Nokea
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: The correct answer is C because during the active phase of labor, the cervix dilates from 4 to 7 centimeters, and the patient typically experiences the urge to push as the baby descends further down the birth canal. This indicates progress in labor and readiness for the second stage. Choices A, B, and D are incorrect as they do not specifically align with the characteristics of the active phase of labor. Choice A is not necessarily indicative of the active phase, choice B may happen at any stage of labor, and choice D is more characteristic of transition phase rather than the active phase.
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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: 1 hour for a multiparous person, 2 hours for a nulliparous person. This is based on the typical duration of the third stage of labor, which involves the delivery of the placenta. In general, the third stage is expected to last around 5-30 minutes. However, for safety reasons and to allow for variations in individual cases, it is recommended to extend the time frame to 1 hour for multiparous individuals (those who have given birth before) and 2 hours for nulliparous individuals (those giving birth for the first time). This extended time frame ensures that healthcare providers have enough time to monitor and intervene if necessary without rushing the delivery of the placenta.
Other choices are incorrect because they provide either too short (A and B) or too long (D) timeframes for the third stage of labor, which could lead to inadequate monitoring or unnecessary interventions.
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. Nullipara refers to a woman giving birth for the first time, while multipara refers to a woman who has given birth multiple times. The primary difference between their labors is the total duration. Nulliparas typically have longer labors due to the body's first experience with childbirth. The other choices (B, C, D) are not the primary difference between nullipara and multipara labors. Pain experience, cervical dilation, and labor mechanisms can vary based on individual factors, but the key distinction lies in the overall duration of labor based on parity.
A patient who is 8 cm dilated develops circumoral numbness and dizziness. What is the nurse’s priority intervention?
- A. Call the health care provider immediately.
- B. Increase intravenous fluid, as these are signs of hypovolemia.
- C. Have the patient slow down her breathing.
- D. Have her start pushing, as these are signs of the beginning of the second stage.
Correct Answer: C
Rationale: The correct answer is C: Have the patient slow down her breathing. Circumoral numbness and dizziness are signs of hyperventilation, which can occur due to rapid breathing during labor. Slowing down the patient's breathing helps prevent respiratory alkalosis and promotes proper oxygenation for both the mother and the baby. Calling the health care provider immediately (A) may cause a delay in addressing the immediate issue. Increasing IV fluids (B) may not address the root cause of the symptoms. Having her start pushing (D) prematurely can be harmful if she is not fully dilated.
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.
The nurse is planning care for a patient during the fourth stage of labor. Which interventions should the nurse plan to implement? (Select all that apply.)
- A. Offer the patient a warm blanket.
- B. Place an ice pack on the perineum.
- C. Massage the uterus if it is boggy.
- D. Delay breastfeeding until the patient is reste
Correct Answer: A
Rationale: The correct answer is A: Offer the patient a warm blanket. In the fourth stage of labor, the mother experiences postpartum hemorrhage risk due to uterine atony. Keeping the patient warm helps prevent hypothermia, which can lead to increased bleeding. Ice packs (B) are not indicated as they can cause vasoconstriction and inhibit proper blood flow. Massaging the uterus (C) is appropriate in the third stage of labor to prevent hemorrhage but not in the fourth stage. Delaying breastfeeding (D) is incorrect as early breastfeeding promotes uterine contractions, reducing the risk of postpartum hemorrhage.