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When does the active phase of labor begin according to ACOG?
- A. 6 cm
- B. 3 cm
- C. 5 cm
- D. 10 cm
Correct Answer: A
Rationale: The active phase of labor according to ACOG begins at 6 cm dilation. At this point, contractions become stronger and more frequent, leading to faster cervical dilation. This stage signifies significant progress towards delivery. Choice B (3 cm) is incorrect as it falls within the early phase of labor. Choice C (5 cm) is also incorrect as it is near the beginning of the active phase but not the specific transition point. Choice D (10 cm) is incorrect as it marks full dilation and the transition to the second stage of labor.
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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. During contractions, maternal circulating blood volume increases temporarily due to the compression of blood vessels. Therefore, assessing vital signs between contractions provides a more accurate baseline measurement. Choice A is incorrect because vital signs taken during contractions may be affected by the pain and stress of labor. Choice B is incorrect as fetal heart rate assessment is a separate priority. Choice C is incorrect as maternal blood flow to the heart actually increases during contractions to ensure adequate oxygen supply.
Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis?
- A. Station
- B. Flexion
- C. Descent
- D. Engagement
Correct Answer: B
Rationale: The correct answer is B: Flexion. Flexion of the fetal head is crucial for the smallest anterior-posterior diameter to enter the pelvis first. This position optimizes the fit of the fetal head through the maternal pelvis, reducing the risk of complications during labor. Station (A) refers to the level of the presenting part in the pelvis, descent (C) is the downward movement of the fetus, and engagement (D) is when the widest diameter of the fetal head passes through the maternal pelvic inlet. However, these factors do not specifically address the orientation of the fetal head to ensure the smallest diameter enters the pelvis.
A fetus is positioned in a longitudinal lie with its head in the fundus with both hips and knees flexed. Which presentation is this known as?
- A. Frank breech
- B. Complete breech
- C. Vertex
- D. Transverse
Correct Answer: B
Rationale: The correct answer is B: Complete breech. In a complete breech presentation, the fetus is positioned with its head in the fundus, hips flexed, and knees flexed. This position is unique to the complete breech presentation. A: Frank breech would have the hips flexed, but the knees extended. C: Vertex position is when the head is down towards the birth canal. D: Transverse is when the fetus is lying horizontally across the uterus. Therefore, based on the description provided in the question, the correct answer is B as it matches the specific presentation described.
How long is the expected length of the third stage of labor?
- A. 60 minutes or less
- B. 30 minutes or less
- C. 1 hour for a multiparous person, 2 hours for a nulliparous person
- D. 3 hours for a multiparous person, 4 hours for a nulliparous person
Correct Answer: C
Rationale: The correct answer is C because the expected length of the third stage of labor, which is the delivery of the placenta, is typically around 1 hour for a multiparous person (someone who has given birth before) and around 2 hours for a nulliparous person (someone who is giving birth for the first time). This is based on the normal physiological process of the uterus contracting to expel the placenta. Choice A and B are incorrect as they provide specific time limits that are not generally applicable to all individuals. Choice D is incorrect as it suggests longer durations which are beyond the typical range for the third stage of labor.