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A 28-year-old woman without risk factors has now reached the second stage of labor. What is the optimal position for her at this point?
- A. Supine
- B. Lateral recumbent
- C. Lithotomy
- D. Squatting
Correct Answer: B
Rationale: The optimal position for a 28-year-old woman in the second stage of labor is the lateral recumbent position (Choice B). This position helps maximize pelvic diameter and blood flow to the uterus, facilitating labor progress. It also reduces the risk of fetal heart rate abnormalities compared to the supine position (Choice A). Lithotomy position (Choice C) can hinder the descent of the baby and increase the risk of perineal trauma. Squatting (Choice D) may be uncomfortable and less effective in promoting efficient labor progress compared to the lateral recumbent position.
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During the COVID-19 pandemic, what was revealed about the importance of labor support?
- A. Labor support can only be provided by the significant other.
- B. Laboring patients did not need support from outside sources.
- C. Outcomes for birth were not changed by pandemic requirements.
- D. Patients during the pandemic's support ban experienced more depression.
Correct Answer: D
Rationale: The correct answer is D because patients who experienced a support ban during the pandemic were more likely to experience depression due to the lack of emotional and physical support during labor. This is supported by research showing the negative impact of isolation on mental health. Choices A and B are incorrect as labor support can come from various sources, not just the significant other, and patients benefit from support during labor. Choice C is incorrect as pandemic requirements did impact birth outcomes, such as increased stress and anxiety levels.
What should the nurse consider when the birthing person has a decrease in blood pressure after the placenta is delivered?
- A. The birthing person is in pain.
- B. Place the newborn skin-to-skin.
- C. The bladder is distended
- D. Check for possible hemorrhage.
Correct Answer: E
Rationale: It seems like option E is missing from the choices provided. Could you please provide the correct options so that I can give you a detailed explanation for the correct answer?
Arrange the seven cardinal movements of labor, in order.
- A. Descent
- B. Expulsion
- C. Extension
- D. External rotation
Correct Answer: A
Rationale: The correct order of cardinal movements of labor is:
1. Engagement
2. Descent
3. Flexion
4. Internal rotation
5. Extension
6. Restitution
7. External rotation
Engagement occurs first as the fetal presenting part enters the maternal pelvis. Descent is the second cardinal movement, where the fetus moves down the birth canal. Flexion follows, allowing the smallest diameter of the fetal head to present. Internal rotation positions the fetus for delivery. Extension occurs next, facilitating the passage of the head through the birth canal. Restitution aligns the fetal head with the shoulders. External rotation allows the shoulders to rotate for delivery. Therefore, Descent is the correct first cardinal movement in the sequence. Other choices like Expulsion, Extension, and External rotation occur later in the process and are not in the correct order.
The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between contractions. Which statement is the appropriate rationale for assessing maternal vital signs between contractions raNtheRr thaIn aGt anBot.heCr inMterval? U S N T O
- A. Vital signs taken during contractions are inaccurat
- B. During a contraction, assessing fetal heart rate is the priority.
- C. Maternal blood flow to the heart is reduced during contractions.
- D. Maternal circulating blood volume increases temporarily during contractions.
Correct Answer: D
Rationale: The correct answer is D. During contractions, maternal circulating blood volume increases temporarily due to the compression of blood vessels. Therefore, assessing vital signs between contractions provides a more accurate baseline measurement. Choice A is incorrect because vital signs taken during contractions may be affected by the pain and stress of labor. Choice B is incorrect as fetal heart rate assessment is a separate priority. Choice C is incorrect as maternal blood flow to the heart actually increases during contractions to ensure adequate oxygen supply.
Why is precipitous labor most often seen in multiparous women?
- A. The cervix weakens after each delivery.
- B. The cervix can dilate and efface simultaneously.
- C. The multigravida uterus is better able to coordinate muscle movements.
- D. It is more difficult for multiparous women to know when labor begins.
Correct Answer: C
Rationale: The correct answer is C because the multigravida uterus has undergone labor before, making muscle coordination more efficient. This allows for faster and more coordinated contractions, leading to precipitous labor. Choice A is incorrect because the cervix does not weaken after each delivery. Choice B is incorrect as simultaneous dilation and effacement are not specific to multiparous women. Choice D is incorrect because the ability to recognize labor onset is not a determining factor in the occurrence of precipitous labor.