Question

Which of the following best explains the significance of the cardinal movements of labor?

Answer 1

Correct Answers:

The cardinal movements of labor facilitate the fetus's passage through the birth canal by allowing it to maneuver into the optimal position for delivery.

Rationale :

🤰 The cardinal movements are a sequence of positional changes the fetus must perform: engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.

🤰 These movements align the smallest diameters of the fetal skull with the maternal pelvis to ease passage.

🤰 They occur involuntarily, driven by uterine contractions, fetal head molding, and maternal pushing.

🤰 Without proper execution, labor may stall, leading to dystocia, assisted delivery, or cesarean birth.

🤰 Their significance lies in ensuring both maternal safety and efficient delivery of the newborn.

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Answer 2

Correct Answers:

Tachycardia

Rationale :

❤️ The first clinical sign of hypovolemic shock from postpartum hemorrhage is tachycardia.

❤️ This reflects the body’s compensatory mechanism, where the heart pumps faster to maintain cardiac output despite falling blood volume.

❤️ Hypotension, clammy skin, and decreased urine output are later signs once compensation fails.

❤️ Early recognition of tachycardia is critical for initiating fluid replacement, blood transfusion, and uterotonics before the shock worsens.

❤️ Prompt nursing response prevents organ hypoperfusion, multi-organ dysfunction, and maternal death.

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Answer 3

Correct Answers:

Regular contractions becoming more frequent and intense

Rationale :

🍼 True labor is defined by rhythmic contractions that gradually increase in strength, duration, and frequency.

🍼 These contractions cause progressive cervical dilation and effacement, distinguishing them from false labor.

🍼 Discomfort radiates from the back to the abdomen, unlike Braxton Hicks contractions which are felt in the groin.

🍼 Activity such as walking does not relieve true labor contractions, while it may lessen false contractions.

🍼 Recognizing these features allows nurses to provide timely admission, support, and labor monitoring

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Answer 4

Correct Answers:

A sudden drop in blood pressure and increased heart rate

Rationale :

🩸 Postpartum hemorrhage (PPH) can cause rapid maternal deterioration.

🩸 The combination of falling blood pressure and compensatory tachycardia indicates severe intravascular volume loss.

🩸 These cues signal the body is in the early stages of shock, demanding immediate intervention.

🩸 Delayed recognition can lead to irreversible hypovolemic shock, organ failure, and maternal death.

🩸 Immediate actions include uterine massage, IV fluids, blood transfusion, and notifying the provider.

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Answer 5

Correct Answers:

Expulsion of the placenta and membranes

Rationale :

👩‍🍼 Labor has three clearly defined stages:

Stage 1: Onset of contractions → full cervical dilation (10 cm).

Stage 2: Delivery of the infant.

Stage 3: Delivery of the placenta and membranes.

👩‍🍼 The third stage ends when the placenta is expelled intact, signaling the completion of childbirth.

👩‍🍼 Retained placenta fragments can cause severe postpartum hemorrhage and infection.

👩‍🍼 Nurses must assess for placental completeness and monitor uterine tone afterward.

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Answer 6

Correct Answers:

Cervical laceration

Rationale :

🩸 Delivering a macrosomic infant (over 4,000 g/8 lbs 13 oz) stretches maternal tissues beyond their normal capacity.

🩸 This increases the risk of cervical and vaginal lacerations, especially after a prolonged or rapid labor.

🩸 A hallmark finding is bright red vaginal bleeding that persists despite a firm, well-contracted uterus.

🩸 Lacerations must be promptly identified and surgically repaired to control bleeding and prevent hypovolemic shock.

🩸 The nurse plays a key role in monitoring lochia, reporting abnormal bleeding patterns, and supporting hemodynamic stability.

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Answer 7

Correct Answers:

Sacral pressure

Rationale :

🤰 Sacral (counter) pressure involves applying firm, continuous pressure with the hand, fist, or tennis ball against the woman’s sacrum.

🤰 It is especially effective for back labor pain caused by an occiput posterior (OP) fetal position, where the fetal head presses against maternal sacral nerves.

🤰 This method helps redistribute pressure and reduce maternal discomfort during contractions.

🤰 It is a nonpharmacological comfort technique that allows the support person to actively participate in labor care.

🤰 Nurses often teach labor partners this technique as part of supportive care and pain management.

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Answer 8

Correct Answers:

To provide anesthesia for episiotomy and perineal repair

Rationale :

💉 A pudendal nerve block provides localized anesthesia to the perineum, vulva, and lower vagina.

💉 It does not relieve labor contraction pain but is highly effective for procedures such as episiotomy, forceps delivery, or suturing lacerations.

💉 It is performed just before delivery or immediately after to manage perineal pain.

