Fetal Position And Presentation (maternal And Child Nursing)

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 Fetal Position And Presentation (maternal And Child Nursing)
Welcome to Maternal and Child Health Nursing (HESI EXAMINATION) Prepared by: Jeffrey Viernes There are basically 3 positions that your baby can be in; breach, shoulder and arm, and cephalic (head first). Breach means the baby is coming feet or butt first which only happens in about 3% of births. The most rare presentation is the shoulder and arm position which means that the baby is lying sideways which only happens in less than 1% of births. The most common position for birth is head first (cephalic). Cephalic presentation is considered normal and occurs in about 97% of births. However, there are eight different ways a baby could be facing while head down. This is the type of presentation we are going to concentrate on in this article. 1. Occiput Posterior (OP) - head facing mot more

  
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  • 1. 

    Determine the fetal postion presented in the picture above.
    • A. 

      Right occipitotransverse

    • B. 

      Left occipitotransverse

    • C. 

      Right occipitoposterior

    • D. 

      Left occipitoposterior


  • 2. 

    Identify the fetal position presented above.
    • A. 

      Left occipitoanterior

    • B. 

      Right occipitoanterior

    • C. 

      Right occipitoposterior

    • D. 

      Left occipitoposterior


  • 3. 

    Determine the fetal position above.
    • A. 

      Right occipitoposterior

    • B. 

      Left occipitoposterior

    • C. 

      Right occipitotransverse

    • D. 

      Left occipitotransverse


  • 4. 

    Determine the fetal position provided above.
    • A. 

      Left occipitoposterior

    • B. 

      Right occipitoposterior

    • C. 

      Right occipitotransverse

    • D. 

      Left occipitotransverse


  • 5. 

    Deternine the fetal presentation presented above.
    • A. 

      Shoulder presentation

    • B. 

      Frank breech

    • C. 

      Single footling breech

    • D. 

      Compete breech


  • 6. 

    Determine the fetal presentation presnted above.
    • A. 

      Frank breech

    • B. 

      Single footling breech

    • C. 

      Complete breech

    • D. 

      Shoulder breech


  • 7. 

    Determine the fetal presentation presented above by using the Leopold maneuvers.
    • A. 

      Frank breech

    • B. 

      Single footling breech

    • C. 

      Complete breech

    • D. 

      Shoulder presentation


  • 8. 

    Determine thefetal position that is presented above.
    • A. 

      Frank breech

    • B. 

      Single or (double) footling breech

    • C. 

      Shoulder presentation

    • D. 

      Complete breech


  • 9. 
    A student nurse is differentiating TRUE labor from FALSE labor to 39th week pregnant woman admitted to the labor and delivery department last night. The student nurse needs further teaching if she mentioned which of the following?
    • A. 

      "True labor usually begins in your lower back and it may extend to your abdomen"

    • B. 

      "There will be thinning or disappearance of the cervix during true labor"

    • C. 

      "Ambulation will relieve your abdominal pain when you're in true labor"

    • D. 

      "There are no cervical changes in false labor"


  • 10. 
    Match the following stages of Intrapartum Process to their respected or appropriate descriptions.
    • A. Stage 1
    • A.
    • B. Stage 3
    • B.
    • C. Stage 2
    • C.
    • D. Stage 4
    • D.

  • 11. 
    What are the prodromal labor signs? Select all that apply.
    • A. 

      Lightening

    • B. 

      Braxton Hicks contraction

    • C. 

      Left occipital anterior position of the fetus for delivery

    • D. 

      Cervical softening

    • E. 

      Slight effacement

    • F. 

      Bloody show or expulsion of the mucus plug

    • G. 

      Nesting

    • H. 

      Station 0


  • 12. 
    The nurse practitioner palpated the head of the fetus to be in Station 0. As a nurse you would described this assessment data in the right medical terminology as:

  • 13. 
    The nurse practitioner described to the patient that she is 3 cm effacement. The mother was shy to ask question to the nurse practitioner. When you went to the room and gave her towels, she asked you what effacement means. As an LPN you know that effacement means:
    • A. 

      "It is the degree of cervical dilation which is usually 0-10 centimeters "

    • B. 

      "it is the thinning or disappearance of the cervix during cervical dilation or labor"

    • C. 

      "The nurse practitioner is pertaining to the fetal location in relation to the ischial spine located in your hip bone"

    • D. 

      "The nurse practitioner is just hungry at that time, she doesn't know what she's talking about, don't worry about what she said."


  • 14. 
    What anatomical part of the fetus is the BEST part to hear the fetal heart rate (FHR)?
    • A. 

      The back of the fetus

    • B. 

