Nokea
A fetus is in the occiput anterior position. During the cardinal movement of extension, which events are occurring? Select all that apply.
- A. The fetal head lines up with the pelvic outlet.
- B. The occiput passes under the symphysis pubis.
- C. The fetal head is engaged.
- D. The head is delivered.
Correct Answer: A
Rationale: During extension, the fetal head lines up with the pelvic outlet, and the occiput passes under the symphysis pubis.
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While attending the delivery of a patient with GODM, the nurse notices the retraction of the fetal head onto the perineum. What is the nurse’s next best action?
- A. Apply fundal pressure
- B. Assist the woman to left lateral position
- C. Flex the mother to left lateral position
- D. Assist the woman to hands-and-knees position
Correct Answer: D
Rationale: The retraction of the fetal head onto the perineum during labor can be indicative of shoulder dystocia or other obstructive complications, requiring immediate action. The best response is to assist the mother into hands-and-knees position, which can relieve pressure on the perineum and help with fetal descent.
How does becoming a parent cause the birthing person to feel?
- A. overwhelming feelings of joy or a sense of euphoria
- B. a wide variety of emotions specific to each person's experience
- C. overwhelming fear or sadness at the loss of their previous life
- D. exhausted with little interest the newborn
Correct Answer: B
Rationale: Becoming a parent can trigger a wide range of emotions that can vary from person to person. While feelings of joy and euphoria are commonly experienced, it is important to acknowledge that parenthood also brings about challenges, uncertainties, fears, and even feelings of loss or sadness. Each individual's background, personal experiences, support system, and circumstances play a significant role in shaping how they feel when they become a parent. It is normal for birthing persons to navigate through a mix of emotions as they adjust to their new role and responsibilities. Therefore, option B is the most appropriate choice as it recognizes the diverse emotional responses that can accompany the experience of becoming a parent.
If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold's maneuvers, what presenting part do you anticipate palpating in a vaginal exam?
- A. brow
- B. breech
- C. face
- D. occiput
Correct Answer: D
Rationale: If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold's maneuvers, it means the baby is presenting in an extended position with the occiput being the lead point of the presenting part during a vaginal exam. This position is known as occiput posterior. The fetal occiput is the back of the head, and it is the optimal position for vaginal delivery as the smallest diameter of the baby's head will be presenting at the cervix, facilitating an easier descent through the birth canal.
Which maternal factor may inhibit fetal descent during labor?
- A. A full bladder
- B. Decreased peristalsis
- C. Rupture of membranes
- D. Reduction in internal uterine size
Correct Answer: A
Rationale: A full bladder can inhibit fetal descent during labor by obstructing the pathway for the baby to descend through the birth canal. A distended bladder can physically block the baby's head from moving down and putting pressure on the cervix, which is necessary for the progress of labor. It is important for pregnant individuals to empty their bladder regularly during labor to optimize the conditions for fetal descent and facilitate a smoother delivery process.
The onset of labor is multifactorial. These reasons include which of the following? Select all that apply.
- A. Increase in progesterone
- B. Increase in estrogen
- C. Increase in human chorionic gonadotropin
- D. Aging of placenta
Correct Answer: B
Rationale: Increase in progesterone, estrogen, aging of placenta, and fetal hormones are the factors contributing to the onset of labor.