Dif cognitive level apply ref p 375 top nursing

DIF: Cognitive Level: Apply REF: p. 375
TOP: Nursing Process: Planning | Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
13.
Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus
for initiating respirations immediately after birth. Which change in fetal physiologic activity
is not part of this process?
a.
Fetal lung fluid is cleared from the air passages during labor and vaginal birth.
b.
Fetal partial pressure of oxygen (PO2) decreases.
c.
Fetal partial pressure of carbon dioxide in arterial blood (PaCO2) increases.
d.
Fetal respiratory movements increase during labor.
ANS: D
Fetal respiratory movements actually decrease during labor. Fetal lung fluid is cleared from the
air passages during labor and vaginal birth. Fetal PO2 decreases, and fetal PaCO2 increases.
DIF: Cognitive Level: Understand REF: p. 379
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
14.
Which description of the four stages of labor is correct for both the definition and the
duration?
a.
First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
b.
Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
c.
Third stage: active pushing to birth; 20 minutes (multiparous woman), 50 minutes
(nulliparous woman)
d.
Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour
ANS: A
Full dilation may occur in less than 1 hour, but in first-time pregnancies full dilation can take up
to 20 hours. The second stage of labor extends from full dilation to birth and takes an average of
20 to 50 minutes, although 2 hours is still considered normal. The third stage of labor extends
from birth to the expulsion of the placenta and usually takes a few minutes. The fourth stage
begins after the expulsion of the placenta and lasts until homeostasis is reestablished
(approximately 2 hours).

DIF: Cognitive Level: Understand REF: pp. 376-377 TOP: Nursing Process: Diagnosis
MSC: Client Needs: Health Promotion and Maintenance
15.
Nurses should be cognizant of what regarding the mechanism of labor?
a.
Seven critical movements must progress in a more or less orderly sequence.
b.
Asynclitism is sometimes achieved by means of the Leopold’s maneuver.
c.
Effects of the forces determining descent are modified by the shape of the woman’s pelvis
and the size of the fetal head.
d.
At birth, the baby is said to achieve “restitution”; that is, a return to the C-shape of the
womb.
ANS: C
The size of the maternal pelvis and the ability of the fetal head to mold also affect the process.
The seven identifiable movements of the mechanism of labor simultaneously occur in
combinations, not in precise sequences. Asynclitism is the deflection of the baby’s head; the
Leopold’s maneuver is a means of judging descent by palpating the mother’s abdomen.