💉 Advantages: rapid onset, minimal systemic effects, and no impact on uterine contractions or fetal heart rate.

💉 This block allows for effective, safe perineal repair without requiring general anesthesia.

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Answer 9

Correct Answers:

To enhance fetal lung maturity

Rationale :

🌬️ Betamethasone, a corticosteroid, is administered to women at risk of preterm labor between 24 and 34 weeks gestation.

🌬️ It stimulates fetal lung cells to produce surfactant, a substance that prevents alveolar collapse after birth.

🌬️ This significantly reduces the incidence of respiratory distress syndrome (RDS), intraventricular hemorrhage, and neonatal mortality.

🌬️ The medication does not affect maternal contractions directly but provides a lifesaving advantage to preterm infants.

🌬️ Nurses ensure timely administration (two doses 24 hours apart) and monitor for maternal glucose changes in diabetic patients.

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Answer 10

Correct Answers:

Ensure the patient has been NPO for at least 8 hours

Rationale :

🛑 Preoperative NPO status is essential to prevent aspiration of stomach contents during anesthesia induction.

🛑 Aspiration can lead to chemical pneumonitis (Mendelson’s syndrome), a serious complication.

🛑 While fundal assessments, lochia checks, and ambulation are important, they are post-cesarean priorities, not pre-op.

🛑 Ensuring NPO status is a safety measure that reduces perioperative morbidity and mortality.

🛑 Nurses also verify IV access, baseline vitals, and lab work, but NPO status remains the top priority before surgery.

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Custom N105Maternal & NewbornUnit Test 2, CAD July 2025

No.

1 :
Which of the following best explains the significance of the cardinal movements of labor?

2 :
What is the first sign of hypovolemic shock from postpartum hemorrhage?

3 :
.At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse knows what indicates the beginning of true labor?

4 :
A postpartum patient is experiencing excessive bleeding. Which of the following cues should the nurse recognize as indicative of postpartum hemorrhage requiring immediate intervention?

5 :
What marks the end of the third stage of labor?

6 :
After a prolonged labor, a woman vaginally delivered a 10-pound. 3-ounce infant boy. What complication should the nurse be alert for in the immediate postpartum period?

7 :
A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back. What is this technique?

8 :
In which situation is a pudendal nerve block most appropriately indicated during labor?

9 :
A nurse is caring for a pregnant woman at 30 weeks gestation who is at risk for preterm labor. Which of the following is the primary reason betamethasone may be prescribed for this patient?

10 :
A nurse is assigned to care for a patient who is scheduled for a cesarean delivery. Which of the following nursing interventions is most important to complete before the procedure?

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Custom N105Maternal & NewbornUnit Test 2, CAD July 2025

No.

1 : Which of the following best explains the significance of the cardinal movements of labor?

2 : What is the first sign of hypovolemic shock from postpartum hemorrhage?

3 : .At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse knows what indicates the beginning of true labor?

4 : A postpartum patient is experiencing excessive bleeding. Which of the following cues should the nurse recognize as indicative of postpartum hemorrhage requiring immediate intervention?

5 : What marks the end of the third stage of labor?

6 : After a prolonged labor, a woman vaginally delivered a 10-pound. 3-ounce infant boy. What complication should the nurse be alert for in the immediate postpartum period?

7 : A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back. What is this technique?

8 : In which situation is a pudendal nerve block most appropriately indicated during labor?

9 : A nurse is caring for a pregnant woman at 30 weeks gestation who is at risk for preterm labor. Which of the following is the primary reason betamethasone may be prescribed for this patient?

10 : A nurse is assigned to care for a patient who is scheduled for a cesarean delivery. Which of the following nursing interventions is most important to complete before the procedure?

1 :
Which of the following best explains the significance of the cardinal movements of labor?

2 :
What is the first sign of hypovolemic shock from postpartum hemorrhage?

3 :
.At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse knows what indicates the beginning of true labor?

4 :
A postpartum patient is experiencing excessive bleeding. Which of the following cues should the nurse recognize as indicative of postpartum hemorrhage requiring immediate intervention?

5 :
What marks the end of the third stage of labor?

6 :
After a prolonged labor, a woman vaginally delivered a 10-pound. 3-ounce infant boy. What complication should the nurse be alert for in the immediate postpartum period?

7 :
A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back. What is this technique?

8 :
In which situation is a pudendal nerve block most appropriately indicated during labor?

9 :
A nurse is caring for a pregnant woman at 30 weeks gestation who is at risk for preterm labor. Which of the following is the primary reason betamethasone may be prescribed for this patient?

10 :
A nurse is assigned to care for a patient who is scheduled for a cesarean delivery. Which of the following nursing interventions is most important to complete before the procedure?