North American Registry of Midwives (NARM) Practice Exam

Hypertonic uterine dysfunction is characterized by:

1. Weak and ineffective contractions

2. Painful contractions with no progression

3. Regular and non-painful contractions

4. Gradual increasing contraction intensity

The correct answer is: Painful contractions with no progression

Hypertonic uterine dysfunction is characterized by painful contractions that do not lead to effective progression of labor. This type of dysfunction occurs when the uterus experiences frequent, strong contractions that are often painful but fail to contribute positively to the cervical dilation or advancement of labor. This condition can result in a scenario where the mother is experiencing significant discomfort without the expected progress in labor, which can be distressing both physically and emotionally. Understanding this dysfunction is crucial for midwives and practitioners, as it can impact decisions regarding the management of labor and delivery, including potential interventions to alleviate discomfort and facilitate effective contractions. The other options do not accurately describe hypertonic uterine dysfunction. For instance, weak and ineffective contractions would typically be associated with hypotonic dysfunction, while regular and non-painful contractions would not reflect the associated pain characteristic of hypertonic dysfunction. Gradual increasing intensity is typically a normal pattern of progression during labor, which is not characteristic of hypertonic uterine dysfunction.