Processes of Birth: Maternal-Newborn Nursing Exam Questions and Answers, Exams of Nursing

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Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

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 - correct answer ☑☑ 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

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

blood supply to the placenta gradually stops with contractions. 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. - correct answer ☑☑ d. Maternal circulating blood volume increases temporarily during contractions.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

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. Uncontrolled maternal hyperventilation during labor results in a. metabolic acidosis. b. metabolic alkalosis. c. respiratory acidosis. d. respiratory alkalosis. - correct answer ☑☑ d.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

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. 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 - correct answer ☑☑ b. Engagement

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

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.

5. 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

d. pulling the cervix over the fetus and amniotic sac. - correct answer ☑☑ 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 stronger at the fundus. The internal size becomes smaller with the contractions; this helps push the fetus down. PTS: 1 DIF: Cognitive Level: Application REF: 198 Pregnant patients can usually tolerate the normal blood loss associated with childbirth because of which physiologic adaptation to pregnancy? a. A higher hematocrit b. Increased leukocytes

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

c. Increased blood volume d. A lower fibrinogen level - correct answer ☑☑ c. Increased blood volume Women have a significant increase in blood volume during pregnancy. After birth, the additional circulating volume is no longer necessary. The hematocrit decreases with pregnancy because of the high fluid volume. Leukocyte levels increase during labor, but that is not the reason for the toleration of blood loss. Fibrinogen levels increase with pregnancy. The nurse is assessing the duration of a patient's labor contractions. Which method does the nurse implement to assess the duration of labor contractions? a. Assess the strongest intensity of each contraction. b. Assess uterine relaxation between two contractions.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

c. Assess from the beginning to the end of each contraction. d. Assess from the beginning of one contraction to the beginning of the next. - correct answer ☑☑ c. Assess from the beginning to the end of each contraction. Duration of labor contractions is the average length of contractions from beginning to end. Assessing the strongest intensity of each contraction assesses the strength or intensity of the contractions. Assessing uterine relaxation between two contractions is the interval of the contraction phase. Assessing from the beginning of one contraction to the beginning of the next is the frequency of the contractions. Which physiologic event is the key indicator of the commencement of true labor? a. Bloody show b.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

Cervical dilation and effacement c. Fetal descent into the pelvic inlet d. Uterine contractions every 7 minutes - correct answer ☑☑ 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. Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis? a. Station b. Flexion

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

c. Descent d. Engagement - correct answer ☑☑ 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. An increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of a. lightening. b.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

breech presentation. c. urinary tract infection. d. onset of Braxton-Hicks contractions. - correct answer ☑☑ 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. 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

This results from molding. b. This results from lightening. c. This results from the fetal lie. d. This results from the fetal presentation. - correct answer ☑☑ 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. A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor? a.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

Latent phase b. Active phase c. Second stage d. Third stage - correct answer ☑☑ b. Actice 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. 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

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. - correct answer ☑☑ 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. A laboring patient asks the nurse how she will know that the contraction is at its peak. The nurse explains that the contraction peaks during which stage of measurement? a.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

The acme b. The interval c. The increment d. The decrement - correct answer ☑☑ a. The acme A patient in labor presents with a breech presentation. The nurse understands that a breech presentation is associated with a. more rapid labor. b. a high risk of infection. c. maternal perineal trauma. d.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

umbilical cord compression. - correct answer ☑☑ d. umbilical cord compression. The primary difference between the labor of a nullipara and that of a multipara is a. total duration of labor. b. level of pain experienced. c. amount of cervical dilation. d. sequence of labor mechanisms. - correct answer ☑☑ a. total duration of labor. Which maternal factor may inhibit fetal descent during labor? a. A full bladder

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

b. Decreased peristalsis c. Rupture of membranes d. Reduction in internal uterine size - correct answer ☑☑ a. A full bladder Which assessment finding would cause a concern for a patient who had delivered vaginally? a. Estimated blood loss (EBL) of 500 mL during the birth process b. White blood cell count of 28,000 mm3 postbirth c. Patient complains of fingers tingling d. Patient complains of thirst - correct answer ☑☑ c.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

Patient complains of fingers tingling 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. - correct answer ☑☑ b. Notify the health care provider. Which assessment finding indicates that cervical dilation and/or effacement has occurred? a.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

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 - correct answer ☑☑ c. Bloody mucus drainage from vagina 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

buttocks are in the right upper quadrant of the abdomen.

• correct answer ☑☑ c. buttocks are in the left posterior quadrant of the pelvis. 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. - correct answer ☑☑ a. cervical dilation. 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

"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." - correct answer ☑☑ b. "Breathe with me slowly, in through your nose and out through your mouth." 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

On her left side c. On her right side d. On her hands and knees - correct answer ☑☑ b. On her left side 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.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

"You will likely not feel you baby's movements as much now, so do not be concerned." - correct answer ☑☑ b. "That process is called lightening. Do you have to urinate more frequently?" 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 - correct answer ☑☑ c. Stage 1, active phase

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

A laboring patient states to the nurse, "I have to push!" What is the next nursing action? a. Contact the health care provider. b. Examine the patient's cervix for dilation. c. Review with her how to bear down with contractions. d. Ask her partner to support her head with each push. - correct answer ☑☑ b. Examine the patient's cervix for dilation. After birth of the placenta the patient states, "All of a sudden I feel very cold." What is the most appropriate nursing action at this time? a. Place a warm blanket over the patient. b. Place the baby on the patient's abdomen.

Foundations of Maternal-Newborn &

Women's Health Nursing, 7th Edition

Exam Question and Answer

c. Tell the patient that chills are expected after birth. d. "What do you mean by your words 'very cold'?" - correct answer ☑☑ a. Place a warm blanket over the patient. A 28-year-old gravida 1, para 0 patient who is at term calls the labor and birth unit stating that she thinks she is in labor. She states that she does have some vaginal discharge and feels wet; however, it is not bloody in nature. She relates a contraction pattern that is irregular, ranging from 5 to 7 minutes and lasting 30 seconds. Which questions should the nurse pose to the patient during this telephone triage? (Select all that apply.) a. Does she think that her membranes have ruptured? b. Is there any evidence of bloody show? c.