Nurses Research Publication - Your Special Baby: Real Lamaze Perpared Childbirth

Your Special Baby: Real Lamaze Perpared Childbirth

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1.	If a pregnant woman suspects a decrease or change in fetal movements from the 26th week of pregnancy or after, she should:
	a.	Place her hands on either side of her abdomen and gently shake her abdomen from left to right.
	b.	Discuss it with her doctor or midwife at her next prenatal appointment.
	c.	Eat a small meal or drink orange juice, lie on her left side for one hour and record the number of fetal movements felt.
	d.	Call her doctor or midwife immediately.
	e.	Go directly to the labor unit at the nearest hospital.

2.	According to the American College of Obstetricians and Gynecologists, an informed consent includes:
	a.	The process(es) contemplated by the physician as treatment, its risks and hazards.
	b.	The chances for recovery after treatment.
	c.	The necessity of the treatment.
	d.	The feasibility of alternative methods of treatment.
	e.	All of the above.

3.	The American Academy of Pediatrics’ Committee on Drugs has recently stated:
	a.	There is no drug, whether prescription or over-the-counter remedy, which has been proven safe for the unborn child.
	b.	Properly prescribed medications during pregnancy are safe for the unborn child.
	c.	Over-the-counter medications with no disclaimer against use during pregnancy are safe for the unborn child.
	d.	Properly prescribed medications used after the 4th month of pregnancy are safe for the unborn child.
	e.	Over-the-counter medications with no disclaimer against the use after the 4th month of pregnancy are safe for the unborn child.

4.	Severe Stomach pains, a severe headache and fever over 100.4F:
	a.	Indicates a case of polynephritis.
	b.	Are some of the danger signs of pregnancy.
	c.	Indicate cord prolapse.
	d.	Are precursors of abruption placenta.
	e.	Occur with preterm labor.

5.	Sexual intimacy during pregnancy may be contraindicated due to:
	a.	Threatened preterm labor.
	b.	Vaginal bleeding and/or placenta previa.
	c.	Incompetent cervix.
	d.	a & c.
	e.	a, b & c

6.	Sexual intimacy postpartum may be contraindicated due to:
	a.	Possibility of infection until the placental site heals.
	b.	Pain from the episiotomy site and/or unrepaired vaginal lacerations.
	c.	Fatigue.
	d.	a & b
	e.	a, b & c.

7.	The weight of the fetus at birth is due to:
	a.	Maternal health, nutrition and eating habits prior to conception.
	b.	Maternal health habits such as smoking, alcohol ingestion, drugs or medications taken.
	c.	Maternal age, parity and pregnancy weight gain.
	d.	Placental sufficiency.
	e.	All of the above.

8.	The average optimal weight gain of pregnancy is:
	a.	25-35 pounds.
	b.	25-30 pounds.
	c.	20-24 pounds.
	d.	30-40 pounds.
	e.	40-60 pounds.

9.	Women carrying more than one fetus should gain:
	a.	At least 24 pounds.
	b.	20-25 pounds.
	c.	25-35 pounds.
	d.	30-40 pounds.
	e.	40-60 pounds.

10.	Pelvic rocks are done to:
	a.	Relax the pelvis.
	b.	Improve posture and relieve backache.
	c.	Improve the curve of the pelvis during second stage labor.
	d.	Prevent posterior presentation of the fetus.
	e.	Strengthen the oblique muscles.

11.	Kegels are done to:
	a.	Strengthen abdominal muscle tone and improve circulation.
	b.	Assist expansion of the rib cage and relieve symptoms of SOB and/or heartburn.
	c.	Assist with second stage labor and improve circulation to the episiotomy site.
	d.	Prevent formation of lower extremity blood clots due to pressure of the growing fetus on major blood vessels.
	e.	Aid in return to sexual intimacy immediately postpartum.

12.	To improve patient-to-caregiver communication:
	a.	The patient should think of herself as consumer purchasing a service.
	b.	Ask questions at each appointment and be sure she understands the answers.
	c.	Have the coach attend prenatal appointments as much as possible.
	d.	Ask questions fully clothed and across the desk from ones’ primary caregiver, not in the examining room.
	e.	All of the above.

13.	Signs of progress in labor can be summed up with two words:
	a.	Breathe and relax.
	b.	Pain and blood.
	c.	Fear and tension.
	d.	Fight or flight.
	e.	Endorphins and active relaxation.

14.	The release of epinephrine, as in the Fight-or-Flight Response, tends to cause:
	a.	An increase in the rapidity of labor.
	b.	Restlessness.
	c.	Animated behavior.
	d.	A decrease in uterine circulation and contractions leading to a prolonged labor.
	e.	A desire to ambulate in labor.

15.	Visualization involves:
	a.	Focusing on each contraction.
	b.	Cultural expectations.
	c.	Mentally focusing on a positive image.
	d.	Shared life experiences.
	e.	All of the above.

