2024 Intrapartum Review

A 32-year-old woman is dilated 4 cm. The health care provider states that she has a roomy pelvis and the baby is in the ROA position at +1 station. Her contractions are occurring every 10 minutes, lasting 30 to 40 seconds, and palpate mild in intensity. She is calm and relaxed. Given this information, which essential component of labor is unexpected and likely to slow the progress of labor at this time?

• Passageway

• Passenger

• Powers

• Psyche

The fetus is in a cephalic presentation. The occiput is facing toward the front and slightly to the right of the mother's pelvis, and the fetus is exhibiting a flexed attitude. How is the position of the fetus documented for this situation?

• LOA

• LOP

• ROA

• ROP

A client has just delivered a healthy baby, but the placenta has not yet delivered. What stage of labor does this scenario represent?

• First

• Second

• Third

• Fourth

Which of the following statements made by a pregnant client indicate false labor? Select all that apply.

• "My bag of waters just broke."

• "The contractions are irregular."

• "The contraction feels tight and is located in my abdomen."

• "Walking has made the contractions stop."

• "I am having a lot of bloody, mucus-type discharge."

A 22-year-old client is in the office for a checkup at 36 weeks' gestation. Which comment made by the client indicates that she needs additional education about pain relief during labor?

• "I have discussed pain relief options with the doctor and my childbirth educator."

• "I'm so glad that I won't have any pain because I'm going to have an epidural."

• "I've been practicing the relaxation exercises I learned in my childbirth class."

• "I want to have medications through the IV if the pain gets so bad that I can't handle it."

A 34-year-old gravida 3, para 2 client is experiencing severe back pain with every contraction She is extremely uncomfortable and upset because she has never had this type of pain with her other labors. What interventions are most likely to help in this situation?

• Comfort measures, intermittent labor support by the nurse, and reassurance that the pain is temporary

• Counterpressure with a fist or tennis ball to the lower back and water injections

• Effleurage, ambulation, and frequent position changes

• Hypnosis, imagery, and slow chest breathing

The nurse is preparing a woman for epidural anesthesia. The woman asks, "Why am I getting more IV fluids?" What reply by the nurse is best?

• "Don't worry, this is a routine procedure in preparation for an epidural."

• "I'll slow the IV down so you won't feel so cold."

• "IV fluids help postdural puncture headaches."

• "IV fluids help prevent the blood pressure from dropping too low."

The thinning and shortening of the cervix in preparation for birth is known as ____________.

A woman presents to the labor suite and states, "I have water leaking down my legs." Which of the following is the priority nursing intervention?

• Determine fetal heart rate (FHR)

• Perform a Fern test

• Check the woman's blood pressure

• Test her urine for protein

A laboring client is placed on external electronic fetal monitoring and reveals this pattern. The nurse identifies this as which of the following periodic changes?

• Early decelerations

• Late decelerations

• Variable decelerations

• Accelerations