Maternity Test Bank Exam 1
Chapter 13: Labor and Birth Processes -
1. A new mother asks the nurse when the soft spot on her sons head will go away. The
nurses answer is based on the knowledge that the anterior fontanel closes after birth by
_____ months.
a. 2 c. 12
b. 8 d. 18 - d. 18
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. c. Attitude.
b. Presentation. d. Position. - c. Attitude.
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
mothers right side close to midline. What is the likely position of the fetus?
a. ROA c. RSA
b. LSP d. LOA - c. RSA
4. The nurse has received report regarding her patient in labor. The womans last
vaginal examination was recorded as 3 cm, 30%, and ?2-2. The nurses 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. - b. The cervix is 3 cm dilated, it is effaced 30%, and the presenting
part is 2 cm above the ischial spines.
5. To care for a laboring woman adequately, the nurse understands that the
__________ stage of labor varies the most in length?
a. First c. Third
b. Second d. Fourth - a. First
6. The nurse would expect which maternal cardiovascular finding during labor?
a. Increased cardiac output
b. Decreased pulse rate
c. Decreased white blood cell (WBC) count
d. Decreased blood pressure - a. Increased cardiac output
,7. The factors that affect the process of labor and birth, known commonly as the five Ps,
include all except:
a. Passenger. c. Powers.
b. Passageway. d. Pressure. - d. Pressure.
8. The slight overlapping of cranial bones or shaping of the fetal head during labor is
called:
a. Lightening. c. Ferguson reflex.
b. Molding. d. Valsalva maneuver. - b. Molding.
9. Which presentation is described accurately in terms of both presenting part and
frequency of occurrence?
a. Cephalic: occiput; at least 95% c. Shoulder: scapula; 10% to 15%
b. Breech: sacrum; 10% to 15% d. Cephalic: cranial; 80% to 85% - a. Cephalic: occiput;
at least 95%
10. With regard to factors that affect how the fetus moves through the birth canal,
nurses should be aware that:
a. The fetal attitude describes the angle at which the fetus exits the uterus.
b. Of the two primary fetal lies, the horizontal lie is that in which the long axis of the
fetus is parallel to the long axis of the mother.
c. The normal attitude of the fetus is called general flexion.
d. The transverse lie is preferred for vaginal birth. - c. The normal attitude of the fetus is
called general flexion.
11. As relates to fetal positioning during labor, nurses should be aware that:
a. Position is a measure of the degree of descent of the presenting part of the fetus
through the birth canal.
b. Birth is imminent when the presenting part is at +4 to +5 cm below the spine.
c. The largest transverse diameter of the presenting part is the suboccipitobregmatic
diameter.
d. Engagement is the term used to describe the beginning of labor. - b. Birth is imminent
when the presenting part is at +4 to +5 cm below the spine.
12. Which basic type of pelvis includes the correct description and percentage of
occurrence in women?
a. Gynecoid: classic female; heart shaped; 75%
b. Android: resembling the male; wider oval; 15%
c. Anthropoid: resembling the ape; narrower; 10%
d. Platypelloid: flattened, wide, shallow; 3% - d. Platypelloid: flattened, wide, shallow;
3%
13. In relation to primary and secondary powers, the maternity nurse comprehends 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 closer 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. - a.
Primary powers are responsible for effacement and dilation of the cervix
14. While providing care to a patient in active labor, the nurse should instruct the
woman that:
a. The supine position commonly used in the United States increases blood flow.
b. The all fours position, on her hands and knees, is hard on her back.
c. Frequent changes in position will help relieve her fatigue and increase her comfort.
d. In a sitting or squatting position, her abdominal muscles will have to work harder - c.
Frequent changes in position will help relieve her fatigue and increase her comfort.
15. Which description of the four stages of labor is correct for both definition and
duration?
a. First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20
hours
b. Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
c. Third state: active pushing to birth; 20 minutes (multiparous women), 50 minutes
(first-timer)
d. Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour - a. First
stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
16. With regard to the turns and other adjustments of the fetus during the birth process,
known as the mechanism of labor, nurses should be aware that:
a. The seven critical movements must progress in a more or less orderly sequence.
b. Asynclitism sometimes is achieved by means of the Leopold maneuver.
c. The effects of the forces determining descent are modified by the shape of the
womans pelvis and the size of the fetal head.
d. At birth the baby is said to achieve restitution (i.e., a return to the C-shape of the
womb). - c. The effects of the forces determining descent are modified by the shape of
the womans pelvis and the size of the fetal head.
17. In order to evaluate the condition of the patient accurately during labor, the nurse
should be aware that:
a. The womans blood pressure will increase during contractions and fall 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 will reduce leg cramps.
d. The endogenous endorphins released during labor will raise the womans pain
threshold and produce sedation. - d. The endogenous endorphins released during labor
will raise the womans pain threshold and produce sedation.
, 18. The maternity nurse understands that as the uterus contracts during labor,
maternal-fetal exchange of
oxygen and waste products:
a. Continues except when placental functions are reduced.
b. Increases as blood pressure decreases.
c. Diminishes as the spiral arteries are compressed.
d. Is not significantly affected. - c. Diminishes as the spiral arteries are compressed.
19. Which statement is the best rationale for assessing maternal vital signs between
contractions?
a. During a contraction, assessing fetal heart rates is the priority.
b. Maternal circulating blood volume increases temporarily during contractions.
c. Maternal blood flow to the heart is reduced during contractions.
d. Vital signs taken during contractions are not accurate. - b. Maternal circulating blood
volume increases temporarily during contractions.
20. In order to care for obstetric patients adequately, the nurse understands that labor
contractions facilitate cervical dilation by:
a. Contracting the lower uterine segment.
b. Enlarging the internal size of the uterus.
c. Promoting blood flow to the cervix.
d. Pulling the cervix over the fetus and amniotic sac. - d. Pulling the cervix over the fetus
and amniotic sac.
21. To teach patients about the process of labor adequately, the nurse knows that which
event is the best indicator of true labor?
a. Bloody show c. Fetal descent into the pelvic inlet
b. Cervical dilation and effacement d. Uterine contractions every 7 minutes - b. Cervical
dilation and effacement
22. Which occurrence is associated with cervical dilation and effacement?
a. Bloody show c. Lightening
b. False labor d. Bladder distention - a. Bloody show
23. The primary difference between the labor of a nullipara and that of a multipara is
the:
a. Amount of cervical dilation. c. Level of pain experienced. b. Total duration of labor. d.
Sequence of labor mechanisms. - b. Total duration of labor.
24. A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum
unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to
30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and
uneffaced (unchanged from admission). Membranes are intact. The nurse should
expect the woman to be:
a. Admitted and prepared for a cesarean birth.
