15.9.1: Review Questions
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Review Questions
1 .
What is a direct influence on cervical dilation? Select all that apply.
- positioning of the pregnant person
- strength of uterine contractions
- length of time since ROM
- fetal presentation
- 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?
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The mucus plug starts to be expelled due to increased estrogen before contractions begin.
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The mucus plug is expelled after the membranes rupture during labor.
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Effacement and dilation of the cervix decrease the area where the mucus plug sits.
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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?
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brow
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breech
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face
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occiput
4 .
What makes up the powers of labor and birth?
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contractions and pushing efforts
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pelvis and pelvic floor tissues
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fetal position, attitude, lie, and presentation
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oxytocin
5 .
When does the active phase of labor begin according to ACOG?
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6 cm
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3 cm
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5 cm
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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?
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Assess for rupture of membranes.
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Assess for bloody show.
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Assess for dilation of the cervix.
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Assess for stool.
7 .
When does the second stage of labor begin?
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at birth
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when the early phase ends
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when the cervix is completely dilated and effaced
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when pushing begins
8 .
How long is the expected length of the third stage of labor?
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60 minutes or less
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30 minutes or less
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1 hour for a multiparous person, 2 hours for a nulliparous person
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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?
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Support pushing efforts with feedback on how much progress is being made.
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Ensure epidural anesthesia is adequate for pain control, reposition frequently, provide dietary intake per provider’s order.
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Assess for any bleeding or amniotic fluid presence in the vaginal discharge.
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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?
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patient moaning with contractions
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contractions 3 minutes apart lasting 60 seconds
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blood pressure 142/88
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respiratory rate 22
11 .
What changes in hormones initiate labor?
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decreased progesterone, decreased estrogen, absence of oxytocin
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increased progesterone, decreased estrogen, absence of oxytocin
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increased progesterone, decreased estrogen, presence of oxytocin
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decreased progesterone, increased estrogen, effects of oxytocin
12 .
During the second stage, what do the birthing person’s vital signs most likely show?
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increased heart rate during contractions, baseline heart rate between contractions
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increased heart rate during contractions, decreased heart rate between contractions
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decreased heart rate during contractions, increased heart rate between contractions
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decreased heart rate during contractions, baseline heart rate between contractions
13 .
During the third stage of labor, what may the birthing person experience?
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expulsion of their fetus with vaginal bleeding
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cramping, gush of fresh vaginal bleeding, lengthening of the umbilical cord
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frequent episodes of dyspnea
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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?
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The birthing person is in pain.
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Place the newborn skin-to-skin.
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The bladder is distended.
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Check for possible hemorrhage.
15 .
How does becoming a parent cause the birthing person to feel?
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overwhelming feelings of joy or a sense of euphoria
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a wide variety of emotions specific to each person’s experience
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overwhelming fear or sadness at the loss of their previous life
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exhausted with little interest the newborn
16 .
How should the nurse respect the rapid psychologic changes occurring in the fourth stage of labor?
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Invite the family to come in and see the newborn.
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Take the lead from the parents regarding interruption of the bonding.
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Ask multiple questions about taking pictures of the newborn.
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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?
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Explain that roles will not change at home.
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Explain that stresses will be over now that the newborn is born.
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Tell the parents not to stress over household changes.
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Prepare them for possible strains on relationships.
18 .
What effect will the presence of support people in labor most likely have?
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improve the experience of the birthing person
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improve the outcomes of the birthing person
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improve the outcomes and experience of the birthing person
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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?
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Educate the family that the pain the laboring person is experiencing is normal.
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Ask them all to leave the room.
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Explain that if the laboring person got an epidural, she would be more comfortable.
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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?
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Labor support can only be provided by the significant other.
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Laboring patients did not need support from outside sources.
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Outcomes for birth were not changed by pandemic requirements.
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Patients during the pandemic’s support ban experienced more depression.
21 .
When should the nurse consider suggesting a doula?
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when the patient asks for an epidural
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if the nurse is unable to support the patient
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when the support person is in the military and cannot attend the birth
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if the patient is going to have an emergency cesarean birth