41. Refers to the route a fetus must travel from the uterus through the cervix and vagina to the external perineum.*1 pointA. PassengerB. PassageC. PowerD. Psyche42. How long after delivery does the fundus completely descend into the pelvis, making it no longer palpable through the abdomen?*1 pointA. 4 weeksB. 6 weeksC. 10 daysD. 2 weeks43. As you check Mrs. Aquino, you find that her fundus is 2 finger breadths above the umbilicus and displaced to the side. It is not as firm as you would desire, but bleeding is not excessive at this point. You also assess:*1 pointA. possible bladder distentionB. the time she last received oxytocinC. whether she is breast or bottle feedingD. whether her infant was vertex or breech44. The rate of decrease in the height of the fundus each day is normally:*1 pointA. 1 inchB. 2 inchesC. 1 cmD. 2 cm45. Vaginal examination provides the following data: membranes intact, cervix 3 cm, dilated and 50% effaced, presenting part at -2 station. Which of the following nursing actions do you carry out next?*1 pointA. Ask the client to pushB. administer enemaC. prepare delivery roomD. assess vital signs and FHR

24. As a primigravida progresses with her labor, she begins to bear down with her contractions. You tell her that pushing in the absence of contractions before the cervix is fully dilated will lead to:*1 pointA. more rapid dilationB. cord prolapsedC. more rapid effacementD. development of cervical edema25. Complete flexion of the fetal head is advantageous for vaginal delivery because:*1 pointA. the fetus presents the smallest anteroposterior diameter of his skullB. the occipitomental diameter will be presented for deliveryC. the fetus presents the largest anteroposterior diameter of his skullD. the long axis of the fetus is parallel to the mother’s spine26. A postpartum nurse is providing instructions to a client after delivery of a healthy newborn infant. The nurse instructs the client that she should expect normal bowel elimination to return:*1 pointA. 3 days postpartumB. 7 days postpartumC. On the day of deliveryD. Within 2 weeks postpartum27. Mr. Young’s wife has requested her PRN medicines for pain. Of the following actions, which has the highest priority in relation to administering the medications?*1 pointA. providing privacy during the injectionB. assessing maternal vital signs and fetal heart rateC. assessing uterine contractions and the progress of laborD. informing her that she may become drowsy and/or nauseated28. The nurse encourages a multigravida to empty her bladder every 2 to 3 hours while she is in labor because:*1 pointA. a full bladder impedes the descent of the fetusB. a full bladder may rupture during laborC. a bruised bladder may predispose to pyelonephritisD. urine specimens are needed for glucose and albumin29. Which of the following fetal heart rates would be expected in the fetus of a laboring woman who is full -term?    *1 pointA. 80-100 beats per minuteB. 100-120 beats per minuteC. 120-160 beats per minuteD. 160-180 beats per minute30. Best time to get FHT:*1 pointA. at the beginning of uterine contractionB. just after a uterine contractionC. 10 minutes after a uterine contractionD. at the beginning and at the end of contraction

Your friend is saying that she is 5 months pregnant. She got married 6 months ago. You were confused because when you examined her abdomen. You located the uterine fundus 3 fingers above the level of the umbilicus. You explained to your friend that she is already _______ pregnant.

