Chapter 09 Labor and Birth Processes

Chapter 09  Labor and Birth Processes

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A new mother asks the nurse when the “soft spot” on her son’s head will go away. The nurse’s answer is based on the knowledge that the anterior fontanel closes after birth by:
a.
2 months.
b.
8 months.
c.
12 months.
d.
18 months.

ANS: D

Feedback
A
The larger of the two fontanels, the anterior fontanel, closes by 18 months after birth.
B
The larger of the two fontanels, the anterior fontanel, closes by 18 months after birth.
C
The larger of the two fontanels, the anterior fontanel, closes by 18 months after birth.
D
The anterior fontanel closes by 18 months after birth.

DIF: Cognitive Level: Knowledge REF: 266
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Planning

2. When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:
a.
Lie.
b.
Presentation.
c.
Attitude.
d.
Position.

ANS: C

Feedback
A
Lie is the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother.
B
Presentation refers to the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor at term.
C
Attitude is the relation of the fetal body parts to one another.
D
Position is the relation of the presenting part to the four quadrants of the mother’s pelvis.

DIF: Cognitive Level: Knowledge REF: 268
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

3. When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother’s right side close to midline. What is the likely position of the fetus?
a.
ROA
b.
LSP
c.
RSA
d.
LOA

ANS: C

Feedback
A
Fetal position is denoted with a three-letter abbreviation. The first letter indicates the presenting part in either the right or left side of the maternal pelvis. The second letter indicates the anatomic presenting part of the fetus. The third letter stands for the location of the presenting part in relation to the anterior, posterior, or transverse portion of the maternal pelvis. Palpation of a round, firm fetal part in the fundal portion of the uterus would be the fetal head, indicating that the fetus is in a breech position with the sacrum as the presenting part in the maternal pelvis. Palpation of the fetal spine along the mother’s right side denotes the location of the presenting part in the mother’s pelvis. The ability to palpate the fetal spine indicates that the fetus is anteriorly positioned in the maternal pelvis.
B
Fetal position is denoted with a three-letter abbreviation. The first letter indicates the presenting part in either the right or left side of the maternal pelvis. The second letter indicates the anatomic presenting part of the fetus. The third letter stands for the location of the presenting part in relation to the anterior, posterior, or transverse portion of the maternal pelvis. Palpation of a round, firm fetal part in the fundal portion of the uterus would be the fetal head, indicating that the fetus is in a breech position with the sacrum as the presenting part in the maternal pelvis. Palpation of the fetal spine along the mother’s right side denotes the location of the presenting part in the mother’s pelvis. The ability to palpate the fetal spine indicates that the fetus is anteriorly positioned in the maternal pelvis.
C
The fetus is positioned anteriorly in the right side of the maternal pelvis with the sacrum as the presenting part. RSA is the correct three-letter abbreviation to indicate this fetal position.
D
Fetal position is denoted with a three-letter abbreviation. The first letter indicates the presenting part in either the right or left side of the maternal pelvis. The second letter indicates the anatomic presenting part of the fetus. The third letter stands for the location of the presenting part in relation to the anterior, posterior, or transverse portion of the maternal pelvis. Palpation of a round, firm fetal part in the fundal portion of the uterus would be the fetal head, indicating that the fetus is in a breech position with the sacrum as the presenting part in the maternal pelvis. Palpation of the fetal spine along the mother’s right side denotes the location of the presenting part in the mother’s pelvis. The ability to palpate the fetal spine indicates that the fetus is anteriorly positioned in the maternal pelvis.

DIF: Cognitive Level: Comprehension REF: 269
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

4. The nurse has received a report about a woman in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and -2. The nurse’s interpretation of this assessment is that:
a.
The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines.
b.
The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
c.
The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines.
d.
The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.

ANS: B

Feedback
A
The sterile vaginal examination is recorded as centimeters of cervical dilation, percentage of cervical dilation, and the relationship of the presenting part to the ischial spines (either above or below). For this woman the cervix is dilated 3 cm and effaced 30%, and the presenting part is 2 cm above the ischial spines.
B
This is the correct description of the vaginal examination for this woman in labor.
C
The sterile vaginal examination is recorded as centimeters of cervical dilation, percentage of cervical dilation, and the relationship of the presenting part to the ischial spines (either above or below). For this woman the cervix is dilated 3 cm and effaced 30%, and the presenting part is 2 cm above the ischial spines.
D
The sterile vaginal examination is recorded as centimeters of cervical dilation, percentage of cervical dilation, and the relationship of the presenting part to the ischial spines (either above or below). For this woman the cervix is dilated 3 cm and effaced 30%, and the presenting part is 2 cm above the ischial spines.

DIF: Cognitive Level: Comprehension REF: 269
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment, Planning

5. Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased?
a.
Semirecumbent
b.
Sitting
c.
Squatting
d.
Side-lying

ANS: C

Feedback
A
Kneeling or squatting moves the uterus forward and aligns the fetus with the pelvic inlet; this can facilitate the second stage of labor by increasing the pelvic outlet.
B
Kneeling or squatting moves the uterus forward and aligns the fetus with the pelvic inlet; this can facilitate the second stage of labor by increasing the pelvic outlet.
C
This position may help increase the pelvic outlet.
D
Kneeling or squatting moves the uterus forward and aligns the fetus with the pelvic inlet; this can facilitate the second stage of labor by increasing the pelvic outlet.

DIF: Cognitive Level: Comprehension REF: 275
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Implementation