Chapter 12: Processes of Birth

Chapter 12: Processes of Birth

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The husband of a laboring woman asks the nurse how he can help his wife throughout the first stage of labor. The nurse informs him that in addition to all that he’s doing now, he could tell her when the contractions are:

a.	2 minutes apart.
b.	at their acme.
c.	at their increment.
d.	at their decrement.

 

 

ANS:  B

When the contraction is most intense, the coach can tell the laboring woman that this contraction will be over soon to help her remain focused. Describing the frequency of the contractions is not usually helpful. The increment occurs as the contraction begins in the fundus and spreads through the uterus. Calling attention to this phase may cause the woman to become tense. The woman does not need anyone to tell her that the contraction is decreasing in intensity.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   196, 197

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Health Promotion and Maintenance

 

2. The nurse is explaining to a group of nursing students what occurs during active labor as the uterus contracts. Which statement explains the maternal-fetal exchange of oxygen and waste products during a contraction?

a.	Is not significantly affected
b.	Increases as blood pressure decreases
c.	Diminishes as the spiral arteries are compressed
d.	Continues except when placental functions are reduced

 

 

ANS:  C

During labor contractions, the maternal blood supply to the placenta gradually stops as the spiral arteries supplying the intervillous space are compressed by the contracting uterine muscle. The exchange of oxygen and waste products is affected by contractions. The exchange of oxygen and waste products decreases. The maternal blood supply to the placenta gradually stops with contractions.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   199

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

 

3. The nurse is directing an unlicensed assistive personnel (UAP) to take maternal vital signs between contractions. Which statement is the best rationale for assessing maternal vital signs between contractions?

a.	Vital signs taken during contractions are not accurate.
b.	During a contraction, assessing fetal heart rate is the priority.
c.	Maternal blood flow to the heart is reduced during contractions.
d.	Maternal circulating blood volume increases temporarily during contractions.

 

 

ANS:  D

During uterine contractions, blood flow to the placenta temporarily stops, causing a relative increase in the mother’s blood volume, which in turn temporarily increases blood pressure and slows the pulse. Vital signs are altered by contractions but are considered accurate for a period of time. It is important to monitor the fetal response to contractions, but the question is concerned with the maternal vital signs. Maternal blood flow is increased during a contraction.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   198

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Safe and Effective Care Environment

 

4. Uncontrolled maternal hyperventilation during labor results in:

a.	metabolic acidosis.
b.	metabolic alkalosis.
c.	respiratory acidosis.
d.	respiratory alkalosis.

 

 

ANS:  D

Rapid deep respirations cause the laboring woman to lose carbon dioxide through exhalation, resulting in respiratory alkalosis. Hyperventilation does not cause respiratory acidosis, metabolic acidosis, or metabolic alkalosis.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   198

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

 

5. Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?

a.	Extension
b.	Engagement
c.	Internal rotation
d.	External rotation

 

 

ANS:  B

Engagement occurs when the presenting part fully enters the pelvic inlet. Extension occurs when the fetal head meets resistance from the tissues of the pelvic floor and the fetal neck stops under the symphysis. This causes the fetal head to extend. Internal rotation occurs when the fetus enters the pelvic inlet. The rotation allows the longest fetal head diameter to conform to the longest diameter of the maternal pelvis. External rotation occurs after the birth of the head. The head then turns to the side so the shoulders can internally rotate and are positioned with their transverse diameter in the anteroposterior diameter of the pelvic outlet.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   209

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Health Promotion and Maintenance