1. Ms. Marcelo asks how long she will be in labor. All of the following factors will influence the length of her labor EXCEPT:*1 pointA. Mental attitude of the motherB. Size of the placentaC. Position of the fetus in the uteroD. Power of uterine contractions2. When the client returns to bed, she is encouraged to assume a position of comfort but preferably not to lie on her back. Supine position is likely to predispose her to:*1 pointA. BackacheB. DyspneaC. HypotensionD. Nausea3. The client asks the nurse about regaining her pre-pregnant weight. The nurse explains that the physiologic changes that results to weight loss during the first six weeks postpartum is due to the following EXCEPT:*1 pointA. Uterine bleedingB. Lochial dischargeC. Increase urine outputD. Increase perspiration4. The nurse is taking the vital signs of a woman who delivered a healthy newborn infant 4 hours ago. The nurse notes that the mother’s temperature is 37. 8 ˚C. Which of the following actions would be most appropriate?*1 pointA. Retake the temperature in 15 minutesB. Document the findingsC. Notify the physicianD. Increased hydration by encouraging oral fluids5. A fully dilated woman was rushed in the delivery unit. As the head is being delivered, which action should the nurse do next?*1 pointA. Place a slight pressure on the fundusB. Deliver the posterior shoulder of the neonateC. Check the neonate’s neck for umbilical cordD. Suction the mouth of the neonate6. Glessy determines that a client is in the second stage of labor and may start pushing. What marks the beginning of the second stage and what marks the end?*1 pointA. Cervical dilation of 7 to 8 cm; complete cervical dilationB. Complete cervical dilation; delivery of the neonateC. Cervical dilation of 7 to 8cm; delivery of the placentaD. Complete cervical dilation; delivery of the placenta7. Nurse Glessy is aware that the following would be an inappropriate indication of placental detachment?*1 pointA. Abrupt lengthening of the cordB. Increase in the number of contractionsC. Relaxation of the uterusD. Increased vaginal bleeding8. Karen didn’t recognize for over an hour that she was in labor. A sign of true labor is:*1 pointA. Sudden increase energy from epinephrine releaseB. “Nagging” but constant pain in the lower backC. Urinary urgency from increased bladder pressureD. “Show” or release of the cervical mucus plug9. Karen asks you which fetal position and presentation are ideal. Your best answer would be:*1 pointA. Right Occipitoanterior with full flexionB. Left transverse anterior in moderate flexionC. Right occipitoposterior with no flexionD. Left sacroanterior with full flexion10.  During the assessment of a client in labor the cervix is determined to be 4cm dilated. The nurse understands that this client is in the stage of labor known as:*1 pointA. FirstB. SecondC. ThirdD. Fourth11. The nurse is aware that a client at 40 weeks’ gestation is experiencing true labor if:*1 pointA. cervical dilatation has occurredB. the pains become more noticeableC. her membranes have rupturedD. the fetal heart rate baseline decreases12. A postpartum nurse is caring for a client who delivered a viable newborn infant 2 hours ago. The nurse palpates the fundus and notes the character of the lochia. Which characteristic of the lochia would the nurse expect to note at this time?*1 pointA. white-colored lochiaB. serosanguinous lochiaC. pink-colored lochiaD. dark red-colored lochia13. A nurse is monitoring a postpartum client in the fourth stage of labor. Which of the following findings, if noted by the nurse, would indicate a complication related to a laceration of the birth canal?*1 pointA. Presence of dark red lochiaB. Palpation of the fundus at the level of the umbilicusC. Palpation of the uterus as a firm contracted ballD. The saturation of more than one perineal pad per hour14. It has been 12 hours since the client’s delivery of a newborn. The nurse assesses the mother to the process of involution and documents that it is progressing normally when palpation of the client’s fundus is noted:*1 pointA. at the level of the umbilicusB. midway between the umbilicus and the symphysis pubisC. one finger breath below the umbilicusD. two finger breadths below the umbilicus15.  Mr. Young’s wife cervix is dilated 8cm. There is a sudden increase in the amount of bloody show. She vomits and her legs begin to tremble. She then becomes very irritable and cries out, “I can’t take it anymore.” At this time which of the following actions is most appropriate:*1 pointA. give her a dose of PRN of her pain relief medicationB. notify her physician of the possibility of hemorrhageC. review the breathing techniques with her againD. explain that she is progressing normally through labor16. A nurse is assisting in caring for a woman in labor who is receiving oxytoxin by intravenous infusion. The nurse monitors the client, knowing that which of the following indicates an adequate contraction pattern?*1 pointA. Three to five contractions in a 10-minute period, with resultant cervical dilatationB. One contraction per minute, with resultant cervical dilatationC. Four contractions every 5 minutes, with resultant cervical dilatationD. One contraction every 10 minutes without resultant cervical dilatation17. Approximately 15 minutes after delivery of a viable term neonate, a multiparous patient complains of chilling sensation. Which of the following would the nurse do next?*1 pointA. decrease the rate of IV fluidsB. assess the patient’s pulse rateC. assess the amount of blood lossD. provide the patient with warm blanket18. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as sign of:*1 pointA. uterine atonyB. hematomaC. placental separationD. placenta previa19. A postpartal client has been complaining about the “afterpains” that occur while breastfeeding and questions you about them. You explain to her that they are due to the fact that:*1 pointA. the baby is sucking too vigorously and should nurse more oftenB. the baby’s sucking stimulates the uterus to contractC. she is tense during breastfeeding, resulting in uterine spasmsD. she is probably recalling her labor experience at feeding20.  A nurse performs an assessment on a client who is 4 hours postpartum. The nurse notes that the client has cool, clammy skin and is restless and excessively thirsty. The nurse prepares immediately to:*1 pointA. begin fundal massage and start oxygen by maskB. begin hourly pad counts and reassure the clientC. elevate the head of the bed and assess vital signsD. assess for hypovolemia and notify the health care provider

