NURS 335 Exam 2 Practice Questions
and Correct Answers
What are preliminary signs of labor? ✅Lightening, increase in level of activity, Braxton
Hicks contractions, ripening of cervix
What factors dictate the onset of labor? ✅Bloody show (pink), ROM [may have weight
loss, increased back ache, more sacral pressure, nausea, vomiting, diarrhea]
What is the difference between cervical effacement and dilation? ✅Effacement-
thinning/taking up of the cervix, dilation- widening of cervix
What are signs of true labor? ✅True contractions and dilation
What is considered arrest of labor? ✅Adequate contraction pattern (No cervical
change in 4 hours), Inadequate contraction pattern (No cervical change in 6 hours);
Interventions dependent on situation and what has been done already-- make
decisions, C-section?
What are the cardinal movements and how does that affect the labor process? ✅Stage
2 of labor- allow passage of infant through the pelvis, Engagement & descent, flexion,
Internal rotation to OA position, Extension (for expulsion), External rotation - restitution,
External rotation, Expulsion
Identify the 4 degrees of vaginal lacerations. What degree is an episiotomy considered?
✅1st degree: superficially disrupts mucosa, 2nd degree: divides the perineal body
(episiotomies), 3rd degree: tear involves anal sphincter, 4th degree: tear involves rectal
mucosa, 3rd and 4th degrees are very painful, often have an elective C-section the next
time b/c of pain
What are some methods of measuring FHR? ✅Internal or external monitor
What are some methods of measuring contractions? ✅External - tocotransducer,
intrauterine pressure catheter (IUPC), palpation
What is the purpose of Leopold's maneuvers? ✅Determine presentation, Place
external fetal monitor- want it on their back
How do you measure the frequency and duration of contractions? ✅Fetal monitor-
internal (IUPC) or external (tocometer)
What is tachysystole? ✅6 contractions or more in a 10 minute period—correlate FHR
with contraction to evaluate response to labor
, What is the normal range for fetal heart rate? ✅110-160 beats per minute
What is baseline variability? ✅irregular fluctuations in the baseline FHR measured as
the amplitude fo the peak to trough in bpm-- absent, minimal- less than 5bpm,
moderate- 6-25 bpm, marked- greater than 25 bpm
What does a sinusoidal pattern indicate in FHR tracing? ✅HYPOXIA
What issues can fetal tachycardia indicate? ✅Early signs of fetal hypoxemia, Maternal
or fetal infection, Fetal anemia, Maternal hyperthyroidism, Response to drugs
What issues can fetal bradycardia indicate? ✅Late sign of fetal hypoxia, drugs, cord
compression, maternal hypothermia, maternal hypotension, tachysystole
What are characteristics and significance of variable decelerations? ✅Abrupt, random
What are characteristics and significance of early decelerations? ✅Symmetrical and
associated with contraction, return by end of contraction
What are characteristics and significance of late decelerations? ✅Uteroplacental
insufficiency- variety of reasons, begins after peak of contraction
What are characteristics and significance of accelerations? ✅32 weeks or older-
15bpm above baseline lasting 15 seconds or more, Younger than 32 weeks- 10 bpm
above baseline lasting 10 seconds or more
What are causes of visceral pain during labor? ✅Uterine ischemia, cervical changes,
uterine distention, referred (back)pain
What are causes of somatic pain during labor? ✅Distention and pressure, traction,
laceration
When is general anesthesia used during labor? ✅During a c-section when we don't
have time to do a spinal anesthesia
What are some common systemic medications used for pain management in labor?
✅Opioid agonist- morphine, fentanyl (onset 5 mins, peak 30 mins, duration 2 hours)
Why is it important to know onset, peak, & duration of IV/IM meds given during labor?
✅We do not want to give them something too close to pushing b/c it may cause
respiratory depression in the baby
What inhaled anesthetic is used during labor? ✅Nitrous oxide
