Review Questions

1.

What is a direct influence on cervical dilation? Select all that apply.

1. positioning of the pregnant person
2. strength of uterine contractions
3. length of time since ROM
4. fetal presentation
5. time of last bowel movement

2.

The nurse is providing discharge instructions to a person who was evaluated for possible labor. How does the nurse explain how losing the mucus plug could be a sign of impending labor?

1. The mucus plug starts to be expelled due to increased estrogen before contractions begin.
2. The mucus plug is expelled after the membranes rupture during labor.
3. Effacement and dilation of the cervix decrease the area where the mucus plug sits.
4. Labor is unable to begin until the mucus plug is expelled and creates a space for the fetus.

3.

If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold’s maneuvers, what presenting part do you anticipate palpating in a vaginal exam?

1. brow
2. breech
3. face
4. occiput

4.

What makes up the powers of labor and birth?

1. contractions and pushing efforts
2. pelvis and pelvic floor tissues
3. fetal position, attitude, lie, and presentation
4. oxytocin

5.

When does the active phase of labor begin according to ACOG?

1. 6 cm
2. 3 cm
3. 5 cm
4. 10 cm

6.

The nurse hears the laboring patient making grunting noises. How will the nurse determine if the person is in the active second stage of labor?

1. Assess for rupture of membranes.
2. Assess for bloody show.
3. Assess for dilation of the cervix.
4. Assess for stool.

7.

When does the second stage of labor begin?

1. at birth
2. when the early phase ends
3. when the cervix is completely dilated and effaced
4. when pushing begins

8.

How long is the expected length of the third stage of labor?

1. 60 minutes or less
2. 30 minutes or less
3. 1 hour for a multiparous person, 2 hours for a nulliparous person
4. 3 hours for a multiparous person, 4 hours for a nulliparous person

9.

How can a nurse support the patient during the fourth stage of labor?

1. Support pushing efforts with feedback on how much progress is being made.
2. Ensure epidural anesthesia is adequate for pain control, reposition frequently, provide dietary intake per provider’s order.
3. Assess for any bleeding or amniotic fluid presence in the vaginal discharge.
4. Provide rest, space, and time for bonding between assessments, support for feeding preferences, diligent monitoring for complications, pain management.

10.

The nurse is caring for a patient during the first stage of labor. What is an abnormal finding?

1. patient moaning with contractions
2. contractions 3 minutes apart lasting 60 seconds
3. blood pressure 142/88
4. respiratory rate 22

11.

What changes in hormones initiate labor?

1. decreased progesterone, decreased estrogen, absence of oxytocin
2. increased progesterone, decreased estrogen, absence of oxytocin
3. increased progesterone, decreased estrogen, presence of oxytocin
4. decreased progesterone, increased estrogen, effects of oxytocin

12.

During the second stage, what do the birthing person’s vital signs most likely show?

1. increased heart rate during contractions, baseline heart rate between contractions
2. increased heart rate during contractions, decreased heart rate between contractions
3. decreased heart rate during contractions, increased heart rate between contractions
4. decreased heart rate during contractions, baseline heart rate between contractions

13.

During the third stage of labor, what may the birthing person experience?

1. expulsion of their fetus with vaginal bleeding
2. cramping, gush of fresh vaginal bleeding, lengthening of the umbilical cord
3. frequent episodes of dyspnea
4. increased blood pressure and pain due to expulsive efforts

14.

What should the nurse consider when the birthing person has a decrease in blood pressure after the placenta is delivered?

1. The birthing person is in pain.
2. Place the newborn skin-to-skin.
3. The bladder is distended.
4. Check for possible hemorrhage.

15.

How does becoming a parent cause the birthing person to feel?

1. overwhelming feelings of joy or a sense of euphoria
2. a wide variety of emotions specific to each person’s experience
3. overwhelming fear or sadness at the loss of their previous life
4. exhausted with little interest the newborn

16.

How should the nurse respect the rapid psychologic changes occurring in the fourth stage of labor?

1. Invite the family to come in and see the newborn.
2. Take the lead from the parents regarding interruption of the bonding.
3. Ask multiple questions about taking pictures of the newborn.
4. Take the newborn to the nursery to encourage the parents to rest.

17.

What anticipatory guidance should the nurse provide for new parents regarding sociologic changes?

1. Explain that roles will not change at home.
2. Explain that stresses will be over now that the newborn is born.
3. Tell the parents not to stress over household changes.
4. Prepare them for possible strains on relationships.

18.

What effect will the presence of support people in labor most likely have?

1. improve the experience of the birthing person
2. improve the outcomes of the birthing person
3. improve the outcomes and experience of the birthing person
4. cause birth trauma and/or postpartum depression

19.

The nurse is caring for a laboring patient with multiple family members in the room. How can the nurse address this situation?

1. Educate the family that the pain the laboring person is experiencing is normal.
2. Ask them all to leave the room.
3. Explain that if the laboring person got an epidural, she would be more comfortable.
4. Assume the laboring person wants the family in the room.

20.

During the COVID-19 pandemic, what was revealed about the importance of labor support?

1. Labor support can only be provided by the significant other.
2. Laboring patients did not need support from outside sources.
3. Outcomes for birth were not changed by pandemic requirements.
4. Patients during the pandemic’s support ban experienced more depression.

21.

When should the nurse consider suggesting a doula?

1. when the patient asks for an epidural
2. if the nurse is unable to support the patient
3. when the support person is in the military and cannot attend the birth
4. if the patient is going to have an emergency cesarean birth