Nursing OB Exam 2 Guaranteed Solutions
1. Factors Affecting Labor and Birth
- Labor and birth are influenced by the five Ps: ✔️passenger, passageway, powers, position of the
woman, and psychologic response.
2. Duration of the First Stage of Labor
- The first stage of labor lasts from ✔️the onset of dilation until the cervix is fully dilated.
3. Duration of the Second Stage of Labor
- The second stage of labor lasts from ✔️full cervical dilation to the birth of the infant.
4. Duration of the Third Stage of Labor
- The third stage of labor extends from ✔️the birth of the infant to the expulsion of the placenta.
5. Definition of the Fourth Stage of Labor
- The fourth stage of labor is defined as ✔️the first 2 hours after the birth.
6. Cardinal Movements of Labor
- The cardinal movements during labor involve ✔️engagement, descent, flexion, internal rotation,
extension, restitution, external rotation, and expulsion of the infant.
7. Signs Indicating Onset of Labor
- A primigravida asks the nurse which signs might indicate that labor is approaching. The nurse should
explain:
- A) Weight gain of 1 to 3 lbs.
- B) Quickening.
- C) Fatigue and lethargy.
- D) Bloody show. ✔️D) Bloody show
, Rationale: Typically, women may experience a slight weight loss of 1 to 3 lbs before labor, while
quickening (first fetal movements) occurs between 16 and 20 weeks. A burst of energy, or nesting
instinct, is also common. The passage of the mucous plug, known as the pink or bloody show, indicates
cervical ripening.
8. Definitive Sign Labor Has Begun
- The nurse should inform the primigravida that the definitive sign indicating the onset of labor is:
- A) Progressive uterine contractions with cervical change.
- B) Lightening.
- C) Rupture of membranes.
- D) Passage of the mucous plug. ✔️A) Progressive uterine contractions with cervical change.
Rationale: True labor is marked by regular, progressive contractions that increase both intensity and
frequency, accompanied by cervical change. Lightening, rupture of membranes, and passing the mucous
plug are all premonitory signs.
9. Interpretation of Vaginal Examination Data
- After a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. What is a correct
interpretation of this data?
- A) The fetal presenting part is 1 cm above the ischial spines.
- B) Effacement is 4 cm from completion.
- C) Dilation is 50% completed.
- D) The fetus has achieved passage through the ischial spines. ✔️A) The fetal presenting part is 1 cm
above the ischial spines.
Rationale: A station of -1 indicates the fetal presenting part is above the ischial spines and hasn't
passed through the pelvic inlet yet. Effacement and dilation are measured differently, with completion
indicated by 100% effacement and 10 cm dilation.
10. Assessing Mother's Health During Labor
- To accurately monitor the mother's health during labor, the nurse should recognize that:
- A) The woman's blood pressure increases during contractions and falls back to prelabor normal
between contractions.
- B) 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) Endogenous endorphins released during labor raise the woman's pain threshold and induce
sedation. ✔️D) Endogenous endorphins released during labor raise the woman's pain threshold and
produce sedation.
Rationale: Blood pressure does elevate during contractions but remains somewhat raised between
them. The Valsalva maneuver should generally be avoided due to potential adverse outcomes, including
fetal hypoxia. Pointing toes is not effective for leg cramps. The pressure from the presenting part may
numb the perineal area, lowering perceived pain levels.
11. Indication That Descent Phase Has Begun
- The nurse knows the descent phase of the second stage of labor has begun when:
- A) The amniotic membranes rupture.
- B) The cervix cannot be felt during a vaginal examination.
- C) The woman feels a strong urge to bear down.
- D) The presenting part is below the ischial spines. ✔️C) The woman experiences a strong urge to
bear down.
Rationale: The second stage begins with full cervical dilation, and during descent, many women feel
an increased urge to push. Ruptured membranes don’t mark the transition to this stage, and while
station is relevant, it’s not indicative on its own.
12. Accurate Description of the First Stage of Labor Phases
- Regarding the phases of the first stage of labor, which description is accurate?
- A) Latent: mild, regular contractions; no dilation; duration 2 to 4 hours.
- B) Active: moderate, regular contractions; 4 to 7 cm dilation; duration 3 to 6 hours.
- C) Lull: no contractions; dilation stable; duration 20 to 60 minutes.
- D) Transition: very strong, irregular contractions; 8 to 10 cm dilation; duration 1 to 2 hours. ✔️B)
Active: moderate, regular contractions; 4 to 7 cm dilation; duration 3 to 6 hours.
Rationale: The latent phase typically exhibits mild to moderate, irregular contractions; dilation up to 3
cm; and a duration of 6 to 8 hours. The active phase is characterized by regular contractions between 4
and 7 cm dilated and lasts 3 to 6 hours. There is no officially recognized "lull" phase. The transition
phase is defined by strong to very strong regular contractions, 8 to 10 cm dilation, and a duration of
about 20 to 40 minutes.
, 13. Suggested Position for Second Stage Labor
- Which position should the nurse recommend for second-stage labor to increase the pelvic outlet
size?
- A) Semirecumbent
- B) Sitting
- C) Squatting
- D) Side-lying ✔️C) Squatting
Rationale: Squatting or kneeling positions can assist in increasing the pelvic outlet’s dimensions, aiding
in labor progression. The semirecumbent and side-lying positions do not enhance pelvic outlet size
significantly, while sitting may assist fetal descent but not directly enlarge the outlet.
14. Considerations for the Third Stage of Labor
- Nurses should be aware that regarding the third stage of labor:
- A) The placenta detaches itself from a flaccid uterus.
- B) The duration may be as short as 3 to 5 minutes.
- C) The dark, roughened maternal surface of the placenta should appear before the shiny fetal
surface.
- D) The primary risk for women during this stage is a rapid heart rate. ✔️B) The duration of the third
stage may be as short as 3 to 5 minutes.
Rationale: The placenta cannot detach from a relaxed uterus, and the third stage lasts from fetal birth
until placental delivery, which can take as little as 3 to 5 minutes but can be up to an hour in some cases.
Which surface of the placenta comes out first is not deemed clinically important, while the main concern
during this stage is the risk of postpartum hemorrhage.
15. Five Ps of Labor and Birth
- The charge nurse explains the five Ps of labor and birth, which include: (Select all that apply.)
- A) Passenger
- B) Placenta
- C) Passageway
- D) Psychologic response
- E) Powers
