Second Stage Of Labor Flashcards, test questions and answers

Question 1

What nursing action is the priority for a client in the second stage of labor?

Answer

Promote effective pushing by the client
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Question 2

The nurse is discussing the stages of labor with a group of women in the last month of pregnancy and provides examples of different positional techniques used during the second stage of labor. Which position should the nurse address that provides the best advantage of gravity during delivery? Lithotomy. Kneeling. Squatting. Walking.

Answer

Squatting (B) helps to align the fetus with the pelvic outlet and allows gravity to assist in fetal descent and gives the client an adventitious position for birth.
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Question 3

The nurse is caring for a woman with a previously diagnosed heart disease who is in the second stage of labor. Which assessment findings are of greatest concern? a. edema, basilar rales, and an irregular pulse b. Increased urinary output, and tachycardia c. Shortness of breath, bradycardia, and hypertension d. Regular heart rate, and hypertension

Answer

a. Edema, basilar rales, and an irregular pulse Edema, basilar rales, and an irregular pulse (A) indicate cardiac decompensation and require immediate intervention.
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Question 4

Causes of pain in the second stage of labor:

Answer

Hypoxia of contracting uterine muscle cells Distention of vagina & perineum Pressure on adjacent structures
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Question 5

For a client who’s fully dilated, which of the following actions would be inappropriate during the second stage of labor? 1. Positioning the mother for effective pushing 2. Preparing for delivery of the baby 3. Assessing vital signs every 15 minutes 4. Assessing for rupture of membranes

Answer

Answer: 4 RATIONALES: In most cases, the membranes have ruptured (spontaneously or artificially) by this stage of labor. Positioning for effective pushing, preparing for delivery, and assessing vital signs every 15 minutes are appropriate actions at this time.
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Question 6

Assessment of a client in active labor reveals meconium-stained amniotic fluid and fetal heart sounds in the upper right quadrant. Which of the following is the most likely cause of this situation? 1. Breech position 2. Late decelerations 3. Entrance into the second stage of labor 4. Multiple gestation

Answer

Answer: 1 RATIONALES: Fetal heart sounds in the upper right quadrant and meconium-stained amniotic fluid indicate a breech presentation. The staining is usually caused by the squeezing actions of the uterus on a fetus in the breech position, although late decelerations, entrance into the second stage of labor, and multiple gestation may contribute to meconium-stained amniotic fluid.
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Question 7

Which nursing assessment indicates that a woman who is in the second stage of labor is almost ready to give birth? a. Bloody mucous discharge increases. b. The vulva bulges and encircles the fetal head. c. The membranes rupture during a contraction. d. The fetal head is felt at 0 station during the vaginal examination.

Answer

ANS: B A bulging vulva that encircles the fetal head describes crowning, which occurs shortly before birth. Bloody show occurs throughout the labor process and is not an indication of an imminent birth. Rupture of membranes can occur at any time during the labor process and does not indicate an imminent birth. Birth of the head occurs when the station is +4. A 0 station indicates engagement.
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Question 8

A nurse is caring for a client and her partner during the second stage of labor. The client’s partner asks the nurse to explain how he will know when crowning occurs. Which of the following is an appropriate response by the nurse? A. “The placenta will protrude from the vagina.” B. “Your partner will report a decrease in the intensity of contractions.” C. “The vaginal area will bulge as the baby’s head appears.” D. “Your partner will report less rectal pressure.”

Answer

C
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Question 9

While caring for a pregnant patient with body mass index of 32 during labor, the nurse observes that the second stage of labor lasts for about 11 minutes. The nurse also finds that the expected birth weight of the fetus is around 4200 g. Which complication does the nurse anticipate in the neonate after birth? 1 Erb palsy 2 Klumpke palsy 3 Strawberry hemangioma 4 Erythema toxicum neonatorum Maternal body mass index of greater than 30, a second stage of labor lasting less than 15 minutes, and an infant birth weight higher than 4000 g indicates a risk of Erb palsy or Erb-Duchenne paralysis in the neonate. Klumpke palsy can result due to severe stretching of the upper extremities, while the trunk is relatively less mobile during labor. A maternal body mass index greater than 30, a second stage of labor lasting less than 15 minutes, and infant birth weight higher than 4000 g are not indicators of strawberry hemangioma or erythema toxicum neonatorum.

Answer

While caring for a pregnant patient with body mass index of 32 during labor, the nurse observes that the second stage of labor lasts for about 11 minutes. The nurse also finds that the expected birth weight of the fetus is around 4200 g. Which complication does the nurse anticipate in the neonate after birth? Correct1 Erb palsy 2 Klumpke palsy 3 Strawberry hemangioma 4 Erythema toxicum neonatorum Maternal body mass index of greater than 30, a second stage of labor lasting less than 15 minutes, and an infant birth weight higher than 4000 g indicates a risk of Erb palsy or Erb-Duchenne paralysis in the neonate. Klumpke palsy can result due to severe stretching of the upper extremities, while the trunk is relatively less mobile during labor. A maternal body mass index greater than 30, a second stage of labor lasting less than 15 minutes, and infant birth weight higher than 4000 g are not indicators of strawberry hemangioma or erythema toxicum neonatorum.
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Question 10

What is the priority nursing action during a client’s second stage of labor? Assessing the perineum for bulging Administering the prescribed analgesia Helping the client pant with each contraction Catheterizing the client before the head reaches +3 station

Answer

Assessing the perineum for bulging (A bulging perineum is caused by the pressure of the fetal head against the perineal area and usually signifies imminent birth. Pain medication is not administered this close to the birth; it crosses the placental barrier and can cause respiratory distress in the newborn. During the second stage of labor the client is encouraged to push, not pant, with each contraction. Catheterization may be indicated earlier in labor so uterine contractions are not impeded; voiding will occur spontaneously as the client pushes.)
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