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When should the nurse consider suggesting a doula?
- A. when the patient asks for an epidural
- B. if the nurse is unable to support the patient
- C. when the support person is in the military and cannot attend the birth
- D. if the patient is going to have an emergency cesarean birth
Correct Answer: B
Rationale: The nurse should consider suggesting a doula if they are unable to provide adequate support to the patient. A doula can offer emotional, physical, and informational support to the mother during labor and childbirth. If the nurse is busy with other tasks or unable to provide continuous support, a doula can step in to ensure the patient receives the support she needs. This can lead to a more positive childbirth experience for the patient.
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An increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of
- A. lightening.
- B. breech presentation.
- C. urinary tract infection.
- D. onset of Braxton-Hicks contractions.
Correct Answer: A
Rationale: An increase in urinary frequency and leg cramps after the 36th week of pregnancy are common signs of "lightening." Lightening refers to the descent of the baby into the pelvis in preparation for labor. This shift in position can put pressure on the bladder, leading to increased urinary frequency. Additionally, the pressure on nerves and blood vessels in the pelvis can cause leg cramps. These symptoms are typically experienced in the final weeks of pregnancy and are considered normal signs that the body is preparing for labor.
What effect will the presence of support people in labor most likely have?
- A. improve the experience of the birthing person
- B. improve the outcomes of the birthing person
- C. improve the outcomes and experience of the birthing person
- D. cause birth trauma and/or postpartum depression
Correct Answer: C
Rationale: The presence of support people during labor, such as a partner, family member, doula, or midwife, can have a positive impact on both the outcomes and experience of the birthing person. Studies have shown that having continuous support during labor can lead to shorter labor times, reduced need for medical interventions like cesarean sections or epidurals, increased satisfaction with the birth experience, and decreased likelihood of experiencing postpartum depression. Emotional support, physical comfort, and advocacy provided by support people can help the birthing person feel more empowered, confident, and less stressed during labor, ultimately leading to better outcomes and a more positive birth experience.
A patient admitted to the labor unit asks the nurse to discuss the episiotomy procedure with her. Which is true regarding episiotomy?
- A. An episiotomy is required for all vaginal births.
- B. A midline episiotomy is associated with more third- and fourth-degree lacerations.
- C. A mediolateral episiotomy is easier to repair than a medial episiotomy.
- D. A midline episiotomy is associated with more blood loss.
Correct Answer: B
Rationale: A midline episiotomy is not required for all vaginal births, but it is associated with more third- and fourth-degree lacerations.
A patient admitted to the labor unit asks the nurse to discuss the episiotomy procedure with her. Which is true regarding episiotomy?
- A. An episiotomy is required for all vaginal births.
- B. A midline episiotomy is associated with more third- and fourth-degree lacerations.
- C. A mediolateral episiotomy is easier to repair than a medial episiotomy.
- D. A midline episiotomy is associated with more blood loss.
Correct Answer: B
Rationale: A midline episiotomy is not required for all vaginal births, but it is associated with more third- and fourth-degree lacerations.
While attending the delivery of a patient with GODM, the nurse notices the retraction of the fetal head onto the perineum. What is the nurse’s next best action?
- A. Apply fundal pressure
- B. Assist the woman to left lateral position
- C. Flex the mother to left lateral position
- D. Assist the woman to hands-and-knees position
Correct Answer: D
Rationale: The retraction of the fetal head onto the perineum during labor can be indicative of shoulder dystocia or other obstructive complications, requiring immediate action. The best response is to assist the mother into hands-and-knees position, which can relieve pressure on the perineum and help with fetal descent.