BEST ANSWERS NCLEX EXAM Labor and Delivery EXAM 2024, 2026 WITH 100 Percent VERIFIED ANSWERS

QUESTIONS AND ANSWERS Define lie. spine of the fetus in relationship to the spine of the mother longitudinal (parallel) transverse (right angles) oblique (slight angle off a true transverse) Define presentation. part of the fetus that enters into the pelvic inlet of mom cephalic/vertex (head) breech (frank:flexion of hips and extension of knees; complete: flexion of hips and knees; footling/incomplete: extension of hips and knees) shoulder (transverse lie) Define attitude. relationship of fetal parts to each other (flexion of head and extremities on chest) Define position. fetal reference point to mom's pelvis What is vertex presentation dependent upon? degree of flexion of fetal head on chest occiput O (full flexion) chin M (full extension) brow B (moderate extension) What is breech presentation sacrum (S) What is shoulder presentation? scapula (SC) What is the standard three letter abbreviation? LOA vertex presentation with fetal occiput on the left side toward the front of her pelvis What is zero station equal with? the level of the ischial spines What is +5 station? presenting part is BELOW ZERO STATION What is -5 station? presenting part is ABOVE ZERO STATION What is engagement? when the presenting part is at zero station What are the three parts of contraction? increment (steep increase) acme/peak (strongest intensity) decrement (decline in intensity) What is REPORTABLE frequency of contractions? less than every 2 minutes What is REPORTABLE duration of contractions? greater than 90 seconds (potential for fetal distress or uterine rupture) Define intensity. the strength of contraction at acme What is the primary power? involuntary uterine contraction What is the secondary power? voluntary bearing down efforts What are appropriate breathing techniques? begin and end with a cleansing breath in and out in through the nose and out through the mouth What are the symptoms of maternal hyperventilation? respiratory alkalosis, lightheadedness, dizzy, tingling of fingers and circumoral numbness treat by breathing into cupped hands or paper bag What are the cardinal mechanisms and movements of labor in vertex presentation? 1. descent 2. flexion 3. internal rotation (head rotates from occiput transverse/oblique position to anterior/posterior at pelvic outlet) 4. extension (head moved backward) 5. resitution and external rotation (align and bringing shoulders to anterior posterior diameter) 6. expulsion (anterior shoulder, posterior shoulder, rest of body When do impending signs of labor start? Can be several weeks before labor What are some impending signs of labor? lightening: settling of uterus fetal presenting part into pelvis and decreased abdominal distention increased braxton-hicks contractions: mild, intermittent, irregular contractions that decrease with activity heightened anxiety weight loss 2-3lbs 3-4days before onset of labor fetal movements may appear less active What are some ONSET signs of labor? mucus plug expulsion pink/brown-tinged discharge (bloody show) regular contractions increasing in frequency, duration, and intensity spontaneous rupture of membranes (if positive nitrazine test will turn blue) What are the stages of labor? dilation from 0-10 and 1-100% effacement first stage (latent, active, transition) second stage