Question

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St. Paul University Dumaguete

College of Nursing

NCM 107 – Intrapartum

Name : __________________________________Year Level & Section______________

1. Which of the following best defines the intrapartum period?

A. Time from complete cervical dilatation through delivery of the newborn.

B. Period from the onset of contractions through complete cervical dilation.

C. Period from the onset of contractions to the first 1 to 4 hours after delivery.

D. Time from the 28th week of gestation through 28 days after birth of the newborn.

2. Very Preterm birth are babies born alive at :

A. less than 28 weeks

B. 28 to 32 weeks

C. 32 to 37 weeks

D. 38 weeks

3. Pressure on the cervix stimulates nerve plexus causing release of oxytocin by maternal posterior pituitary gland. This is known as:

A. McRobert’s Maneuver

B. Crede’s prophylaxis

C. Ferguson’s Reflex

D. None of the above

4. Which of the following is true of the theory of labor:

A. An increase in progesterone allows estrogen to stimulate the contractile response of the uterus.

B. A decrease in progesterone allows estrogen to stimulate the contractile response of the uterus.

C. A decrease in estrogen allows progesterone to stimulate the contractile response of the uterus.

D. An increase in estrogen allows progesterone to stimulate the contractile response of the uterus.

5. Which of the following statement is true of the possible causes of the onset of labor. Select all that apply:

A. Uterine muscles stretch cause the release of prostaglandin.

B. Prostaglandin and oxytocin works together to activate contractions.

C. Placental aging triggers initiation of contractions.

D. Rising fetal cortisol levels increases progesterone formation and initiates contraction.

6. The true signs of labor includes the following except:

A. Rupture of membrane

B. Uterine contractions

C. Show

D. Lightening

7. The woman will experience an irregular contractions and is termed as _______ which will become stronger, longer and more frequent when labor is neat at hand,

A. True labor

B. Braxton Hick’s contractions

C. Chadwick’s

D. Goodell’s sign

8. Early morning, the woman experienced a leaking bag of water. Which of the following statement of the woman that is incorrect and need health teaching? Select all that apply.

A. “Sexual intercourse should be avoided.”

B. “I can still walk in the house and do household chores.”

C. “I will go to the hospital by tomorrow.”

D. None of the above.

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9. Which of the following factors affecting labor is associated with the passageway?

A. Size of the head and its ability to mold to the maternal pelvis.

B. The presentation of the fetus in relation to the maternal pelvis,

C. The structure of the maternal pelvis.

D. The frequency, duration and strength of uterine contractions.

10. A typical female pelvis with rounded inlet:

A. Android

B. Anthropoid

C. Gynecoid

D. Platypelloid

Answer 1

1. Which of the following best defines the intrapartum period?

A. Time from complete cervical dilatation through delivery of the newborn.

B. Period from the onset of contractions through complete cervical dilation.

C. Period from the onset of contractions to the first 1 to 4 hours after delivery.

D. Time from the 28th week of gestation through 28 days after birth of the newborn.

Answer: C. Period from the onset of contractions to the first 1 to 4 hours after delivery.

Explanation for the correct answer:

The intrapartum period is defined as the period from the beginning of the contractions of true labour which causes cervical dilation in the pregnant woman to the first 1 to 4 hours after the delivery of the the newborn and the placenta. The intrapartum period is the most crucial period in the the delivery of the newborn and the care of the pregnant women and needs continuous monitoring and care .As the above answer option defines the intrapartum period most correctly hence, this is the correct answer option.

the reason why the other options are not the correct answer:

The time from complete cervical dilatation through delivery of the newborn is the second stage of labour.Period from the onset of contractions through complete cervical dilation is the first stage of labour.The time from the 28th week of gestation through 28 days after birth of the newborn is encompassed as the peripartum period.As neither of the other three options define the intrapartum period correctly, hence these options are not the correct answer options

2. Very Preterm birth are babies born alive at :

A. less than 28 weeks

B. 28 to 32 weeks

C. 32 to 37 weeks

D. 38 weeks

Answer:B. 28 to 32 weeks

Explanation for the correct answer:

As per the W H O definition , the birth of baby after 37 weeks of pregnancy are completed is  defined as term labor and the babies are called term babies.Babies born before 37 weeks or 259 days of gestation are completed are  called as preterm babies.The preterm babies are divided into different subcategories depending upon the age of gestation/ completed weeks of pregnancy at which they are delivered.

1. babies delivered less than 37 weeks are preterm babies

2.babies delivered between 32 to <37 weeks of gestation are moderate or late preterm babies

3. babies delivered between 28 to <32 weeks of gestation are defined as very preterm babies

4. babies delivered at less than 28 weeks of gestation are defined as extremely preterm babies.