      The apical pulse located in the heart

    • C. 

      Brachial artery

    • D. 

      The popliteal


  • 15. 
    The patient in labor is hyperventilating with a respiratory rate of 29. You are expecting that the client will have an acid-base imbalance and is in a respiratory alkalosis condition becuase she is releasing too much carbon dioxide outside her body. As an LPN you would noticed the patient to have which of the following presenting manifestation? Select all that apply.
    • A. 

      Productive and persistent coughing

    • B. 

      Dizziness

    • C. 

      Tingling in the fingers

    • D. 

      Pallor


  • 16. 
    When should a laboring mother begins to voluntarily push the fetus?
    • A. 

      When the cervix is at 10 cm dilation

    • B. 

      When the cervix is at 3 cm dilation

    • C. 

      When the fetal station is at -2

    • D. 

      When the fetal station is engaged


  • 17. 
    What are the FIVE symptoms of respiratory distress in the newborn? Slect all that apply.
    • A. 

      Tachypnea

    • B. 

      Tachycardia

    • C. 

      Pallor or dusky color

    • D. 

      Flaring of the nares

    • E. 

      Chest retraction

    • F. 

      Grunting

    • G. 

      Decreased blood pressure

    • H. 

      Smiling and crying


  • 18. 
    What medication should be given to the newly born child to prevent ophtalmia neonatorum from gonorrheal exposure through the birth canal in a vaginal delivery?
    • A. 

      Pitocin

    • B. 

      Silver nitrate

    • C. 

      Butorphanol

    • D. 

      Vitamin K


  • 19. 
    What are the CARDINAL MOVEMENTS of the fetus during delivery? Select all that apply.
    • A. 

      Engagement

    • B. 

      Descent

    • C. 

      Flexion

    • D. 

      Internal rotation

    • E. 

      Extension

    • F. 

      Restitution

    • G. 

      External rotation

    • H. 

      Breeching

    • I. 

      Inversion

    • J. 

      Eversion


  • 20. 
    When should we administer a pudendal block?
    • A. 

      First stage of labor

    • B. 

      Second stage of labor

    • C. 

      Third stage of labor

    • D. 

      Fourth stage of labor


  • 21. 
    What are the FIRST signs of regional block effectiveness?
    • A. 

      Warmth and tingling sensation of the big toe

    • B. 

      Cool and tingling sensation of the big toe

    • C. 

      Tingling sensation in the lateral portion of the mouth and slight dizziness

    • D. 

      Tingling sensation in the arms and chest pain


  • 22. 
    The nurse is applying Erythromycin on the newborn to prevent ophthalmia neonatorum. She is aware that to apply this medication correctly to the newborn, she must consider which nursing implication?
    • A. 

      Instruct the parents that can wipe the excess medications around the baby's eye after 1 minute

    • B. 

      Place a thin line of ointment along the entire lower lid in conjunctival sac

    • C. 

      Irrigate the neonate's eye first with normal saline and instill Erythromycin from inner to outer portion of the lower eyelid

    • D. 

      Inject the medication in the newborn's eye until it bleeds


  • 23. 
    When is the appropriate time to give oxytocin to the patient?
    • A. 

      After the placenta is delivered

    • B. 

      Before the placenta is delivered

    • C. 

      Before laboring

    • D. 

      If pain does not go away during laboring


  • 24. 
    What are the  normal Puerpireum changes relating to the body of the postpartal woman? Select all that apply.
    • A. 

      Rugae in the vagina reappears within 3 weeks

    • B. 

      Pulse may decrease to 50

    • C. 

      The fundus is at the level of the umbilicus after delivery

    • D. 

      25,000 WBC count

    • E. 

      Palmar erythema declines quickly

    • F. 

      Pelvic muscle regain tone in 6 weeks unless diastasis recti

    • G. 

      Abdominal muscle regain tone in 3-6 weeks

    • H. 

      Bowel movement is expected for 2 to 3 days


  • 25. 
    What are the  normal Puerpireum changes relating to the body of the postpartal woman? Select all that apply.
    • A. 

      Colostrum is expressed first, and then milk

    • B. 

      30000 mL/day of urine is normal after delivery because of 40% gain during pregnancy

    • C. 

      Chloasma and hyperpigmentation decreases

    • D. 

      Coagulation factors postpartally increases

    • E. 

      ESR value is elevated for the first 10 days postpartum

    • F. 

      Hematocrit decreases because of hemodilution

    • G. 

      They are risk for UTI


  • 26. 
    Match the following colors of locial flow that is present postpartally to the appropriate definition or characteristics.
    • A. Lochia rubra
    • A.
    • B. Lochia serosa
    • B.
    • C. Lochia alba
    • C.

