Ob Chapter 16

Front 1

With regard to primary and secondary powers, the maternity nurse should understand that:
a) Primary powers are responsible for effacement and dilation of the cervix
b) Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnancies
c) Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation
d) Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs

Back 1

Primary powers are responsible for effacement and dilation of the cervix

Front 2

Nurses can advise their clients that all are signs that precede labor except:
a) A return of urinary frequency as a result of increased bladder pressure
b) Persistent low backache from relaxed pelvic joints
c) Stronger and more frequent uterine (Braxton Hicks) contractions
d) A decline in energy, as the body stores up for labor

Back 2

A decline in energy, as the body stores up for labor

Front 3

In order to accurately assess the health of the mother accurately during labor, the nurse should be aware that:
a) The woman's blood pressure increases during contractions and falls back to prelabor normal between contractions
b) Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia
c) Having the woman point her toes reduces leg cramps
d) The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation

Back 3

The endogenous endorphins released during labor raise the womans pain threshold and produce sedation

Front 4

The nurse knows that the second stage of labor, the descent phase, has begun when:
a) The amniotic membranes rupture
b) The cervix cannot be felt during a vaginal examination
c) The woman experiences a strong urge to bear down
d) The presenting part is below the ischial spines

Back 4

The woman experiences a strong urge to bear down

Front 5

All statements about normal labor are true except:
a) A single fetus presents by vertex
b) It is completed within 8 hours
c) A regular progression of contractions, effacement, dilation, and descent occurs
d) No complications are involved

Back 5

It is completed within 8 hours

Front 6

Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?
a) Latent: milk, regular contractions; no dilation; blood show; duration of 2 to 4 hours
b) Active: moderate, regular contractions; 4 to 7cm dilation; duration of 3 to 6 hours
c) Lull: no contractions; dilation stable; duration of 20 to 60 minutes
d) Transition: very strong but irregular contractions; 8 to 10cm dilation; duration of 1 to 2 hours

Back 6

Active: moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hours

Front 7

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

Back 7

Squatting

Front 8

Fetal circulation can be affected by many factors during labor. Accurate assessment of the laboring woman and fetus requires knowledge of these expected adaptations. Which factor will not affect fetal circulation during labor?
a) Fetal position
b) Uterine contractions
c) Blood pressure
d) Umbilical cord blood flow

Back 8

Fetal position

Front 9

Concerning the third stage of labor, nurses should be aware that:
a) The placenta eventually detaches itself from a flaccid uterus
b) The duration of the third stage may be as short as 3 to 5 minutes
c) It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surface
d) The major risk for women during the third stage is a rapid heart rate

Back 9

The duration of the third stage may be as short as 3 to 5 minutes