1. Ms. Marcelo asks how long she will be in labor. All of the following factors will influence the length of her labor EXCEPT:*1 pointA. Mental attitude of the motherB. Size of the placentaC. Position of the fetus in the uteroD. Power of uterine contractions2. When the client returns to bed, she is encouraged to assume a position of comfort but preferably not to lie on her back. Supine position is likely to predispose her to:*1 pointA. BackacheB. DyspneaC. HypotensionD. Nausea

11. The nurse is aware that a client at 40 weeks’ gestation is experiencing true labor if:*1 pointA. cervical dilatation has occurredB. the pains become more noticeableC. her membranes have rupturedD. the fetal heart rate baseline decreases12. A postpartum nurse is caring for a client who delivered a viable newborn infant 2 hours ago. The nurse palpates the fundus and notes the character of the lochia. Which characteristic of the lochia would the nurse expect to note at this time?*1 pointA. white-colored lochiaB. serosanguinous lochiaC. pink-colored lochiaD. dark red-colored lochia13. A nurse is monitoring a postpartum client in the fourth stage of labor. Which of the following findings, if noted by the nurse, would indicate a complication related to a laceration of the birth canal?*1 pointA. Presence of dark red lochiaB. Palpation of the fundus at the level of the umbilicusC. Palpation of the uterus as a firm contracted ballD. The saturation of more than one perineal pad per hour14. It has been 12 hours since the client’s delivery of a newborn. The nurse assesses the mother to the process of involution and documents that it is progressing normally when palpation of the client’s fundus is noted:*1 pointA. at the level of the umbilicusB. midway between the umbilicus and the symphysis pubisC. one finger breath below the umbilicusD. two finger breadths below the umbilicus15.  Mr. Young’s wife cervix is dilated 8cm. There is a sudden increase in the amount of bloody show. She vomits and her legs begin to tremble. She then becomes very irritable and cries out, “I can’t take it anymore.” At this time which of the following actions is most appropriate:*1 pointA. give her a dose of PRN of her pain relief medicationB. notify her physician of the possibility of hemorrhageC. review the breathing techniques with her againD. explain that she is progressing normally through labor16. A nurse is assisting in caring for a woman in labor who is receiving oxytoxin by intravenous infusion. The nurse monitors the client, knowing that which of the following indicates an adequate contraction pattern?*1 pointA. Three to five contractions in a 10-minute period, with resultant cervical dilatationB. One contraction per minute, with resultant cervical dilatationC. Four contractions every 5 minutes, with resultant cervical dilatationD. One contraction every 10 minutes without resultant cervical dilatation17. Approximately 15 minutes after delivery of a viable term neonate, a multiparous patient complains of chilling sensation. Which of the following would the nurse do next?*1 pointA. decrease the rate of IV fluidsB. assess the patient’s pulse rateC. assess the amount of blood lossD. provide the patient with warm blanket18. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as sign of:*1 pointA. uterine atonyB. hematomaC. placental separationD. placenta previa19. A postpartal client has been complaining about the “afterpains” that occur while breastfeeding and questions you about them. You explain to her that they are due to the fact that:*1 pointA. the baby is sucking too vigorously and should nurse more oftenB. the baby’s sucking stimulates the uterus to contractC. she is tense during breastfeeding, resulting in uterine spasmsD. she is probably recalling her labor experience at feeding20.  A nurse performs an assessment on a client who is 4 hours postpartum. The nurse notes that the client has cool, clammy skin and is restless and excessively thirsty. The nurse prepares immediately to:*1 pointA. begin fundal massage and start oxygen by maskB. begin hourly pad counts and reassure the clientC. elevate the head of the bed and assess vital signsD. assess for hypovolemia and notify the health care provider