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Maternal-Newborn & Women's Health Nursing: Processes of Birth - Questions & Answers, Exams of Nursing

Western Washington University (WWU)Nursing

A series of multiple-choice questions and answers focusing on the physiological processes of childbirth. it covers key aspects of labor, including uterine contractions, maternal vital signs, respiratory changes, cervical dilation, and fetal positioning. the questions are designed to test understanding of the complex physiological adaptations during labor and delivery, making it a valuable resource for nursing students.

Typology: Exams

2024/2025

Available from 05/02/2025

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CHAPTER 12 PROCESSES OF BIRTH FOUNDATIONS OF
MATERNAL-NEWBORN & WOMEN'S HEALTH NURSING,
7TH EDITION-QUESTIONS WITH CORRECT ANSWERS
1. The nurse is explaining the physiology of uterine contractions to a group of nursing students. Which
statement best explains the maternal-fetal exchange of oxygen and waste products during a
contraction?
a. Little to no affect
b. Increases as blood pressure decreases
c. Diminishes as the spiral arteries are compressed
d .Continues except when placental functions are reduced
c. Diminishes as the spiral arteries are compressed
During labor contractions, the maternal blood supply to the placenta gradually stops as the spiral
arteries supplying the intervillous space are compressed by the contracting uterine muscle. The
exchange of oxygen and waste products is affected by contractions. The exchange of oxygen and waste
products decreases. The maternal blood supply to the placenta gradually stops with contractions.
2. The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between
contractions. Which statement is the appropriate rationale for assessing maternal vital signs between
contractions rather than at another interval?
a. Vital signs taken during contractions are inaccurate.
b. During a contraction, assessing fetal heart rate is the priority.
c. Maternal blood flow to the heart is reduced during contractions.
d. Maternal circulating blood volume increases temporarily during contractions.
d. Maternal circulating blood volume increases temporarily during contractions.
During uterine contractions, blood flow to the placenta temporarily stops, causing a relative increase in
the mother's blood volume, which in turn temporarily increases blood pressure and slows the pulse.
Vital signs are altered by contractions but are considered accurate for a period of time. It is important to
monitor the fetal response to contractions, but the question is concerned with the maternal vital signs.
Maternal blood flow is increased during a contraction.
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CHAPTER 12 PROCESSES OF BIRTH FOUNDATIONS OF

MATERNAL-NEWBORN & WOMEN'S HEALTH NURSING,

7TH EDITION-QUESTIONS WITH CORRECT ANSWERS

  1. The nurse is explaining the physiology of uterine contractions to a group of nursing students. Which statement best explains the maternal-fetal exchange of oxygen and waste products during a contraction? a. Little to no affect b. Increases as blood pressure decreases c. Diminishes as the spiral arteries are compressed d .Continues except when placental functions are reduced c. Diminishes as the spiral arteries are compressed During labor contractions, the maternal blood supply to the placenta gradually stops as the spiral arteries supplying the intervillous space are compressed by the contracting uterine muscle. The exchange of oxygen and waste products is affected by contractions. The exchange of oxygen and waste products decreases. The maternal blood supply to the placenta gradually stops with contractions.
  2. The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between contractions. Which statement is the appropriate rationale for assessing maternal vital signs between contractions rather than at another interval? a. Vital signs taken during contractions are inaccurate. b. During a contraction, assessing fetal heart rate is the priority. c. Maternal blood flow to the heart is reduced during contractions. d. Maternal circulating blood volume increases temporarily during contractions. d. Maternal circulating blood volume increases temporarily during contractions. During uterine contractions, blood flow to the placenta temporarily stops, causing a relative increase in the mother's blood volume, which in turn temporarily increases blood pressure and slows the pulse. Vital signs are altered by contractions but are considered accurate for a period of time. It is important to monitor the fetal response to contractions, but the question is concerned with the maternal vital signs. Maternal blood flow is increased during a contraction.
  1. Uncontrolled maternal hyperventilation during labor results in a. metabolic acidosis. b. metabolic alkalosis. c. respiratory acidosis. d. respiratory alkalosis. d. respiratory alkalosis. Rapid deep respirations cause the laboring woman to lose carbon dioxide through exhalation, resulting in respiratory alkalosis. Hyperventilation does not cause respiratory acidosis, metabolic acidosis, or metabolic alkalosis.
  2. Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet? a. Extension b. Engagement c. Internal rotation d. External rotation b. Engagement Engagement occurs when the presenting part fully enters the pelvic inlet. Extension occurs when the fetal head meets resistance from the tissues of the pelvic floor and the fetal neck stops under the symphysis. This causes the fetal head to extend. Internal rotation occurs when the fetus enters the pelvic inlet. The rotation allows the longest fetal head diameter to conform to the longest diameter of the maternal pelvis. External rotation occurs after the birth of the head. The head then turns to the side so the shoulders can internally rotate and are positioned with their transverse diameter in the anteroposterior diameter of the pelvic outlet.
  3. The laboring patient asks the nurse how the labor contractions cause the cervix to dilate. The nurse responds that labor contractions facilitate cervical dilation by a. promoting blood flow to the cervix. b. contracting the lower uterine segment. c. enlarging the internal size of the uterus. d. pulling the cervix over the fetus and amniotic sac. d. pulling the cervix over the fetus and amniotic sac. Effective uterine contractions pull the cervix upward at the same time the fetus and amniotic sac are pushed downward. Blood flow decreases to the uterus during a contraction. The contractions are

