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A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
- A. Latent phase
- B. Active phase
- C. Second stage
- D. Third stage
Correct Answer: B
Rationale: The correct answer is B: Active phase. At 6 cm dilation, the active phase of labor begins, where cervical dilation accelerates. In this phase, contractions become stronger and closer together, promoting effacement and descent of the baby. The latent phase (choice A) occurs at 0-6 cm dilation, characterized by slower progress. The second stage (choice C) is when the baby is born, not based on cervical dilation. The third stage (choice D) is the delivery of the placenta, not determined by cervical dilation. Therefore, at 6 cm dilation, the patient is in the active phase of labor.
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The nurse is caring for a laboring patient with multiple family members in the room. How can the nurse address this situation?
- A. Educate the family that the pain the laboring person is experiencing is normal.
- B. Ask them all to leave the room.
- C. Explain that if the laboring person got an epidural, she would be more comfortable
- D. Assume the laboring person wants the family in the room
Correct Answer: B
Rationale: The correct answer is B, asking all family members to leave the room. This is important to provide privacy, reduce distractions, and maintain the laboring person's comfort and focus. Educating the family on pain normalcy (A) is secondary to the laboring person's immediate needs. Suggesting an epidural (C) without the laboring person's consent is inappropriate. Assuming the laboring person wants the family in the room (D) disregards the individual's preferences and comfort.
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
- A. Extension
- B. Engagement
- C. Internal rotation
- D. External rotation
Correct Answer: B
Rationale: The correct answer is B: Engagement. Engagement occurs when the largest diameter of the fetal presenting part passes through the pelvic inlet, indicating the descent of the fetal head into the pelvis. This is a crucial step in labor progress as it signifies the baby's readiness for birth.
A: Extension occurs during the second stage of labor when the baby's head passes through the birth canal.
C: Internal rotation is the movement of the baby's head within the pelvis to align with the maternal pelvis.
D: External rotation happens after the baby's head is delivered to allow for the shoulders to rotate for birth.
In summary, engagement is the correct answer as it specifically refers to the largest diameter of the fetal presenting part passing the pelvic inlet, setting the stage for the progression of labor.
Which is the cervical exam that most indicates the use of misoprostol?
- A. 1 cm dilated, 20% effaced, -3 station, firm and posterior
- B. 3-4 cm dilated, 50% effaced, -2 station, firm and midposition
- C. 5 cm dilated, 80% effaced, 0 station, soft and midposition
- D. 6 cm dilated, 100% effaced, +1 station, soft and anterior
Correct Answer: A
Rationale: Step 1: Misoprostol is a medication used for cervical ripening and induction of labor.
Step 2: The characteristics of the cervix that indicate the need for misoprostol are early in the dilation process (1 cm dilated), minimally effaced (20%), high station (-3), and firm and posterior position.
Step 3: Choice A best aligns with these characteristics, making it the correct answer.
Step 4: Choices B, C, and D are more advanced in dilation, effacement, station, and cervical position which do not indicate the need for misoprostol.
During the third stage of labor, what may the birthing person experience?
- A. expulsion of their fetus with vaginal bleeding
- B. cramping, gush of fresh vaginal bleeding, lengthening of the umbilical cord
- C. frequent episodes of dyspnea
- D. increased blood pressure and pain due to expulsive efforts
Correct Answer: B
Rationale: During the third stage of labor, the birthing person may experience cramping, a gush of fresh vaginal bleeding, and lengthening of the umbilical cord. This is due to the delivery of the placenta. Cramping helps expel the placenta, fresh vaginal bleeding is normal after delivery, and the lengthening of the umbilical cord indicates that the placenta is detaching. Choices A, C, and D are incorrect as they do not accurately describe the typical experiences during the third stage of labor.
The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all that apply.)
- A. Progesterone levels become higher than estrogen levels.
- B. Natural oxytocin in conjunction with other substances plays a role
- C. Stretching, pressure, and irritation of the uterus and cervix increase
- D. The secretion of prostaglandins from the fetal membranes decreases.
Correct Answer: B
Rationale: Step 1: Natural oxytocin is a hormone that plays a crucial role in initiating labor by stimulating uterine contractions.
Step 2: Other substances like prostaglandins also contribute to the initiation of labor by promoting cervical ripening and uterine contractions.
Step 3: Therefore, the correct answer is B as it accurately reflects the role of natural oxytocin and other substances in the initiation of labor.
Summary:
A: Progesterone levels becoming higher than estrogen levels is not directly related to the initiation of labor.
C: While stretching, pressure, and irritation of the uterus and cervix can contribute to labor, they are not the primary factors in labor initiation.
D: The secretion of prostaglandins from the fetal membranes actually increases during labor to facilitate the process, so this statement is incorrect.