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CT#2 Chapter 13


A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? “The contractions slow down when I walk around.”
Which of the following would indicate to the nurse that the placenta is separating? Uterus becomes globular
When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics? Degree of thinning
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following? Moderately strong contractions every 4 minutes, lasting about 1 minute
A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? Upright
A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: Transition phase of the first stage of labor
The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth? Cesarean
Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: Latent phase of the first stage
A client is admitted to the labor and birthing suite in early labor. On review of her medical record, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted? Gynecoid
A woman telephones her health care provider and reports that her “water just broke.” Which suggestion by the nurse would be most appropriate? “Come to the clinic or emergency department for an evaluation.”
After teaching a group of students about the maternal bony pelvis, which statement by the group indicates that the teaching was successful? The pelvic outlet is associated with the true pelvis.
A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as: –2
Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? Frank
A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which of the following has most likely occurred? Lightening
After teaching a group of students about the factors affecting the labor process, the instructor determines that the teaching was successful when the group identifies which of the following as a component of the true pelvis? (Select all that apply.) Pelvic inlet Mid pelvis Pelvic outlet
A nurse is documenting fetal lie of a woman in labor. Which term would the nurse most likely use? Longitudinal
The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which of the following is the presenting part? Buttocks
A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which of the following would the nurse most likely include? (Select all that apply.) Internal rotation Descent Flexion
The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which of the following? Peak
A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? Respiratory rate of 10 breaths /minute
When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage? Cervical dilation
A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor? Contractions every 1 minute, cervical dilation 9 cm-
A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which of the following would the nurse most likely include when discussing measures to promote coping for a positive labor experience? (Select all that apply.) Presence of a support partner Low anxiety level Participation in a pregnancy exercise program
During a follow-up prenatal visit, a pregnant woman asks the nurse, “How long do you think I will be in labor?” Which response by the nurse would be most appropriate? “It's difficult to predict how your labor will progress, but we'll be there for you the entire time.”
A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse identify as being most important in allowing the fetal head to move through the pelvis? Sutures
Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station? 0
Created by: Macneany



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