labor and delivery questions and answers

labor and delivery questions and answers Related

Review labor and delivery questions and answers related questions and content

The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between contractions. Which statement is the appropriate rationale for assessing maternal vital signs between contractions raNtheRr thaIn aGt anBot.heCr inMterval? U S N T O

  • A. Vital signs taken during contractions are inaccurat
  • B. During a contraction, assessing fetal heart rate is the priority.
  • C. Maternal blood flow to the heart is reduced during contractions.
  • D. Maternal circulating blood volume increases temporarily during contractions.
Correct Answer: D

Rationale: The correct answer is D: Maternal circulating blood volume increases temporarily during contractions.
1. During contractions, the uterus contracts, temporarily reducing blood flow to the placenta and increasing blood volume in the maternal circulation.
2. This temporary increase in blood volume can affect vital signs, such as blood pressure and heart rate.
3. Assessing maternal vital signs between contractions provides a more accurate baseline reading.
4. Choice A is incorrect because vital signs taken during contractions may be affected by the temporary increase in blood volume.
5. Choice B is incorrect as assessing fetal heart rate is a separate priority and not directly related to maternal vital signs.
6. Choice C is incorrect as maternal blood flow to the heart is not reduced during contractions.

You may also like to solve these questions

A 35-year-old gravida 1, para 0 is admitted to the labor and delivery unit. She reports intense rectal pressure. Which stage of labor is probable?

  • A. First stage, latent
  • B. Second stage
  • C. Third stage
  • D. Fourth stage
Correct Answer: B

Rationale: The correct answer is B: Second stage. This stage of labor is characterized by full dilation of the cervix and ends with the delivery of the baby. The intense rectal pressure reported by the patient indicates that the baby is descending through the birth canal, which is a hallmark sign of the second stage. In contrast, the first stage, latent (choice A) is characterized by early labor contractions and cervical dilation up to 6 cm. The third stage (choice C) is the delivery of the placenta, and the fourth stage (choice D) is the immediate postpartum period. The key here is recognizing the specific symptom of intense rectal pressure, which aligns with the second stage of labor.

Which woman is the best candidate for a trial of labor after cesarean (TOLAC)?

  • A. A 34-year-old gravida 2, para 1 with one previous classical cesarean section for prematurity
  • B. A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD
  • C. A 31-year-old gravida 4, para 2 with one previous low-transverse cesarean section for late decelerations
  • D. A 27-year-old gravida 3, para 2 with one previous T-shaped incision for macrosomia
Correct Answer: B

Rationale: Rationale for Choice B (Correct Answer):
- A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD is the best candidate for TOLAC.
- Low-transverse incisions have the lowest risk of uterine rupture during labor.
- CPD is not a contraindication for TOLAC.
- Young age and low parity are favorable factors for successful TOLAC.
- Therefore, this candidate has the highest likelihood of a successful VBAC.

Summary for Other Choices:
- Choice A: Classical cesarean section carries a high risk of uterine rupture; prematurity increases this risk.
- Choice C: Low-transverse incision is favorable, but the indication for the previous cesarean (late decelerations) may indicate an ongoing fetal concern.
- Choice D: T-shaped incision increases the risk of uterine rupture; macrosomia is a risk factor for failed TOL

A 28-year-old woman without risk factors has now reached the second stage of labor. What is the optimal position for her at this point?

  • A. Supine
  • B. Lateral recumbent
  • C. Lithotomy
  • D. Squatting
Correct Answer: B

Rationale: The optimal position for a 28-year-old woman in the second stage of labor is the lateral recumbent position (Choice B). This position helps maximize pelvic diameter and blood flow to the uterus, facilitating labor progress. It also reduces the risk of fetal heart rate abnormalities compared to the supine position (Choice A). Lithotomy position (Choice C) can hinder the descent of the baby and increase the risk of perineal trauma. Squatting (Choice D) may be uncomfortable and less effective in promoting efficient labor progress compared to the lateral recumbent position.

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.

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.

Copyright © 2025 Nokea. All rights reserved.