1. Birth of
    the baby

  2. Birth of
    the placenta

  3. Local anesthesia for vaginal/
    perineal repair

  4. Repair of the Perineum

Test yourself on the placenta

Instructions: Instructions: Complete each of the following ten questions by choosing the single best answer. Complete all of the questions, then click on the "Submit Test" button at the end.

Question 1:

A natural cleavage plane between the placenta and the uterine wall is formed when the cotyledons of the maternal surface of the placenta extend into the:

(A) myometrium
(B) uterine wall
(C) deciduas basalis
(D) amniotic membrane

Question 2:

The location of the tear in the amniotic membranes on examination after the birth of the placenta indicates:
(A) a problem with the placenta in utero
(B) the probable attachment location of the placenta in utero
(C) too rapid expulsion of the placenta
(D) a Schultz mechanism of placental expulsion

Question 3:

Placing your hand over the uterus through the abdominal wall during the third stage of labor assists you to:

(A) massage the uterus to encourage separation
(B) determine when the placenta has separated
(C) push the placenta out of the uterus
(C) deliver the placenta as soon as the baby is born

Question 4:

Examination of the placenta immediately after its birth enables you to:
a. identify whether the placenta and membranes have been completely expelled
b. quickly remove it from the sterile field
c. note the health status of the placenta
d. note variations from normal structure
e. instruct the family in its structure and function

(A) a, b ,c
(B) b ,d, e
(C) a ,c, d
(D) a, d, e

Question 5:

Exercising patience during the third stage of labor, with vigilant attention to signs of progress or conversely, signs of problems, enables:

a. prompt action when appropriate
b. avoidance of a problem
c. a peaceful conclusion of the birth process
d. more rapid expulsion of the placenta
e. progression of normal physiological processes

(A) a, c, e
(B) a, b, d
(C) c, d, e
(D) a, b, d

Question 6:

Failure of the placenta to separate and deliver, in the absence of bleeding, may indicate:
a. an immediate need for intervention
b. a placenta accreta, increta or percreta
c. poor uterine contractility
d. no problem
e. an undiagnosed twin

(A) a, c, e
(B) c, d, e
(C) b, c, e
(D) a, b, d

Question 7:

A placental fragment or membranes retained in the uterus may be suspected immediately after the birth of the placenta when:

a. there are missing segments on examination of the placenta
b. there is continued bleeding after the birth of the placenta
c. the mother feels pressure in her vagina
d. the uterus changes its shape when felt abdominally

(A) a, c
(B) a, d
(C) b, c
(D) a, b

Question 8:

Safe and effective manual removal of the placenta involves:
a. pulling off everything you find, including "strings" of tissue
b. developing a cleavage plane between the placenta or cotyledon and the uterine wall
c. using the side of your hand/fingers, not the finger tips, in sweeping the uterus
d. moving quickly and vigorously through the uterus

(A) a, c
(B) b, d
(C) b, c
(D) a, b

Question 9:

Bimanual compression of the uterus is appropriately used when:
(A) the placenta fails to separate after the birth
(B) retained placental fragments are suspected following the birth of the placenta
(C) there is heavy bleeding immediately following the birth of the placenta
(D) there is a cervical laceration

Question 10:

The appropriate sequence of use of medications for a postpartum hemorrhage due to atony is:
a. Hemabate IM
b. Pitocin IV infusion in an appropriate IV solution
c. Methergine IM

(A) b, c, a
(B) a, c, b
(C) c, b, a
(D) a, b, c

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Nurse Midwifery
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