  • 27. 
    What is the most common cause of uterine atony in the first 24 hours postpartum?
    • A. 

      Decreased lochial flow

    • B. 

      Full bladder

    • C. 

      Retained placenta

    • D. 

      Too late administration of morphine sulfate


  • 28. 
    You are on duty in the labor and delivery department with some nursing students. A patient delivered an 8 pounds baby girl with an Apgar score of 10. The physician initiated the first assessment on the fundus of the mother. She noted soft anf boggy uterus. The physician continuously massage the uterus until the fragments and a gush of dark red blood came out into the woman's vagina. After 10 days, the woman came back complaining of painful dark red bleeding on her vagina. The physician suspected a subinvolution. One of the student asked what subinvolution means. As a nurse, you would correctly state that subinvolution:
    • A. 

      Is the dark red bleeding caused by improperly healed placental site

    • B. 

      Is the decreasing height of the fundus postpartum, and usually one finger breadth per day

    • C. 

      Is the abnormal pregnancy that happens in the fallopian tube

    • D. 

      Is the initial reaction of the family to the newly born child


  • 29. 
    Match the following Methods of Contraceptions to their appropriate usage or characteristics.
    • A. Diaphragm
    • A.
    • B. Cervical cap
    • B.
    • C. Condom
    • C.
    • D. Symptothemal Pto-Themal
    • D.
    • E. IUD
    • E.
    • F. Oral contraceptives
    • F.
    • G. Transdermal contraceptives
    • G.
    • H. Norplant
    • H.
    • I. Depo shots
    • I.
    • J. Mittleschmerz
    • J.

  • 30. 
    What are the objective manifestations of positive maternal-infant bonding. Select all that apply. 
    • A. 

      Eye contact between mother and infant

    • B. 

      Exploration of infant from head to toe

    • C. 

      Stroking, kissing, and fondling the neonate

    • D. 

      Smiling, talking,singing and kicking the neonate

    • E. 

      Use of exclaiming expressions

    • F. 

      Naming the newborn as alien's child

    • G. 

      Taking out the clothes of the infant and letting the child cry


  • 31. 
    What are the objective manifestations of positive maternal-infant bonding. Select all that apply. 
    • A. 

      Eye contact between mother and infant

    • B. 

      Exploration of infant from head to toe

    • C. 

      Stroking, kissing, and fondling the neonate

    • D. 

      Smiling, talking,singing and kicking the neonate

    • E. 

      Use of exclaiming expressions

    • F. 

      Naming the newborn as alien's child

    • G. 

      Taking out the clothes of the infant and letting the child cry


  • 32. 
    A postpartum mother feels unexplained tearfulness, feeling down and "not feeling to eat well". As a nurse, your correct response would be:
    • A. 

      "I understand how you feel, this is normal especially if you have a bad looking child"

    • B. 

      This is called the postpartum blues, they are normal behaviors of the postpartum mother especially 5 days following delivery"

    • C. 

      "You don't feel well?, take a walk with your husband in the hallway with the newborn child."

    • D. 

      "I completely understand how you feel, let me refer you to a psychiatrist, this signifies that you have dementia."


  • 33. 
    A woman who just delivered twenty four hours ago with a full term infant sleeps the whole day and needs assistance in doing activities of daily living. The nurse identified this as normal especially during the first 24 to 48 hours postpartum. According to Riva Rubin, what stage of maternal psychological adaptation  is the postpartum mother in?
    • A. 

      Taking-in stage

    • B. 

      Taking-hold stage

    • C. 

      Letting-go stage

    • D. 

      Let-down stage


  • 34. 

    A full term mother delivered a baby with an Apgar score of 9, head circumference of 33, chest circumference of 32, weight of 8 pounds, and height of 19 inches; three hours ago. The physician initiated the assessment of the fundus following 32 hours after delivery. The physician would feel the fundus on which of the following parts in the body? 
    • A. 

      At the level of the umbilicus

    • B. 

      One finger breadth below the umbilicus

    • C. 

      One finger breadth above the umbilicus

    • D. 

      Above the umbilicus and slightly displaced to the right


  • 35. 
    What are the interventions necessary for episiotomy wound?Select all that apply.
    • A. 

      Provide good perineal care

    • B. 

      Lavage the perineum with several squirts of warm water

    • C. 

      Blot dry the perineal area without touching the anal area

    • D. 

      Carefully wiping the perianeal area from back to front to avoid contamination of the vaginal area

    • E. 

      Drink at least 3 liters of fluids (at least 4-6 glasses of water) daily


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