Nokea
What Bishop score describes the most favorable cervix?
- A. 2
- B. 4
- C. 6
- D. 8
Correct Answer: D
Rationale: The Bishop score assesses cervical readiness for labor. A score of 8 indicates a cervix that is most favorable for labor, with characteristics such as cervical dilation, effacement, station of the presenting part, cervical consistency, and cervical position all being favorable for childbirth. A score of 8 signifies a well-prepared cervix for labor, making it the correct answer. Choices A, B, and C (2, 4, and 6) represent scores indicating varying degrees of cervical readiness, but they are not as optimal as a score of 8. A Bishop score of 8 is associated with a higher likelihood of successful induction and progression of labor compared to lower scores.
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Which patient is a candidate for internal monitoring with an intrauterine pressure catheter?
- A. Obese patient whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds
- B. Gravida 1, para 0, whose contractions are 2 to 3 minutes apart, lasting 60 seconds
- C. Multigravida whose contractions are 2 minutes apart, lasting 60 to 70 seconds
- D. Gravida 2, para 1, in latent phase whose contractions are irregular and mild
Correct Answer: B
Rationale: The correct answer is B because the patient is a primigravida (first pregnancy) with frequent contractions (2 to 3 minutes apart, lasting 60 seconds), which indicates active labor and the need for internal monitoring with an intrauterine pressure catheter. This level of contraction frequency and duration suggests progression towards the active phase of labor, where accurate monitoring is crucial for the well-being of both the mother and the baby.
Choice A is incorrect because the contractions are not as frequent or long-lasting as in active labor. Choice C is incorrect because although the contractions are frequent, the duration is longer than typical active labor. Choice D is incorrect because the contractions are irregular and mild, indicating the latent phase of labor where internal monitoring is not necessary.
In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding?
- A. The fetus is at 30 weeks of gestation.
- B. The mother has a history of fast labors.
- C. The mother has been given an epidural block.
- D. The mother has mild preeclampsia but is not in labor.
Correct Answer: A
Rationale: The correct answer is A because at 30 weeks of gestation, a fetal heart rate of 160 to 170 bpm is considered normal due to the fetus's stage of development. Fetal heart rates gradually decrease as gestation progresses. Choices B, C, and D are incorrect because they do not directly impact the fetal heart rate based on gestational age. Choice B, fast labors, does not affect the baseline fetal heart rate. Choice C, epidural block, may cause maternal hypotension but typically doesn't affect the fetal heart rate. Choice D, mild preeclampsia, may lead to fetal distress but does not directly influence the baseline fetal heart rate.
What is a potential risk associated with prolonged second stage labor?
- A. decreased risk of instrumental delivery
- B. decreased risk of cesarean birth
- C. increased risk of fetal distress
- D. increased risk of rapid delivery
Correct Answer: C
Rationale: The correct answer is C: increased risk of fetal distress. Prolonged second stage labor can lead to decreased oxygen supply to the fetus, causing fetal distress. This can result in adverse outcomes for the baby. Other options are incorrect because prolonged second stage labor is actually associated with an increased risk of instrumental delivery (A), an increased risk of cesarean birth (B), and not rapid delivery (D) as it is a prolonged process.
What is a potential complication for the neonate due to precipitous labor?
- A. respiratory distress
- B. low birth weight
- C. prelabor rupture of membranes
- D. placenta previa
Correct Answer: A
Rationale: The correct answer is A: respiratory distress. During precipitous labor, the rapid delivery can cause the neonate to experience respiratory distress due to inadequate time for fluid clearance from the lungs, leading to transient tachypnea or respiratory distress syndrome. This complication can result in difficulty breathing and require immediate medical intervention.
Summary:
B: Low birth weight is not directly associated with precipitous labor.
C: Prelabor rupture of membranes is unrelated to the speed of labor.
D: Placenta previa is a condition involving the placenta's position, not typically related to the duration of labor.
Which clinical finding can be determined only by electronic fetal monitoring?
- A. Variability
- B. Tachycardia
- C. Bradycardia
- D. Fetal response to contractions
Correct Answer: D
Rationale: The correct answer is D because electronic fetal monitoring is the only method that can directly measure and display the fetal heart rate in response to contractions. Variability, tachycardia, and bradycardia can also be observed through electronic fetal monitoring, but fetal response to contractions specifically requires continuous monitoring of the fetal heart rate during contractions. Therefore, D is the only clinical finding that can be determined exclusively through electronic fetal monitoring. Variability (A), tachycardia (B), and bradycardia (C) can be identified through other means of monitoring and assessment as well.