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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.
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It is determined that the presenting part of the fetus is the buttocks. At delivery the fetus's hips are flexed and the knees are extended. How would the nurse record this presentation?
- A. Complete breech
- B. Frank breech
- C. Double footing
- D. Buttocks presentation
Correct Answer: B
Rationale: When a fetus presents in a frank breech position, the legs are flexed at the hips and extend toward the shoulders.
The nurse observes the patient bearing down with contractions and crying out, 'The baby is coming!' What is the best nursing intervention?
- A. Find the physician.
- B. Stay with the woman and use the call bell to get help.
- C. Send the woman's partner to locate a registered nurse.
- D. Assist with deep breathing to slow the labor process.
Correct Answer: B
Rationale: If birth appears to be imminent, the nurse should not leave the woman and should summon help with the call bell.
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 does the nurse note when measuring the frequency of a laboring woman's contractions?
- A. How long the patient states the contractions last
- B. The time between the end of one contraction and the beginning of the next
- C. The time between the beginning and the end of one contraction
- D. The time between the beginning of one contraction and the beginning of the next
Correct Answer: D
Rationale: The frequency of contractions is the elapsed time from the beginning of one contraction to the beginning of the next contraction.
How should the nurse intervene to relieve perineal bruising and edema following delivery?
- A. Place an ice pack on the area for 12 hours.
- B. Place a warm pack on the perineal area for 24 hours.
- C. Administer aspirin to relieve inflammation.
- D. Change the perineal pad frequently.
Correct Answer: A
Rationale: An ice pack can be placed on the mother's perineum to reduce bruising and edema for 12 hours followed by a warm pack after the first 12 to 24 hours after delivery.