Nokea
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.
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Which of the following are signs of impending labor? Select all that apply.
- A. Weight gain
- B. Surge of energy
- C. Increase in urinary frequency
- D. Dyspnea
Correct Answer: B
Rationale: The correct answer is B: Surge of energy. This is a sign of impending labor because some women experience a burst of energy as the body prepares for childbirth. Weight gain (A) is not a typical sign of impending labor, as weight gain usually occurs earlier in pregnancy. Increase in urinary frequency (C) is a common symptom throughout pregnancy and may not specifically indicate impending labor. Dyspnea (D), which is difficulty breathing, is not typically a sign of impending labor unless it is due to specific complications.
The primary difference between the labor of a nullipara and that of a multipara is
- A. total duration of labor.
- B. level of pain experience
- C. amount of cervical dilation.
- D. sequence of labor mechanisms.
Correct Answer: A
Rationale: The correct answer is A: total duration of labor. This is because nulliparas (women who have never given birth before) generally have longer labors compared to multiparas (women who have given birth before). This is due to factors such as the first-time stretching of the birth canal and the body's learning process. The level of pain experience (B) can vary among individuals and is not a primary difference between nulliparas and multiparas. The amount of cervical dilation (C) can be influenced by various factors and is not a defining difference between the two groups. The sequence of labor mechanisms (D) is a universal process in labor and does not differ based on whether a woman is a nullipara or multipara.
When does the active phase of labor begin according to ACOG?
- A. 6 cm
- B. 3 cm
- C. 5 cm
- D. 10 cm
Correct Answer: A
Rationale: The active phase of labor begins at 6 cm dilation according to ACOG guidelines. At this point, the cervix is significantly dilated, signaling the transition to active labor. This stage is crucial as it signifies the acceleration of labor progress and typically involves stronger contractions leading to efficient cervical dilation. Choices B, C, and D are incorrect as they do not align with the established criteria for the active phase of labor. Choice B (3 cm) is too early for active labor, choice C (5 cm) is close but not quite at the threshold for active labor, and choice D (10 cm) is actually the full dilation stage, not the beginning of active labor. Hence, choice A (6 cm) is the correct answer.
Which explains why infants who are delivered via cesarean section before the start of labor have more difficulty transitioning to extrauterine life?
- A. The use of warm IV fluids precipitates hyperthermia.
- B. Regional anesthesia causes respiratory depression.
- C. The maternal left tilt position reduces placental blood flow.
- D. Residual amniotic fluid in the lungs makes spontaneous respirations difficult.
Correct Answer: D
Rationale: The correct answer is D because residual amniotic fluid in the lungs can lead to a condition called transient tachypnea of the newborn (TTN), making spontaneous respirations difficult. This occurs more commonly in infants born via cesarean section before the onset of labor as they may not have had the opportunity to expel the fluid through the vaginal passage. A: Warm IV fluids can help maintain normal body temperature. B: Regional anesthesia may not directly cause respiratory depression in the infant. C: Maternal left tilt position is used to improve blood flow during labor, not relevant to respiratory issues in the newborn.
Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis?
- A. Station
- B. Flexion
- C. Descent
- D. Engagement
Correct Answer: B
Rationale: Flexion is the correct answer. During labor, fetal head flexion allows the smallest anterior-posterior diameter of the head to enter the pelvis first, reducing the risk of cephalopelvic disproportion. Station refers to the level of the presenting part in the maternal pelvis, not the head orientation. Descent is the downward movement of the fetus in the birth canal, not related to head position. Engagement occurs when the widest part of the presenting part reaches the level of the maternal ischial spines, not specifically related to the orientation of the fetal head.