Nokea
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 the seven cardinal movements of labor is: Descent, Flexion, Internal Rotation, Extension, Restitution, External Rotation, and Expulsion. Descent is the first cardinal movement, as the baby moves down the birth canal. Flexion follows to allow the baby's head to pass through the pelvis. Internal Rotation, Extension, and Restitution then occur to facilitate the baby's shoulders and body turning in alignment with the mother's pelvis. External Rotation follows to help the shoulders rotate to the correct position for delivery. Finally, Expulsion is when the baby is born. This sequence ensures a smooth and safe delivery. The other choices are incorrect as they are not part of the specific sequence of cardinal movements during labor.
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How long is the expected length of the third stage of labor?
- A. 60 minutes or less
- B. 30 minutes or less
- C. 1 hour for a multiparous person, 2 hours for a nulliparous person
- D. 3 hours for a multiparous person, 4 hours for a nulliparous person
Correct Answer: C
Rationale: The correct answer is C because the expected length of the third stage of labor, which is the delivery of the placenta, is typically around 1 hour for a multiparous person (someone who has given birth before) and around 2 hours for a nulliparous person (someone who is giving birth for the first time). This is based on the normal physiological process of the uterus contracting to expel the placenta. Choice A and B are incorrect as they provide specific time limits that are not generally applicable to all individuals. Choice D is incorrect as it suggests longer durations which are beyond the typical range for the third stage of labor.
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. This is the priority intervention because a transverse lie is a malpresentation that can lead to complications during labor and delivery. The healthcare provider needs to be informed immediately to determine the best course of action, which may include attempting to manually rotate the baby or preparing for a cesarean section. Performing a vaginal exam (A) can be dangerous and should be avoided in cases of transverse lie. Initiating parenteral therapy (C) and applying oxygen (D) are not priorities in this situation as addressing the malpresentation is more urgent.
Pregnant patients can usually tolerate the normal blood loss associated with childbirth because of which physiologic adaptation to pregnancy?
- A. A higher hematocrit
- B. Increased leukocytes
- C. Increased blood volume
- D. A lower fibrinogen level
Correct Answer: C
Rationale: The correct answer is C: Increased blood volume. During pregnancy, a woman's blood volume increases by about 30-50% to support the growing fetus and prepare for potential blood loss during childbirth. This increased blood volume helps pregnant patients tolerate the normal blood loss associated with childbirth without experiencing severe complications like hypovolemic shock.
Rationale:
A: A higher hematocrit would not directly contribute to increased blood volume and would not help in tolerating blood loss during childbirth.
B: Increased leukocytes are part of the immune response and are not directly related to blood volume or tolerance to blood loss.
D: A lower fibrinogen level would not directly contribute to increased blood volume and would not help in tolerating blood loss during childbirth.
Summary:
Choice C is correct because increased blood volume is a crucial physiologic adaptation during pregnancy that enables pregnant patients to tolerate the normal blood loss associated with childbirth. Choices A, B, and D are incorrect as they are not directly related to this
Which criteria should be verified prior to vacuum or forceps use? Select all that apply.
- A. The woman’s bladder is empty.
- B. The fetus must be at least 34 weeks gestation.
- C. There is a Category I tracing.
- D. The cervix must be completely dilated.
Correct Answer: B
Rationale: The correct answer is B: The fetus must be at least 34 weeks gestation. This is important because before using vacuum or forceps, the fetus should be mature enough to withstand the extraction process. Premature infants may not have fully developed skull bones to withstand the pressure, increasing the risk of injury.
Explanation for other choices:
A: The woman’s bladder is empty - While it's ideal for the bladder to be empty to prevent injury during the procedure, it's not a criteria that must be verified prior to vacuum or forceps use.
C: There is a Category I tracing - Fetal heart rate monitoring is important during labor, but the tracing being Category I does not specifically correlate with the need for vacuum or forceps.
D: The cervix must be completely dilated - While full cervical dilation is necessary for vaginal delivery, it is not a specific criteria to verify before vacuum or forceps use.
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?