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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. This is because nulliparas (women who have never given birth before) generally have longer labors compared to multiparas (women who have given birth before). This is due to factors such as the first-time stretching of the birth canal and the body's learning process. The level of pain experience (B) can vary among individuals and is not a primary difference between nulliparas and multiparas. The amount of cervical dilation (C) can be influenced by various factors and is not a defining difference between the two groups. The sequence of labor mechanisms (D) is a universal process in labor and does not differ based on whether a woman is a nullipara or multipara.
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Which criteria should be verified prior to vacuum or forceps use? Select all that apply.
- A. The woman’s bladder is empty.
- B. The fetus must be at least 34 weeks gestation.
- C. There is a Category I tracing.
- D. The cervix must be completely dilated.
Correct Answer: B
Rationale: The correct answer is B: The fetus must be at least 34 weeks gestation. This is important because before using vacuum or forceps, the fetus should be mature enough to withstand the extraction process. Premature infants may not have fully developed skull bones to withstand the pressure, increasing the risk of injury.
Explanation for other choices:
A: The woman’s bladder is empty - While it's ideal for the bladder to be empty to prevent injury during the procedure, it's not a criteria that must be verified prior to vacuum or forceps use.
C: There is a Category I tracing - Fetal heart rate monitoring is important during labor, but the tracing being Category I does not specifically correlate with the need for vacuum or forceps.
D: The cervix must be completely dilated - While full cervical dilation is necessary for vaginal delivery, it is not a specific criteria to verify before vacuum or forceps use.
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.
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.
Why is precipitous labor most often seen in multiparous women?
- A. The cervix weakens after each delivery.
- B. The cervix can dilate and efface simultaneously.
- C. The multigravida uterus is better able to coordinate muscle movements.
- D. It is more difficult for multiparous women to know when labor begins.
Correct Answer: C
Rationale: Step 1: In multiparous women, the uterus has gone through labor before, making muscle coordination more efficient.
Step 2: Efficient muscle coordination helps in effective contractions, leading to faster labor progress.
Step 3: Multiparous women have experienced labor before, allowing the uterus to contract more effectively.
Step 4: This efficiency in muscle coordination is why precipitous labor is more often seen in multiparous women.
Summary:
A: The weakening of the cervix after each delivery is not a direct cause of precipitous labor.
B: The ability of the cervix to dilate and efface simultaneously does not explain why precipitous labor is more common in multiparous women.
D: The difficulty in knowing when labor begins is not a reason for the occurrence of precipitous labor in multiparous women.
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.