cervix and at -1 station. The nurse recognizes that the client is in which stage of labor?: First, Active
43. A multigravid client has been in labor for several hours and is becoming anxious
and distressed with the intensity of her frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor?: transition phase
44. During labor, a fetus is identified as having uteroplacental insufficiency. Which
tracing should the nurse assess on the monitor to confirm this find- ing?: Fetal heart rate declining late with contractions and remaining depressed
45. While conducting Leopold maneuvers, the nurse determines that the fourth
maneuver does not need to be done. What information caused the nurse to make this decision?: The fetus is not in a cephalic presentation
46. The nurse has been asked to present information to a group of civic leaders
51. A pregnant patient in labor is being encouraged to push with contractions. In which
position should the nurse assist to help the patient at this time?: - Semi-Fowler's position with legs bent against the abdomen
52. Assessment of a pregnant client reveals that she is experiencing Braxton
-Hicks contractions. Which of the following would the nurse explain as the cause of these contractions?: Uterine distention
53. When explaining to a class of pregnant women why labor begins, the nurse will
include the fact that there are several theories that have been proposed to explain why labor begins, although none have been proven scientifically. Which idea is one of those theories?: change in estrogen-to-progesterone ratio
54. A nurse sees a pregnant client at the clinic. The client is close to her due
date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?: increased risk of infection
55. A nurse is explaining to a pregnant client about the changes occurring in the body
in preparation for labor. Which hormone would the nurse include in the explanation as being responsible for causing the pelvic connective tissue to become more relaxed and elastic?: Relaxin
56. A 33-year-old client has been progressing slowly through an unusually long
labor. The nurse assesses the fetal scalp pH and determines it is 7.26. How should the nurse explain this result to the client when asked what it means?: Reassuring; it is associated with normal acid-base balance
57. The nurse is caring for a client who is late in her pregnancy. What assess- ment
finding should the nurse attribute to the role of prostaglandins?: The cervix is softening
58. A nursing instructor is conducting a class on the various types of pelvic shapes to
a group of nursing students. The instructor determines the class is successful when the students correctly choose which factor is specific for an anthropoid pelvis?: Is narrow transversely
59. A nurse is educating a group of nursing students about the molding of the fetal
skull during the birth process. What would the nurse include as the usual cause of molding?: poorly ossified bones of the cranial vault
60. Place the following stages of labor in order from what occurs first to last. All
options must be used.: Latent, active, transition phases; Second phase; Third phase
61. During a prenatal visit a pregnant client asks the nurse how to tell whether the
contractions she is having are true contractions or Braxton Hicks contrac- tions. Which description should the nurse mention as characteristic of true contractions?: increase in duration, frequency, and intensity; felt first in lower back and sweep around to the
client has moved into the active phase based on which assessment findings? Select all that apply.: Contractions lasting up to 60s; cervical dilation 6cm
68. When educating a group of nursing students about the different types of pelvis,
the nurse describes one type as being flat, having a wider transverse diameter than anterior-posterior diameter, with ischial spines that are wide apart, and a short sacrum. The students are correct when they identify this description with which type?: Platypelloid
69. The nurse is determining care for a patient entering the active phase of labor.
Which outcome would be the most appropriate for the patient at this time?: Patient will adjust body to attain the most comfortable position
70. A client in her third trimester of pregnancy arrives at a health care facility with a
report of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities, along with an increase in vaginal discharge. What should the nurse do next?: Continue to monitor the client
71. A client in the third stage of labor has experienced placental separation and
expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm?: to constrict the uterine blood vessels
72. A nurse is assigned the task of educating a pregnant client about birth. Which
nursing interventions should the nurse perform as a part of prenatal education for the client to ensure a positive birth experience? Select all that apply.: Encourage the client to have a sense of mastery and self-control; Encourage the client to have a positive reaction to pregnancy; Provide the client clear information on procedures involved
73. The nurse is providing care to a client in labor. On examination, the nurse
determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is:: 1 cm above the ischial spines
74. A nurse is admitting a client who presents in active labor at 41 weeks' gestation.
The nurse prepares for the possibility of a cesarean delivery after noting the client has which type of pelvis documented?: Andriod
