Chapter 12 The Process of Labor and Birth

Chapter 12  The Process of Labor and Birth

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The perinatal nurse is assessing a woman at 36 weeks’ gestation. Her fundal height measurement was last recorded at 34 cm. The patient’s abdomen appears to be widest from side to side. The nurse suspects the possibility of which type of fetal presentation?
A.
Breech
B.
Cephalic
C.
Face
D.
Shoulder

ANS: D
The fetal presentation may be cephalic, breech, or shoulder. The part of the fetal body first felt by the examining finger during a vaginal examination is the “presenting part.” The shoulder presentation is a transverse lie. This presentation is rare and occurs in less than 1% of births. When a transverse lie is present, the maternal abdomen appears large from side to side rather than up and down. The fetal head is palpated on one maternal side and the breech is palpated on the other side. Additionally, the woman may demonstrate a lower-than-expected fundal height measurement for gestational age.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1

2. The perinatal nurse assessing a laboring woman’s contraction intensity by internal monitoring would expect, during the transition phase, a reading in which of the following ranges?
A.
10 to 12 mm Hg
B.
20 to 40 mm Hg
C.
50 to 70 mm Hg
D.
70 to 90 mm Hg

ANS: D
One method to measure the intensity of uterine contractions is with the use of an internal monitor. If the amniotic membranes have ruptured, an internal pressure catheter is inserted through the cervix and into the uterus to measure the internal pressure generated during the contraction. Normally, the resting pressure in the uterus (between contractions) is 10 to 12 mm Hg. During the acme, contraction intensity ranges from 25 to 40 mm Hg during early labor, 50 to 70 mm Hg during active labor, 70 to 90 mm Hg during the transition phase, and 70 to 100 mm Hg during maternal pushing in the second stage.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1

3. The perinatal nurse knows that when the fetal head is fully extended and the occiput is near the spine, the delivery team should prepare for the presenting fetal part to be which of the following?
A.
Brow
B.
Chin
C.
Face
D.
Sacrum

ANS: C
In the face presentation, the fetal head is fully extended and the occiput is near the fetal spine. The submentobregmatic diameter presents to the maternal pelvis; the face is the presenting part.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Assessment
Difficulty: Easy

PTS: 1

4. The perinatal nurse describes different breech positions to the student nurse. The fetal position with extended legs toward the fetal shoulders is best described as which of the following?
A.
Complete breech
B.
Footling breech
C.
Frank breech
D.
Incomplete breech

ANS: C
There are three types of breech presentations: frank, complete, and footling. The frank breech is the most common of all breech presentations. In this position, the fetal legs are completely extended up toward the fetal shoulders. The hips are flexed, the knees are extended, and the fetal buttocks present first in the maternal pelvis. The complete, or full, breech position is the same as the frank breech position, except the knees are flexed and the legs crossed, with the fetal buttocks presenting first. In the footling breech position, one or both of the fetal leg(s) are extended, with one foot (“single footling”) or both feet (“double footling”) presenting first into the maternal pelvis.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

5. The perinatal nurse is describing the process of fetal engagement to a group of first-time parents in a prenatal class. The nurse explains that in primigravidas, the usual time for engagement to occur is which of the following?
A.
2 weeks before the due date
B.
4 weeks before the due date
C.
6 weeks before the due date
D.
During labor

ANS: A
Engagement is said to have occurred when the widest diameter of the fetal presenting part has passed through the pelvic inlet. In primigravidas, engagement usually occurs approximately 2 weeks before the due date. In multiparas, engagement may occur many weeks before the onset of labor, or it may take place during labor.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1