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The nurse is assessing a patient in the active phase of labor. What should the nurse expect during this phase?
- A. The patient is sociable and excite
- B. The patient is requesting pain medication.
- C. The patient begins to experience the urge to push.
- D. The patient experiences loss of control and irritability.
Correct Answer: C
Rationale: During the active phase of labor, contractions become stronger and more frequent, leading to cervical dilation. This is when the patient typically experiences the urge to push as the cervix reaches around 7-10 cm dilation. This signifies progress towards the second stage of labor. Choices A, B, and D are incorrect as they do not specifically align with the characteristics of the active phase of labor. A patient may exhibit a range of emotions and behaviors during labor, but the key indicator of the active phase is the urge to push due to cervical dilation.
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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 infants delivered via cesarean section before labor may not have had the opportunity to expel amniotic fluid from their lungs through the vaginal passage, leading to respiratory distress. This residual fluid can hinder the initiation of spontaneous respirations, causing difficulty in transitioning to extrauterine life. Choices A, B, and C are incorrect because hyperthermia from warm IV fluids, respiratory depression from regional anesthesia, and reduced placental blood flow from maternal position are not primary factors affecting the infant's ability to transition to extrauterine life in this scenario.
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 according to ACOG begins at 6 cm dilation. At this point, contractions become stronger and more frequent, leading to faster cervical dilation. This stage signifies significant progress towards delivery. Choice B (3 cm) is incorrect as it falls within the early phase of labor. Choice C (5 cm) is also incorrect as it is near the beginning of the active phase but not the specific transition point. Choice D (10 cm) is incorrect as it marks full dilation and the transition to the second stage of labor.
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.
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.
A 28-year-old gravida 1, para 0 patient who is at term calls the labor and birth unit stating that she thinks she is in labor. She states that she does have some vaginal discharge and feels wet;
- A. She relates a contraction pattern that is irregular, ranging from 5 to 7 minutes and lasting 30 seconds. Which questions should the nurse pose to the patient during this telephone triage? (Select all that apply.)
- B. Does she think that her membranes have ruptured?
- C. Is there any evidence of bloody show?
- D. Instruct the patient to keep monitoring her contraction pattern and call you back if they become more regular.
Correct Answer: A
Rationale: The correct answer is A because the patient's irregular contraction pattern and timing indicate early labor. The nurse should ask about the frequency, duration, and intensity of contractions to assess progression. Choices B and C focus on specific signs of labor but do not address the need for continuous monitoring and assessment like choice A does. Choice D does not address the need to gather specific information about the contraction pattern to determine the appropriate next steps. Therefore, A is the correct choice as it directly addresses the patient's current situation and provides guidance on what information is necessary for appropriate triage.