16.	The Gate Control Theory proposes:
	a.	That visualization can alter a woman’s perception of pain.
	b.	That endorphins are released due to massage stimulation of large diameter nerves.
	c.	That the cerebral cortex can only process one set of signals as a primary signal relegating all other incoming signals to a secondary position.
	d.	That the cerebral cortex can only process one set of signals as a primary signal while completely ignoring all other incoming signals.
	e.	That a laboring woman can visualize a place of safety behind a “gate”.

17.	Neuro-muscular relaxation includes:
	a.	Positive affirmations.
	b.	Focusing on each muscle group when tensed and, the, when relaxed.
	c.	Tensing one muscle group while consciously relaxing all others.
	d.	Massage and effleurage.
	e.	Musical stimulation of the parasympathetic nerve system.

18.	Effleurage:
	a.	Facilitates venous and lymphatic flow.
	b.	Stimulates afferent neurons which inhibit pain impulses.
	c.	Can exert an analgesic effect.
	d.	a & b.
	e.	a, b & c.

19.	Focal point:
	a.	Can be an external visual focus.
	b.	Can be an internal visualization.
	c.	Reduces external or extraneous stimuli.
	d.	Is a primary indicator of the laboring woman’s concentration and control.
	e.	All of the above.

20.	Lamaze breathing techniques are:
	a.	A learned skill which enhances relaxation.
	b.	Rhythmic breathing which develops body awareness and oxygenation.
	c.	A learned skill that reduces pain perception.
	d.	a & c
	e.	a, b & c.

21.	Slow, rhythmic breathing:
	a.	Stimulates the parasympathetic nervous system.
	b.	Stimulates the sympathetic nervous system.
	c.	Develops body awareness and improved oxygenation.
	d.	a & c.
	e.	b & c.

22.	Patterned-Paced breathing requires:
	a.	Increased attention focusing by the laboring woman.
	b.	A respiratory cycle approximately half the normal resting respiratory rate.
	c.	Inhalation through the nose and exhalation through the mouth.
	d.	A rapid forceful respiratory exchange.
	e.	A uniform vowel sound with no variation.

23.	Possible detrimental effects on the progress of labor may be:
	a.	Laboring in a large and unfamiliar room or environment.
	b.	Labor room which is well let, neat and tidy.
	c.	Being moved at the time of delivery.
	d.	a & c.
	e.	a, b & c

24.	Non-invasive stimulation of a sluggish labor includes:
	a.	Ambulation and/or position changes.
	b.	Warm towel on the chest with tactile stimulation of nipples.
	c.	Removal of stressful individuals.
	d.	a & b.
	e.	a, b & c.

25.	Which of the following techniques reduce the necessity for an episiotomy?:
	a.	Slow delivery of fetal presenting part with perineal massage.
	b.	Warm compresses and periurethral support and delivery.
	c.	Maternal position to decrease perineal pressure.
	d.	a & b.
	e.	a, b & c.

26.	In primips the fetus typically “drops”, or becomes engaged, how long prior to the onset of spontaneous labor?:
	a.	10 days to 4 weeks.
	b.	2-4 weeks.
	c.	10-14 days.
	d.	1-2 weeks.
	e.	1-2 days.

27.	Weight loss prior to delivery is due to:
	a.	Lack of appetite.
	b.	Stimulation of the adrenal glands.
	c.	Changing estrogen and progesterone levels.
	d.	Fetal stasis.
	e.	b & d

28.	Uterine contractions which stop with changes in position or walking is a sign of:
	a.	Prodromal labor.
	b.	False labor.
	c.	True labor.
	d.	a & c.
	e.	b & c.

29.	When the fetal presenting part is at the level of the ischial spines, it is at what station?:
	a.	-2
	b.	-1
	c.	0
	d.	+1
	e.	+2

30.	Amniotomy causes:
	a.	More intense uterine contractions.
	b.	Assessment of the amniotic fluid.
	c.	More rapid progress of labor than with spontaneous rupture of membranes.
	d.	a & b.
	e.	a, b & c.

31.	The active phase of first stage labor is characterized by:
	a.	Dilatation from 2-5 cms.
	b.	Contractions typically 5-3 minutes apart.
	c.	Spontaneous rupture of membranes.
	d.	The laboring woman’s affect is generally alert and sociable.
	e.	No bloody show.

32.	The second state of labor is characterized by:
	a.	Intense contractions usually 2-5 minutes apart.
	b.	Irritability in the laboring woman.
	c.	The laboring woman may find odors offensive.
	d.	Trembling.
	e.	All of the above.

33.	The placenta usually detaches and delivers how long after delivery of the infant?
	a.	1-5 minutes.
	b.	5-10 minutes.
	c.	10-20 minutes.
	d.	5-30 minutes.
	e.	30-60 minutes.

