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What is the most appropriate statement from the nurse when coaching the laboring woman with a fully dilated cervix to push?
- A. At the beginning of a contraction, hold your breath and push for 10 seconds.'
- B. Take a deep breath and push between contractions.'
- C. Begin pushing when a contraction starts and continue for the duration of the contraction.'
- D. At the beginning of a contraction, take two deep breaths and push with the second exhalation.'
Correct Answer: D
Rationale: When the cervix is fully dilated, the woman should take a deep breath and exhale at the beginning of a contraction, and then take another deep breath and push while exhaling.
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Why should the nurse encourage the mother to void during the fourth stage of labor?
- A. A full bladder could interfere with cervical dilation.
- B. A full bladder could obstruct progress of the infant through the birth canal.
- C. A full bladder could obstruct the passage of the placenta.
- D. A full bladder could predispose the mother to uterine hemorrhage.
Correct Answer: D
Rationale: A full bladder immediately after birth can cause excessive bleeding because it pushes the uterus upward and interferes with contractions.
A pregnant woman, gravida 2, para 1, tells the nurse she desires a VBAC (vaginal birth after cesarean section) with this pregnancy. What is the primary concern regarding complications for this patient during labor and birth?
- A. Eclampsia
- B. Placental abruption
- C. Congestive heart failure
- D. Uterine rupture
Correct Answer: D
Rationale: The main concern for VBAC is uterine rupture, which can disrupt placental blood flow and cause hemorrhage.
What do late decelerations indicate?
- A. A nonreassuring pattern
- B. Uteroplacental insufficiency
- C. Fetal heart depression
- D. Cord compression
- E. Head compression
Correct Answer: A,B,C
Rationale: Late decelerations indicate a nonreassuring pattern, uteroplacental insufficiency, and fetal heart depression.
What are the advantages of a freestanding birth center?
- A. Homelike setting
- B. Designed for high-risk pregnancies
- C. Lower costs
- D. Attended by certified obstetricians
- E. Immediate emergency access
Correct Answer: A,C
Rationale: Advantages of a freestanding birth center include a homelike setting and lower costs, as they do not require expensive departments like emergency or critical care.
What will the nurse remind the patient about contractions during this stage of labor?
- A. They get the infant positioned for delivery.
- B. They push the infant into the vagina.
- C. They dilate and efface the cervix.
- D. They get the mother prepared for true labor.
Correct Answer: C
Rationale: The first stage of labor describes the time from the onset of labor until full dilation of the cervix.