Nokea
The nurse is reviewing the cardinal maneuvers of labor and birth with a group of nursing students. Which maneuver will immediately follow the birth of the baby's head?
- A. Expulsion
- B. Restitution
- C. Internal rotation
- D. External rotation
Correct Answer: A
Rationale: After the baby's head is born, the immediate next step is the expulsion of the baby's body. This is because the expulsion maneuver refers to the delivery of the rest of the baby's body following the birth of the head. Restitution, internal rotation, and external rotation occur before the birth of the baby's head and are part of the cardinal movements of labor and birth. Restitution involves the realignment of the baby's head with their body after the head is born. Internal rotation refers to the baby's head turning to navigate through the birth canal. External rotation involves the baby's head turning back to its original position after delivery. So, the correct answer is A (Expulsion), as it directly follows the birth of the baby's head.
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What drug is an anxiolytic that relieves apprehension and creates a feeling of calm?
- A. hydroxyzine
- B. fentanyl
- C. codeine
- D. morphine
Correct Answer: A
Rationale: The correct answer is A: hydroxyzine. Hydroxyzine is an anxiolytic medication that acts on the central nervous system to relieve apprehension and induce a calming effect. It is commonly used to treat anxiety and tension. Fentanyl, codeine, and morphine are opioid medications primarily used for pain relief and do not have anxiolytic properties. Therefore, hydroxyzine is the correct choice for a drug that specifically targets anxiety and promotes a feeling of calm.
The pregnant patient expresses a desire to schedule birth during the baby's father's furlough
- A. The nurse explains that prior to induction of labor, it is essential to determine which clinical finding?
- B. Dilated cervix
- C. Fetal lung maturity
- D. Rupture of membranes
Correct Answer: C
Rationale: The correct answer is C: Fetal lung maturity. It is essential to determine fetal lung maturity before induction of labor to ensure that the baby's lungs are developed enough to breathe outside the womb. This is important for the baby's well-being and can help prevent complications.
Rationale:
1. Fetal lung maturity is crucial for the baby's ability to breathe independently.
2. Inducing labor without ensuring fetal lung maturity can lead to respiratory distress syndrome in the newborn.
3. A dilated cervix is important for labor progression but does not directly impact the baby's lung maturity.
4. Rupture of membranes may indicate potential labor but does not address the baby's lung development.
During a vaginal exam, the nurse identifies that the fetal station is at +2. What does this finding indicate?
- A. The fetus is high in the pelvis.
- B. The presenting part is at the ischial spines.
- C. The presenting part is below the ischial spines.
- D. The presenting part is crowning.
Correct Answer: C
Rationale: The correct answer is C because when the fetal station is at +2, it indicates that the presenting part is below the ischial spines. This means the baby's head is 2 cm below the ischial spines, which is a significant milestone in the descent of the fetus through the birth canal. The other choices are incorrect because: A) +2 station indicates descent, not that the fetus is high in the pelvis; B) Ischial spines are at 0 station, not +2; D) Crowning is at +5 station, not +2.
Which physiologic effect may occur in the presence of increased maternal pain perception during labor?
- A. Increase in uterine contractions in response to catecholamine secretion
- B. Decrease in blood pressure in response to alpha receptors
- C. Decreased perfusion to the placenta in response to catecholamine secretion
- D. Increased uterine blood flow, causing increase in maternal blood pressure
Correct Answer: C
Rationale: The correct answer is C. Increased maternal pain perception during labor can lead to decreased perfusion to the placenta due to catecholamine secretion. When a mother experiences pain, stress hormones like catecholamines are released, causing vasoconstriction of blood vessels, including those supplying the placenta. This vasoconstriction reduces blood flow to the placenta, potentially compromising fetal oxygenation and nutrient delivery.
Choice A is incorrect because increased catecholamine secretion would not directly cause an increase in uterine contractions. Choice B is incorrect because alpha receptors are not typically involved in decreasing blood pressure in response to pain perception. Choice D is incorrect because increased uterine blood flow would not cause an increase in maternal blood pressure; in fact, it would likely have the opposite effect as increased blood flow typically leads to decreased blood pressure.
The nurse is assisting a patient who wishes to use hydrotherapy during labor. What is the primary benefit of hydrotherapy?
- A. Accelerates cervical dilation.
- B. Increases maternal relaxation.
- C. Reduces the risk of perineal trauma.
- D. Shortens the duration of labor.
Correct Answer: B
Rationale: The correct answer is B: Increases maternal relaxation. Hydrotherapy during labor helps relax the mother by reducing stress, anxiety, and pain perception, promoting a sense of well-being. Relaxation can lead to better pain management and overall labor experience. Choice A is incorrect because hydrotherapy may not directly accelerate cervical dilation. Choice C is incorrect as it may reduce discomfort but does not necessarily prevent perineal trauma. Choice D is incorrect as the duration of labor can vary and is not solely determined by hydrotherapy.