b. Cervical dilation and effacement The conclusive distinction between true and false labor is that contractions of true labor cause progressive change in the cervix. Bloody show can occur before true labor. Fetal descent can occur before true labor. False labor may have contractions that occur this frequently but is usually inconsistent.

  1. Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis? a. Station b. Flexion c. Descent d. Engagement b. Flexion The anterior-posterior diameter of the head varies with how much it is flexed. In the most favorable situation, the head is fully flexed and the anterior-posterior diameter is the suboccipitobregmatic, averaging 9.5 cm. The station is the relationship of the fetal presenting part to the level of the ischial spine. Descent is the moving of the fetus through the birth canal. Engagement occurs when the largest diameter of the fetal presenting part has passed the pelvic outlet.
  2. An increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of a. lightening. b. breech presentation. c. urinary tract infection. d. onset of Braxton-Hicks contractions. a. lightening. As the fetus descends toward the pelvic inlet near the end of pregnancy, increased pelvic pressure occurs, resulting in greater urinary frequency and more leg cramps. Breech presentation does not cause urinary frequency and leg cramps. A urinary tract infection may cause urinary frequency but with burning and would not cause leg cramps. Braxton-Hicks contractions are irregular and mild and occur throughout the pregnancy.
  1. A patient just delivered her baby via the vaginal route. The patient asks the nurse why the baby's head is not round, but oval. Which explanation should the nurse provide the patient? a. This results from molding. b. This results from lightening. c. This results from the fetal lie. d. This results from the fetal presentation. a. This results from molding. The sutures and fontanels allow the bones of the fetal head to move slightly, changing the shape of the fetal head so it can adapt to the size and shape of the pelvis. Lightening is the descent of the fetus toward the pelvic inlet before labor. Lie is the relationship of the long axis of the fetus to the long axis of the mother. Presentation is the fetal part that first enters the pelvic outlet.
  2. A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor? a. Latent phase b. Active phase c. Second stage d. Third stage b. Active Phase The active phase of labor is characterized by cervical dilation of 4 to 7 cm. The latent phase is from the beginning of true labor until 3 cm of cervical dilation. The second stage of labor begins when the cervix is completely dilated until the birth of the baby. The third stage of labor is from the birth of the baby until the expulsion of the placenta.
  3. The nurse is assessing a patient in the active phase of labor. What should the nurse expect during this phase? a. The patient is sociable and excited. b. The patient is requesting pain medication. c. The patient begins to experience the urge to push. d. The patient experiences loss of control and irritability. b. The patient is requesting pain medication. During the active phase of labor, contraction intensity and discomfort increase to the point where women often request pain medication. Sociability and excitability occur during the latent phase. The urge to push occurs at the end of the transition phase or the second stage of labor. Loss of control and irritability occur during the transition phase of labor.

b. White blood cell count of 28,000 mm3 postbirth c. Patient complains of fingers tingling d. Patient complains of thirst c. Patient complains of fingers tingling

