On admission to the labor unit, a primigravid woman at 38 weeks gestation states, “I need to urinate more now but at least I can breathe easier.” The nurse is aware that this is likely due to which physiological process?
- A. Onset of labor
- B. Effacement
- C. Lightening
- D. Rupture of membranes
Correct Answer: C
Rationale: Increased urination and easier breathing are signs of lightening, where the fetal head drops lower into the pelvis.
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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.
Cephalohematoma occurring from an operative vaginal delivery increased a newborn’s risk of developing which of the following complications?
- A. Bulging fontanels
- B. Developmental delays
- C. Jaundice
- D. Macrocephaly
Correct Answer: C
Rationale: Cephalohematomas are a common complication from operative vaginal deliveries. The accumulation of blood between the infant's skull and periosteum increases the risk of jaundice because of the breakdown of red blood cells, which can overwhelm the infant's immature liver and lead to hyperbilirubinemia.
A nurse performs a vaginal examination on her patient in early labor and determines that the head is ballotable. What is this defined as?
- A. Floating
- B. Zero station
- C. +1 station
- D. -2 station
Correct Answer: A
Rationale: Ballotable means the fetal head is floating and can be pushed away from the cervix.
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.
Which female pelvis is most suitable for vaginal delivery?
- A. Gynecoid
- B. Android
- C. Platypelloid
- D. Anthropoid
Correct Answer: A
Rationale: A gynecoid pelvis is the most suitable for vaginal delivery.