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The nurse is caring for a patient during induction of labor. The oxytocin is currently infusing at 6 mU/min. The fetal heart tracing displays a 130 baseline, moderate variability, and no accelerations or decelerations. Uterine contractions have been every 2 minutes for the last 30 minutes. What is the nurse’s next best action?
- A. Reduce the oxytocin infusion to 3 mU/min
- B. Delay the next scheduled oxytocin increase
- C. Maintain infusion at 6 mU/min
- D. Discontinue the oxytocin infusion
Correct Answer: C
Rationale: The fetal heart rate (FHR) is stable, with moderate variability and no decelerations, indicating that the fetus is not in distress. The contractions are occurring at appropriate intervals, so the nurse should maintain the current oxytocin infusion to continue labor progression.
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A laboring patient asks the nurse how she will know that the contraction is at its peak. The nurse explains that the contraction peaks during which stage of measurement?
- A. The acme
- B. The interval
- C. The increment
- D. The decrement
Correct Answer: B
Rationale: The peak of a contraction, also known as its highest point or intensity, is referred to as the acme. This is the stage during which the contraction reaches its maximum strength before gradually subsiding. By identifying the acme of the contraction, healthcare providers can better gauge the progress of labor and assess the intensity of contractions to determine the appropriate course of action for the laboring patient.
A patient admitted to the labor unit asks the nurse to discuss the episiotomy procedure with her. Which is true regarding episiotomy?
- A. An episiotomy is required for all vaginal births.
- B. A midline episiotomy is associated with more third- and fourth-degree lacerations.
- C. A mediolateral episiotomy is easier to repair than a medial episiotomy.
- D. A midline episiotomy is associated with more blood loss.
Correct Answer: B
Rationale: A midline episiotomy is not required for all vaginal births, but it is associated with more third- and fourth-degree lacerations.
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.
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.
During the second stage, what do the birthing person's vital signs most likely show?
- A. increased heart rate during contractions, baseline heart rate between contractions
- B. increased heart rate during contractions, decreased heart rate between contractions
- C. decreased heart rate during contractions, increased heart rate between contractions
- D. decreased heart rate during contractions, baseline heart rate between contractions
Correct Answer: A
Rationale: During the second stage of labor (pushing stage), the birthing person's vital signs most likely show an increased heart rate during contractions and a baseline heart rate between contractions. This increase in heart rate is a normal physiological response to the exertion and pressure of pushing during contractions. Between contractions, the heart rate should return to a more stable baseline. It is important to monitor these vital signs to ensure the well-being of both the birthing person and the baby during childbirth.