As the question asks about very preterm birth/ very preterm babies born alive; hence this is the correct answer option.

the reason why the other options are not the correct answer:

The babies born between 32 to <37 weeks of gestation are defined as moderate or late preterm babies while babies delivered at less than 28 weeks of gestation are defined as extremely preterm babies.The babies born at 38 weeks are called term babies.None of the other three options define the very preterm babies correctly and hence the other options given are not the correct answer options.

3. Pressure on the cervix stimulates nerve plexus causing release of oxytocin by maternal posterior pituitary gland. This is known as:

A. McRobert’s Maneuver

B. Crede’s prophylaxis

C. Ferguson’s Reflex

D. None of the above

Answer:C. Ferguson’s Reflex

Explanation for the correct answer:

Ferguson reflex a also known the fetal ejection reflex .It is a neuroendocrine reflex with positive feedback mechanisms that helps in the delivery of the foetus. The pressure of the posterior wall of the cervix causes the reflex stimulation and release of oxytocin from the posterior pituitary mediated through the nerve plexuses around cervix initiating and maintaining the uterine contractions.These contractactions causes more pressure on cervix and more release of oxytocin The above statement describes Ferguson reflex .Hence this is the correct answer option.

the reason why the other options are not the correct answer:

McRoberts’s maneuver:is an obstetrics maneuver used to deliver the foetus In cases of shoulder dystocia where the mother is asked to fold her legs onto her abdomen in order to facilitate the opening of the maternal passageway and suprapubic pressure is applied to the foetal anterior shoulder to facilitate delivery.

Crede’s prophylaxis is the insertion of antibiotic eye drops( two percent aqueous solution of silver nitrate) into a neonate's eyes in order to prevent gonococcal neonatal conjunctivitis or ophthalmia neonatorum.

As none of these two options define the reflex of pressure on the cervix stimulating nerve plexuses causing release of oxytocin by maternal posterior pituitary gland,hence they are not the correct answer options.

4. Which of the following is true of the theory of labor:

A. An increase in progesterone allows estrogen to stimulate the contractile response of the uterus.

B. A decrease in progesterone allows estrogen to stimulate the contractile response of the uterus.

C. A decrease in estrogen allows progesterone to stimulate the contractile response of the uterus.

D. An increase in estrogen allows progesterone to stimulate the contractile response of the uterus.

Answer:B. A decrease in progesterone allows estrogen to stimulate the contractile response of the uterus.

Explanation for the correct answer:

The hormone progesterone inhibits the uterine contractions throughout pregnancy.During labor,its levels drop. progesterone is a uterine muscle relaxing hormone and maintains pregnancy uterine relaxation.

The hormone oestrogen increases the the number of gap junctions between the smooth muscle cells of the uterine musculature thereby increasing the smooth muscular contractility and promoting strong uterine muscle contractions The.increase in the oestrogen levels also supplements the action of oxytocin from the the posterior pituitary gland and increases effective contractions of the uterus.

In labor, the progesterone levels decreases and the oestrogen levels rise and these hormonal changes along with the actions of oxytocin stimulate uterine contractions and help in fetal expulsion and childbirth. As the above statement explains the hormonal changes that account for the theory of labor truly, hence this is the correct answer option

the reason why the other options are not the correct answer:

The theory of labor does not confirm with the increase in the progesterone levels Progesterone hormone is not responsible for stimulating the contractions of the uterus as it is a uterine relaxing hormone. As the other options do not confirm to the correct theory of labor;hence the other options which are given are not the correct answer options

10. A typical female pelvis with rounded inlet:

A. Android

B. Anthropoid

C. Gynecoid

D. Platypelloid

Answer:C. Gynecoid

Explanation for the correct answer:

A typical female pelvis is a called as a gynecoid pelvis and has a nice smooth rounded inlet and wide outlet and is conducive for normal vaginal delivery by providing optimum maternal passageway. As the above question asks about typical female pelvis hence this is the correct answer option.

the reason why the other options are not the correct answer:

Android pelvis is typically seen in males and has a triangular or heart shaped inlet and a very narrow outlet and generally poses difficulty to normal vaginal deliveries. Anthropoid pelvis is has an oval shaped inlet which is oval in the anterior posterior direction with a slightly narrower outlet and and is commonly associated with fetal non rotation. The Platypelloid pelvis is the rarest type of pelvis wherein the inlet of the pelvis is transversely oval and outlet is very wide and is associated with face presentation commonly. As none of the other options define a typical female pelvis, hence they are not the correct answer options.