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Maternal Labor and Delivery

1. What is a sign of maternal distress during labor?

a. Less intense and less frequent uterine contractions

b. Uterine relaxation between 50-second contractions

c. Heart rate of 90 to 100 beats per minute during labor

d. Reports of needing to have a bowel movement

ANSWER: A

2. Which change is theorized to stimulate the onset of labor?

a. Decreased prostaglandin production

b. Elevated corticotropin-releasing hormone (CRH) levels

c. Increased progesterone production

d. Oxytocin, platelet activating factor, and estrogen withdrawal

ANSWER: B

3. Patricia Nealy is admitted to the maternity wing for a scheduled cesarean delivery.

Why would the nurse teach deep breathing exercises as part of the preoperative preparation?

a. To prevent mucus buildup in the alveoli of the lungs

b. To avoid contraction of the muscles of the diaphragm
c. To promote uterine involution during the surgery
d. To stimulate pulmonary edema absorption

ANSWER: A

4. If the nurse notes a fetal heart rate (FHR) of 90 during the active phase of labor what action
would be appropriate?

a. Encourage the mother to relax and check again in 15 minutes.

b. Assist the mother to stand up and walk around to stimulate the fetus.
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c. Apply oxygen per standing orders and notify the primary care provider.
d. Continue the same schedule of monitoring of FHR and maternal vital signs.

ANSWER: C

5. During the transition phase of labor what would the nurse expect to observe?

a. The mother is calm and in minimal discomfort.

b. The fetal heart rate is minimally affected by the contractions.
c. Support person(s) are coaching the mother in panting.
d. Six to ten minutes are noted between contractions.

ANSWER: C

6. What would be an appropriate nursing intervention for fetal care during labor?

a. Monitor FHR every 30 minutes for a high-risk pregnancy.

b. Maintain the mother in a supine position to promote fetal circulation.
c. Report findings of FHR above 110 and below 160 beats per minute.
d. Administer oxygen to the mother if variability in FHR is reduced.

ANSWER: D

7. Which sign should cause the greatest concern if noted by the nurse?

a. Maternal irritability during the transition phase of labor

b. Amniotic fluid that is green-brown in color
c. FHR that is variable and increased with contractions
d. Contractions of 40-second duration in the active labor phase

ANSWER: B

8. Which is an appropriate plan for vaginal examination during labor?

a. Assess for cervical dilation and effacement every 30 minutes when labor begins.
b. Assess for cervical ripening every 30 minutes during the latent phase,
c. Examine the mother during the peak of contraction to determine impact on the cervix.
d. Perform frequent sterile vaginal examinations during the transition phase of labor.

ANSWER: D

9. What factors indicate the need for an emergency cesarean delivery?

a. Failure of labor to progress

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b. Maternal cardiac distress

c. Fetal distress

d. All of the above

ANSWER: D

10. Nursing care following a cesarean delivery would involve what measures?

a. Wound care to the episiotomy

b. Monitoring for cervical ripening

c. Encouraging deep breathing and coughing

d. Infusing oxytocin to promote placental delivery

ANSWER: C