Exam (elaborations)
Chapter 16 Giving Birth
- Course
- Nursing
- Institution
- University At Buffalo
Chapter 16 Giving Birth
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Chapter 16: Giving BirthTest Bank
MULTIPLE CHOICE
1. The maternity nurse understands that as the uterus contracts during labor, maternal-fetal
exchange of oxygen and waste products
a. Continues except when placental functions are reduced
b. Increases as blood pressure decreases
c. Diminishes as the spiral arteries are compressed
d. Is not significantly affected
ANS: C
Feedback
A The maternal blood supply to the placenta gradually stops with contractions.
B The exchange of oxygen and waste products decreases.
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.
D The exchange of oxygen and waste products is affected by contractions.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 320
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. Which statement is the best rationale for assessing maternal vital signs between contractions?
a. During a contraction, assessing fetal heart rates is the priority.
b. Maternal circulating blood volume increases temporarily during contractions.
c. Maternal blood flow to the heart is reduced during contractions.
d. Vital signs taken during contractions are not accurate.
ANS: B
Feedback
A It is important to monitor fetal response to contractions, but the question is
concerned with the maternal vital signs.
B 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 pulse.
C Maternal blood flow is increased during a contraction.
D Vital signs are altered by contractions but are considered accurate for that period
of time.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 319
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
,3. Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes
the pelvic inlet?
a. Engagement
b. Extension
c. Internal rotation
d. External rotation
ANS: A
Feedback
A Engagement occurs when the presenting part fully enters the pelvic inlet.
B 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.
C 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.
D 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: Knowledge REF: p. 329
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
4. To adequately care for patients, the nurse understands that labor contractions facilitate
cervical dilation by
a. Contracting the lower uterine segment
b. Enlarging the internal size of the uterus
c. Promoting blood flow to the cervix
d. Pulling the cervix over the fetus and amniotic sac
ANS: D
Feedback
A The contractions are stronger at the fundus.
B The internal size becomes smaller with the contractions; this helps to push the
fetus down.
C Blood flow decreases to the uterus during a contraction.
D Effective uterine contractions pull the cervix upward at the same time that the
fetus and amniotic sac are pushed downward.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 319
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. It is important for the nurse providing care during labor to be aware that pregnant women can
usually tolerate the normal blood loss associated with childbirth because they have
a. A higher hematocrit
b. Increased blood volume
c. A lower fibrinogen level
, d. Increased leukocytes
ANS: B
Feedback
A The hematocrit decreases with pregnancy due to the high fluid volume.
B Women have a significant increase in blood volume during pregnancy. After
delivery, the additional circulating volume is no longer necessary.
C Fibrinogen levels increase with pregnancy.
D Leukocyte levels increase during labor, but that is not the reason for the
toleration of blood loss.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 320
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. To assess the duration of labor contractions, the nurse determines the time
a. From the beginning of one contraction to the beginning of the next
b. From the beginning to the end of each contraction
c. Of the strongest intensity of each contraction
d. Of uterine relaxation between two contractions
ANS: B
Feedback
A This is the frequency of the contractions.
B Duration of labor contractions is the average length of contractions from
beginning to end.
C This is the strength or intensity of the contractions.
D This is the interval of the contraction phase.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 318
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
7. To adequately teach patients about the process of labor, the nurse knows that which event is
the best indicator of true labor?
a. Bloody show
b. Cervical dilation and effacement
c. Fetal descent into the pelvic inlet
d. Uterine contractions every 7 minutes
ANS: B
Feedback
A Bloody show can occur before true labor.
B The conclusive distinction between true and false labor is that contractions of
true labor cause progressive change in the cervix.
C Fetal descent can occur before true labor.
D False labor may have contractions that occur this frequently, but it is usually
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