Nokea
A woman has chosen a trial of labor after cesarean. Which findings indicate the best understanding of the nurse’s teaching by the patient?
- A. "It is safer for me to be induced at 39 weeks so that my labor can be controlled and monitored carefully.”
- B. "I will need to arrive to the hospital the night before my induction so that my cervix can be ripened with prostaglandins.”
- C. "If I do not go into labor on my own, I will have to have a cesarean section since Pitocin is contraindicated for me.”
- D. "A balloon catheter may be used to manually ripen my cervix, if necessary”
Correct Answer: D
Rationale: The correct understanding is that cervical ripening may be necessary before induction, and a balloon catheter can be used for this purpose. This is part of the education provided to patients who opt for a trial of labor after cesarean.
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A fetus is positioned in the occiput anterior position. The nurse determines that the fetus is positioned in which way?
- A. The fetal shoulder is closest to the vaginal opening.
- B. The fetal head is closest to the vaginal opening and the occiput is directed toward the maternal symphysis.
- C. The fetal head is closest to the uterine fundus and is directed toward the maternal symphysis.
- D. The fetal head is closest to the vaginal opening and is directed toward the maternal sacrum.
Correct Answer: B
Rationale: The occiput anterior position means the fetal head is closest to the vaginal opening, and the occiput is directed toward the maternal symphysis.
An increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of
- A. lightening.
- B. breech presentation.
- C. urinary tract infection.
- D. onset of Braxton-Hicks contractions.
Correct Answer: A
Rationale: An increase in urinary frequency and leg cramps after the 36th week of pregnancy are common signs of "lightening." Lightening refers to the descent of the baby into the pelvis in preparation for labor. This shift in position can put pressure on the bladder, leading to increased urinary frequency. Additionally, the pressure on nerves and blood vessels in the pelvis can cause leg cramps. These symptoms are typically experienced in the final weeks of pregnancy and are considered normal signs that the body is preparing for labor.
A laboring patient asks the nurse how she will know that the contraction is at its peak. The nurse explains that the contraction peaks during which stage of measurement?
- A. The acme
- B. The interval
- C. The increment
- D. The decrement
Correct Answer: B
Rationale: The peak of a contraction, also known as its highest point or intensity, is referred to as the acme. This is the stage during which the contraction reaches its maximum strength before gradually subsiding. By identifying the acme of the contraction, healthcare providers can better gauge the progress of labor and assess the intensity of contractions to determine the appropriate course of action for the laboring patient.
When should the nurse consider suggesting a doula?
- A. when the patient asks for an epidural
- B. if the nurse is unable to support the patient
- C. when the support person is in the military and cannot attend the birth
- D. if the patient is going to have an emergency cesarean birth
Correct Answer: B
Rationale: The nurse should consider suggesting a doula if they are unable to provide adequate support to the patient. A doula can offer emotional, physical, and informational support to the mother during labor and childbirth. If the nurse is busy with other tasks or unable to provide continuous support, a doula can step in to ensure the patient receives the support she needs. This can lead to a more positive childbirth experience for the patient.
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.