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

During the third stage of labor, theGroup of answer choicescervix becomes dilated to about four inches.estrogen levels begin to rise.baby begins to move down into the vagina.placenta is delivered.

In order for a woman to start pushing, she must be how many cm (s) dilated?*2 points102091

64.     What is the smallest diameter of the fetal head?*1 pointA. SuboccipitobregmaticB. BiparietalC. OccipitomentalD. Occipitofrontal65.  All pregnant women should be thought how to recognized preliminary signs of labor which is:*1 pointA. rupture of membranesB. bright red vaginal bleedingC. increase in level of activityD. bandl’s ring66.     This is the most common presentation in which the head is sharply flexed and allows the suboccipitobregmatic diameter to present to the cervix.*1 pointA. mentumB. faceC. vertexD. brow67.  The physician performs on Mrs. Santos. All of the following statements reflect reasons for performing an episiotomy at the beginning of the second stage of labor except:*1 pointA. an incision is easier to repair, heals faster and can be controlled directionallyB. trauma to the fetal head is decreased as the opening is enlargedC. the second stage of labor is lengthenedD. stretching and tissue necrosis of vaginal mucosa are prevented68.  The best way for the nurse to assess the amount of blood loss following delivery is to:*1 pointA. count or weigh perineal padsB. monitor pulse and blood pressureC. measure the height of the fundusD. check hemoglobin and hematocrit69.  The nurse teaches a primigravida how to measure the frequency of uterine contractions. The nurse should explain to the client that the frequency of uterine contractions is determined:*1 pointA. from the beginning of one contraction to the end of the next contractionB. from the beginning of one contraction to the end of the same contractionC. by the number of contractions that occur within a given period of timeD. by the strength of the contraction at its peak70.  A woman is admitted to a labor unit in active labor. Which of the following assessments would alert you to the possibility that she may have difficulty accepting this child?*1 pointA. ”I’m so tired of being pregnant.”B. ”I haven’t been able to sleep well lately.”C. ”I want this baby to be a boy.”D. ”I am so exhausted.

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

Which of the following is the final stage of labor?Group of answer choicesA) Delivery of the babyB) Dilation and effacement of the cervixD) Delivery of the placentaC) Latent, moderate contractions