Nokea
A woman’s pelvis is described as long and narrow with an anteroposterior diameter greater than the transverse diameter. This is known as which type of pelvis?
- A. Platypelloid
- B. Android
- C. Anthropoid
- D. Gynecoid
Correct Answer: C
Rationale: The correct answer is C: Anthropoid. An anthropoid pelvis is characterized by a long and narrow shape with an anteroposterior diameter greater than the transverse diameter. This type of pelvis resembles the pelvic structure of anthropoid (higher primates) mammals. The other choices are incorrect because:
A: Platypelloid pelvis is flat and broad, not long and narrow.
B: Android pelvis has a heart-shaped inlet with an android appearance, not a long and narrow shape.
D: Gynecoid pelvis is rounded and wider with a transverse diameter greater than the anteroposterior diameter, opposite of the described characteristics.
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On admission to the labor and birth unit, a 38-year-old female, gravida 4, para 3, at term in early labor is found to have a transverse lie on vaginal examination. What is the priority intervention at this time?
- A. Perform a vaginal exam to denote progress.
- B. Notify the health care provider.
- C. Initiate parenteral therapy.
- D. Apply oxygen via nasal cannula at 8 L/minut
Correct Answer: B
Rationale: The correct answer is B: Notify the health care provider. In the case of a transverse lie, the fetus is positioned sideways in the uterus, which can lead to complications during labor. Notifying the health care provider is crucial as they will need to assess the situation and determine the appropriate course of action, such as attempting to manually rotate the fetus or preparing for a cesarean section if necessary. Performing a vaginal exam (choice A) may not be safe or effective in this situation. Initiating parenteral therapy (choice C) and applying oxygen (choice D) are not the priority interventions in the case of a transverse lie.
A gravida 3, para 2 is attempting a vaginal birth without the use of pain medicine or anesthesia. Following spontaneous rupture of membranes, the patient’s cervical exam was 5 cm dilated, 60% effaced, -2 station. Which therapeutic intervention is appropriate for this patient?
- A. Ambulation with assistance
- B. Squatting with support from partner
- C. Sitting on birthing ball
- D. Resting on hands and knees
Correct Answer: C
Rationale: The correct answer is C: Sitting on birthing ball. This position helps to open up the pelvis, allowing gravity to assist in descent of the baby. It also promotes optimal positioning for the baby, reducing the risk of malpresentation. The other choices (A, B, D) do not provide the same benefits in terms of promoting optimal fetal positioning and utilizing gravity to aid in labor progress. Ambulation with assistance may not provide as much support for the pelvis, squatting with support from the partner may not be as stable or comfortable for the mother, and resting on hands and knees may not encourage as much engagement of the baby's head in the pelvis.
What anticipatory guidance should the nurse provide for new parents regarding sociologic changes?
- A. Explain that roles will not change at home
- B. Explain that stresses will be over now that the newborn is born.
- C. Tell the parents not to stress over household changes.
- D. Prepare them for possible strains on relationships.
Correct Answer: D
Rationale: The correct answer is D because it addresses the potential strains on relationships that can occur after the birth of a child. New parents often experience changes in their relationship dynamics due to increased responsibilities, sleep deprivation, and shifts in priorities. By preparing them for these possible strains, the nurse can help them navigate these challenges effectively.
A is incorrect because roles often do change at home with the arrival of a newborn. B is incorrect as stresses can actually increase after the baby is born. C is incorrect as it dismisses the importance of addressing household changes and potential stressors.
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.
During an oxytocin induction, which assessment finding is most concerning to the labor and delivery nurse?
- A. A uterine resting tone of 17 mm Hg
- B. A uterine resting tone of 30 mm Hg
- C. Contractions that are every 3 minutes and last 60 seconds
- D. Contractions that are every 5 minutes and last 60 seconds
Correct Answer: B
Rationale: The correct answer is B (A uterine resting tone of 30 mm Hg) because a high uterine resting tone indicates uterine hyperstimulation, which can lead to uterine rupture, fetal distress, and compromised blood flow to the placenta. A higher resting tone of 30 mm Hg is concerning compared to the normal range of 12-18 mm Hg.
Choice A (A uterine resting tone of 17 mm Hg) is within the normal range, so it is not as concerning as a higher resting tone.
Choices C (Contractions every 3 minutes lasting 60 seconds) and D (Contractions every 5 minutes lasting 60 seconds) describe the frequency and duration of contractions, which are important but are not as immediately concerning as a high uterine resting tone.