Question 1

The labor and delivery nurse is reviewing charts. The nurse should inform the supervisor about which client?

Accepted Answer

A)  Client at 5 c m requesting labor epidural analgesia 
B)  Client whose cervix remains at 6 c m for 4 hours 
C)  Client who has developed nausea and vomiting 
D)  Client requesting her partner to stay with her

Question 2

The nurse has just palpated a laboring woman's contractions. The uterus cannot be indented during a contraction. What would the intensity of these contractions best be characterized as?

Accepted Answer

A)  Weak 
B)  Mild 
C)  Moderate 
D)  Strong

Question 3

A clinic nurse is preparing diagrams of pelvic shapes. Which pelvic shapes are considered least adequate for vaginal childbirth?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  Android 
B)  Anthropoid 
C)  Gynecoid 
D)  Platypelloid 
E)  Lambdoidal suture

Question 4

How would the nurse best analyze the results from a client's sonogram that shows the fetal shoulder as the presenting part?

Accepted Answer

A)  Breech, transverse 
B)  Breech, longitudinal 
C)  Breech, frank 
D)  Vertex, transverse

Question 5

The client at 39 weeks' gestation calls the clinic and reports increased bladder pressure but easier breathing and irregular, mild contractions. She also states that she just cleaned the entire house. Which statement should the nurse make?

Accepted Answer

A)  "You shouldn't work so much at this point in pregnancy." 
B)  "What you are describing is not commonly experienced in the last weeks." 
C)  "Your body may be telling you it is going into labor soon." 
D)  "If the bladder pressure continues, come in to the clinic tomorrow."

Question 6

Which client requires immediate intervention by the labor and delivery nurse?

Accepted Answer

A)  Client at 8 c m, systolic blood pressure has increased 35 m m H g 
B)  Client who delivered 1 hour ago with W B C of 50,000/m m3 
C)  Client at 5 c m with a respiratory rate of 22 between contractions 
D)  Client in active labor with polyuria

Question 7

The client at 40 weeks' gestation reports to the nurse that she has had increased pelvic pressure and increased urinary frequency. Which response by the nurse is best?

Accepted Answer

A)  "Unless you have pain with urination, we don't need to worry about it." 
B)  "These symptoms usually mean the baby's head has descended further." 
C)  "Come in for an appointment today and we'll check everything out." 
D)  "This might indicate that the baby is no longer in a head-down position."

Question 8

The nurse is caring for laboring clients. Which women are experiencing problems related to a critical factor of labor?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  Woman at 7 c m, fetus in general flexion 
B)  Woman at 3 c m, fetus in longitudinal lie 
C)  Woman at 4 c m, fetus with transverse lie 
D)  Woman at 6 c m, fetus at -2 station, mild contractions 
E)  Woman at 5 c m, fetal presenting part is right shoulder

Question 9

The nurse is caring for a laboring client. A cervical exam indicates 8 c m dilation. The client is restless, frequently changing position in an attempt to get comfortable. Which nursing action is most important?

Accepted Answer

A)  Leave the client alone so she can rest. 
B)  Ask the family to take a coffee-and-snack break. 
C)  Encourage the client to have an epidural for pain. 
D)  Reassure the client that she will not be left alone.

Question 10

The charge nurse has received the shift change report. Which client requires immediate intervention?

Accepted Answer

A)  Woman at 6 c m undergoing induction of labor, strong contractions every 3 minutes 
B)  Woman at 4 c m whose fetus is in a longitudinal lie with a cephalic presentation 
C)  Woman at 10 c m and fetus at +2 station experiencing a strong expulsion urge 
D)  Woman at 3 c m screaming in fear because her mother died during childbirth

Question 11

The nurse is teaching a prenatal class about false labor. The nurse should teach clients that false labor will most likely include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  Contractions that do not intensify while walking 
B)  An increase in the intensity and frequency of contractions 
C)  Progressive cervical effacement and dilation 
D)  Pain in the abdomen that does not radiate 
E)  Contractions are at regular intervals

Question 12

A pregnant patient's fetus is in the left-occiput-transverse position. Which diagram should the nurse use to explain this position to the patient?

Accepted Answer

A) 
 
B) 
 
C) 
 
D)

Question 13

The labor and delivery nurse is preparing a prenatal class about facilitating the progress of labor. Which of the following frequent responses to pain should the nurse indicate is most likely to impede progress in labor?

Accepted Answer

A)  Increased pulse 
B)  Elevated blood pressure 
C)  Muscle tension 
D)  Increased respirations

Question 14

When comparing the anterior and posterior fontanelles of a newborn, the nurse knows that both are what?

Accepted Answer

A)  Both are approximately the same size. 
B)  Both close within 12 months of birth. 
C)  Both are used in labor to identify station. 
D)  Both allow for assessing the status of the newborn after birth.

Question 15

The midwife performs a vaginal exam and determines that the fetal head is at a -2 station. What does this indicate to the nurse about the birth?

Accepted Answer

A)  The birth is imminent. 
B)  The birth is likely to occur in 1-2 hours. 
C)  The birth will occur later in the shift. 
D)  The birth is difficult to predict.

Question 16

The nurse is aware that labor and birth will most likely proceed normally when the fetus is in what position?

Accepted Answer

A)  Right-acromion-dorsal-anterior 
B)  Right-sacrum-transverse 
C)  Occiput anterior 
D)  Posterior position

Exam 19: Processes and Stages of Labor and Birth