34.	The pushing position that uses gravity to best advantage and that widens the pelvic outlet by 0.5-2 cms. More than other positions is:
	a.	Lithotomy.
	b.	Semi-lithotomy.
	c.	Squatting.
	d.	Semi-squatting.
	e.	Lateral recumbent

35.	Back labor, or the posterior presentation of the vertex, occurs in how many labors?:
	a.	5%
	b.	10%
	c.	15%
	d.	20%
	e.	25%

36.	Comfort measures which may be helpful to the laboring woman experiencing back labor include:
	a.	Maternal positioning which encourages the fetal weight to be off the maternal spine.
	b.	Counter-pressure.
	c.	Temperature changes with counter-pressure.
	d.	Emotional support and encouragement.
	e.	All of the above.

37.	Legitimate reasons to induce or augment a labor include:
	a.	Prolonged ruptured membranes.
	b.	Postmaturity or prolonged pregnancy.
	c.	Diabetic patients.
	d.	a & b
	e.	a, b & c.

38.	For a laboring patient receiving Pitocin, she must also have:
	a.	Ruptures membranes and an IV.
	b.	Electronic fetal monitoring and an IV.
	c.	A PCA (patient-controlled administration) pump for IV narcotic administration.
	d.	An obstetrician in the labor and delivery unit at all times.
	e.	A neonatologist available for the delivery.

39.	The goal of fetal monitoring is:
	a.	To assess fetal well-being in response to the stress of labor.
	b.	To predict fetal outcome.
	c.	To provide continuous documentation for legal purposes.
	d.	To predict the need for a neonatologists’ presence at the delivery.
	e.	To assess fetal response to medication administration.

40.	External fetal monitoring:
	a.	Includes the use of an IUPC.
	b.	Can be used for stress testing.
	c.	Includes the use of a fetal scalp electrode.
	d.	Accurately records the intensity of uterine contractions.
	e.	Accurately records the fetal heart beat wherever the IUPC is placed abdominally.

41.	An unplanned Cesarean delivery may be due to:
	a.	Failure to progress.
	b.	CPD.
	c.	Breech or other malpresentation.
	d.	Abruptio placenta.
	e.	All of the above.

42.	Immediate post-op assessment of the Cesarean patient includes:
	a.	Vital signs and level of anesthesia.
	b.	Fundal firmness and lochia flow.
	c.	Reactivity of pupils.
	d.	a & b
	e.	a & c.

43.	Which statement about Cesareans is true?:
	a.	Seven out of 10 women who had a Cesarean delivery for “failure to progress” have had successful trials of labor and subsequent vaginal deliveries.
	b.	The Cesarean delivery rate in the U.S. is 40%.
	c.	The possibility of rupture of the uterine scar is 3%.
	d.	A Cesarean delivery costs 3 times that of a vaginal delivery.
	e.	Lower socioeconomic women tend to have a higher Cesarean delivery rate.

44.	Narcotic analgesics:
	a.	Help to reduce, abolish or alter maternal perception of pain without loss of consciousness.
	b.	May cause lowered body temperature, poor muscle tone and increased jaundice in the newborn.
	c.	Promotes relaxation between contractions.
	d.	a & c.
	e.	a, b & c.

45.	Epidural anesthesia during labor:
	a.	May require Pitocin augmentation to stimulate a sluggish labor.
	b.	May require urinary catheterization.
	c.	May cause a drop in maternal blood pressure.
	d.	Diminished the urge to push and bearing-down reflex.
	e.	All of the above.

46.	Signs and symptoms of preterm labor include:
	a.	Regular, rhythmic uterine labor contractions.
	b.	Maternal infection.
	c.	Cervical dilatation and effacement.
	d.	a & c.
	e.	a, b & c.

47.	Some possible causative factors in preterm labor are:
	a.	DES exposure and/or more than 2 first-trimester abortions.
	b.	Maternal infection and/or smoking more than 10 cigarettes a day.
	c.	Incompetent cervix and/or maternal hypertensive disease.
	d.	Multi gestation and/or history of cone biopsy.
	e.	All of the above.

48.	Home monitoring for preterm labor may include:
	a.	Regular, scheduled non-stress tests.
	b.	Regular external monitoring with a tocodynamometer.
	c.	Amniocentesis at 32 weeks gestation.
	d.	Bi-weekly IV therapy.
	e.	All of the above

49.	An APGAR score between 4-7 of the newborn:
	a.	Indicated infant adjustment to extra-uterine life.
	b.	Indicates a strong, lusty infant cry.
	c.	Indicated the need for special resuscitative measures.
	d.	Indicates no reflex response.
	e.	Indicates no need for special neonatology intervention.

50.	A precipitous labor:
	a.	Is typical in multiparous labors.
	b.	Is typical in twin gestations.
	c.	Is birth of the neonate in 3 hours or less from the onset of labor.
	d.	Is typical in post date labors.
	e.	Tends to occur in truly diabetic women.