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When does the second stage of labor begin?
- A. at birth
- B. when the early phase ends
- C. when the cervix is completely dilated and effaced
- D. when pushing begins
Correct Answer: D
Rationale: The correct answer is D because the second stage of labor begins when the mother starts pushing to deliver the baby. This stage involves the actual delivery of the baby and ends with the birth. The other choices are incorrect because:
A: Labor begins before the second stage.
B: The early phase is part of the first stage of labor.
C: Full dilation and effacement mark the transition between the first and second stages but pushing is when the second stage actually begins.
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The nurse is caring for a laboring patient with multiple family members in the room. How can the nurse address this situation?
- A. Educate the family that the pain the laboring person is experiencing is normal.
- B. Ask them all to leave the room.
- C. Explain that if the laboring person got an epidural, she would be more comfortable
- D. Assume the laboring person wants the family in the room
Correct Answer: B
Rationale: The correct answer is B because having multiple family members in the room during labor can be overwhelming and hinder the progress of labor. It is important for the laboring person to have privacy, focus, and reduce stress for a smoother labor experience. Asking the family members to leave the room ensures a calm and supportive environment for the laboring person.
Incorrect Choices:
A: Educating the family about pain normalcy is helpful, but privacy and focus are more crucial during labor.
C: Mentioning epidural may not be appropriate as it is the laboring person's decision and may not be the best option for everyone.
D: Assuming the laboring person wants family in the room without considering their preference may not be the best approach for their comfort and progress in labor.
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
- A. Extension
- B. Engagement
- C. Internal rotation
- D. External rotation
Correct Answer: B
Rationale: The correct answer is B: Engagement. Engagement occurs when the largest diameter of the fetal presenting part (usually the biparietal diameter of the fetal head) passes through the pelvic inlet. This marks the beginning of the descent of the fetal head into the pelvis in preparation for birth. Extension (A) refers to the movement of the fetal head as it passes through the birth canal. Internal rotation (C) is the movement of the fetal head to align with the maternal pelvis. External rotation (D) occurs as the fetal head exits the birth canal.
Which is the cervical exam that most indicates the use of misoprostol?
- A. 1 cm dilated, 20% effaced, -3 station, firm and posterior
- B. 3-4 cm dilated, 50% effaced, -2 station, firm and midposition
- C. 5 cm dilated, 80% effaced, 0 station, soft and midposition
- D. 6 cm dilated, 100% effaced, +1 station, soft and anterior
Correct Answer: A
Rationale: Step 1: Misoprostol is a medication used for cervical ripening and induction of labor.
Step 2: The characteristics of the cervix that indicate the need for misoprostol are early in the dilation process (1 cm dilated), minimally effaced (20%), high station (-3), and firm and posterior position.
Step 3: Choice A best aligns with these characteristics, making it the correct answer.
Step 4: Choices B, C, and D are more advanced in dilation, effacement, station, and cervical position which do not indicate the need for misoprostol.
A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
- A. Latent phase
- B. Active phase
- C. Second stage
- D. Third stage
Correct Answer: B
Rationale: The correct answer is B: Active phase. At 6 cm dilation, the active phase of labor begins, where cervical dilation accelerates. In this phase, contractions become stronger and closer together, promoting effacement and descent of the baby. The latent phase (choice A) occurs at 0-6 cm dilation, characterized by slower progress. The second stage (choice C) is when the baby is born, not based on cervical dilation. The third stage (choice D) is the delivery of the placenta, not determined by cervical dilation. Therefore, at 6 cm dilation, the patient is in the active phase of labor.
Which assessment finding would cause a concern for a patient who had delivered vaginally?
- A. Estimated blood loss (EBL) of 500 mL during the birth process
- B. White blood cell count of 28,000 mm3 postbirth
- C. Patient complains of fingers tingling
- D. Patient complains of thirst
Correct Answer: B
Rationale: The correct answer is B - White blood cell count of 28,000 mm3 postbirth. This finding indicates a possible infection or inflammation, which can be concerning after vaginal delivery. A high white blood cell count may suggest an ongoing infection that needs immediate attention.
A: Estimated blood loss of 500 mL is within normal range for vaginal delivery and is not a cause for concern.
C: Fingers tingling may be due to various reasons unrelated to the delivery process and is not a typical concern post vaginal delivery.
D: Thirst is a common symptom post-delivery and is not indicative of a serious complication.