  1. On admission to the labor and birth unit, a 38-year-old female, gravida 4, para 3, at term in early labor is found to have a transverse lie on vaginal examination. What is the priority intervention at this time? a. Perform a vaginal exam to denote progress. b. Notify the health care provider. c. Initiate parenteral therapy. d. Apply oxygen via nasal cannula at 8 L/minute. b. Notify the health care provider.
  2. Which assessment finding indicates that cervical dilation and/or effacement has occurred? a. Onset of irregular contractions b. Cephalic presentation at 0 station c. Bloody mucus drainage from vagina d. Fetal heart tones (FHTs) present in the lower right quadrant c. Bloody mucus drainage from vagina
  3. If a notation on the patient's health record states that the fetal position is LSP, this indicates that the a. head is in the right posterior quadrant of the pelvis. b. head is in the left anterior quadrant of the pelvis. c. buttocks are in the left posterior quadrant of the pelvis. d. buttocks are in the right upper quadrant of the abdomen. c. buttocks are in the left posterior quadrant of the pelvis.
  4. To determine if the patient is in true labor, the nurse would assess for changes in a. cervical dilation. b. amount of bloody show. c. fetal position and station. d. pattern of uterine contractions. a. cervical dilation.
  1. The health care provider for a laboring patient makes the following entry into the patient's record: 3/50%/+1. What instruction will the nurse implement with the patient? a. "You will need to remain in bed attached to the electronic fetal monitor." b. "Breathe with me slowly, in through your nose and out through your mouth." c. "I will begin the administration of 1000 mL of IV fluid so you can have an epidural." d. "Your partner will need to change into scrub attire to attend the imminent birth." b. "Breathe with me slowly, in through your nose and out through your mouth."
  2. The examiner indicates to the labor nurse that the fetus is in the left occiput anterior (LOA) position. To facilitate the labor process, how will the nurse position the laboring patient? a. On her back b. On her left side c. On her right side d. On her hands and knees b. On her left side
  3. The primiparous patient at 39 weeks' gestation states to the nurse, "I can breathe easier now." What is the nurse's most appropriate response? a. "Your labor will start any day now since the baby has dropped." b. "That process is called lightening. Do you have to urinate more frequently?" c. "Contact your health care provider when your contractions are every 5 minutes for 1 hour." d. "You will likely not feel you baby's movements as much now, so do not be concerned." b. "That process is called lightening. Do you have to urinate more frequently?"
  4. The nurse assesses a laboring patient's contraction pattern and notes the frequency at every 3 to 4 minutes, duration 50 to 60 seconds, and the intensity is moderate by palpation. What is the most accurate documentation for this contraction pattern? a. Stage 1, latent phase b. Stage 2, latent phase c. Stage 1, active phase d. Stage 2, active phase c. Stage 1, active phase

d. In true labor, contractions are inconsistent in frequency, duration, and intensity in the early stages. e. In true labor your contractions tend to increase in frequency, duration, and intensity with walking. a. n true labor, the cervix begins to dilate. c. In true labor, contractions often resemble menstrual cramps during early labor. e. In true labor your contractions tend to increase in frequency, duration, and intensity with walking.

  1. The nurse who elects to practice in the area of obstetrics often hears discussion regarding the four Ps. What are the four Ps that interact during childbirth? (Select all that apply.) a. Powers b. Passage c. Position d. Passenger e. Psyche a. Powers b. Passage d. Passenger e. Psyche
  2. The nurse is planning care for a patient during the fourth stage of labor. Which interventions should the nurse plan to implement? (Select all that apply.) a. Offer the patient a warm blanket. b. Place an ice pack on the perineum. c. Massage the uterus if it is boggy. d. Delay breastfeeding until the patient is rested. e. Explain to the patient that the lochia will be light pink in color. a. Offer the patient a warm blanket. b. Place an ice pack on the perineum. c. Massage the uterus if it is boggy.
  3. Which clinical finding should the nurse expect to assess in the third stage of labor that indicates the placenta has separated from the uterine wall? (Select all that apply.) a. A gush of blood appears. b. The uterus rises upward in the abdomen. c. The fundus descends below the umbilicus. d. The cord descends further from the vagina. e. The uterus becomes boggy and soft, with an elongated shape.

a. A gush of blood appears. b. The uterus rises upward in the abdomen. d. The cord descends further from the vagina.

  1. The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all that apply.) a. Progesterone levels become higher than estrogen levels. b. Natural oxytocin in conjunction with other substances plays a role. c. Stretching, pressure, and irritation of the uterus and cervix increase. d. The secretion of prostaglandins from the fetal membranes decreases. b. Natural oxytocin in conjunction with other substances plays a role. c.Stretching, pressure, and irritation of the uterus and cervix increase.