OB Week 6

A nurse identifies contractions every 3 minutes lasting 60 seconds with increasing intensity and cervical dilation progressing from 3 cm to 5 cm. Which finding confirms true labor?

Cervical change occurs

Which maternal pelvis shape is most favorable for vaginal birth?

Gynecoid

A laboring client is 100% effaced and 10 cm dilated. Which stage of labor is occurring?

Second stage

During Leopold maneuvers, the nurse palpates a smooth firm surface on the left side and small irregular parts on the right. What does this indicate?

Fetal back on left side

A fetus is documented as station +2. What does this mean?

Presenting part below ischial spines

Which finding suggests placental separation?

Uterus becomes globular

Which contraction pattern requires immediate nursing intervention?

Every 1 min × 90 sec

Baseline fetal heart rate is 145 bpm with moderate variability. Interpretation?

Reassuring status

Which variability category is considered normal?

Moderate

Early decelerations are usually caused by:

Head compression

Late decelerations indicate:

Uteroplacental insufficiency

Variable decelerations most commonly result from:

Cord compression

Which intervention is priority for recurrent late decelerations?

Turn client to lateral position

Continuous internal fetal monitoring requires:

Cervix ≥2 cm and ruptured membranes

Which pain-management measure is nonpharmacologic?

Hydrotherapy

Which opioid reversal agent should the nurse have available?

Naloxone

Epidural anesthesia is generally initiated when:

Active labor (4–5 cm)

Before epidural placement, the nurse anticipates:

Fluid bolus

Major maternal complication after epidural:

Hypotension

Priority assessment after epidural?

Blood pressure

Which block is commonly used for forceps birth?

Pudendal block

A woman receiving spinal anesthesia reports severe headache when sitting upright. Priority?

Notify provider—possible spinal headache

During labor the client says, “I can’t do this anymore.” Best response?

“Tell me what feels hardest right now.”

A woman reports sudden gush of fluid. Priority nursing action?

Assess FHR

Which amniotic fluid finding is concerning?

Which amniotic fluid finding is concerning?

During second stage, nurse should:

Support spontaneous bearing-down efforts

Which maternal position improves uteroplacental circulation?

Left lateral

Fetal engagement occurs at:

0 station

During labor maternal BP temporarily increases due to:

Uterine contractions

A nurse notes maternal hyperventilation. Priority?

Encourage slower breathing

Which indicates transition phase?

Strong urge to push

Which finding indicates effective labor support?

Continuous emotional support

Fourth stage of labor focuses primarily on:

Maternal stabilization

Priority postpartum assessment?

Fundus and bleeding

If bladder is distended postpartum, nurse expects:

Boggy displaced uterus

Which indicates effective pushing?

Push with contractions and rest between

FHR baseline 105 bpm for 12 minutes is:

Bradycardia

Most important fetal monitoring goal:

Prevent fetal injury from impaired oxygenation

Which labor factor refers to fetal presentation and position?

Passenger

Which nursing action promotes attachment immediately after birth?

Facilitate skin-to-skin contact