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Which clinical finding should the nurse expect to assess in the third stage of labor that indicates the placenta has separated from the uterine wall? (Select all that apply.)
- A. A gush of blood appears.
- B. The uterus rises upward in the abdomen.
- C. The fundus descends below the umbilicus.
- D. The cord descends further from the vagin
Correct Answer: C
Rationale: A. A gush of blood appears: This clinical finding is indicative of the placenta detaching from the uterine wall and the subsequent expulsion. The sudden release of a significant amount of blood is expected as the placenta separates.
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How does becoming a parent cause the birthing person to feel?
- A. overwhelming feelings of joy or a sense of euphoria
- B. a wide variety of emotions specific to each person's experience
- C. overwhelming fear or sadness at the loss of their previous life
- D. exhausted with little interest the newborn
Correct Answer: B
Rationale: Becoming a parent can trigger a wide range of emotions that can vary from person to person. While feelings of joy and euphoria are commonly experienced, it is important to acknowledge that parenthood also brings about challenges, uncertainties, fears, and even feelings of loss or sadness. Each individual's background, personal experiences, support system, and circumstances play a significant role in shaping how they feel when they become a parent. It is normal for birthing persons to navigate through a mix of emotions as they adjust to their new role and responsibilities. Therefore, option B is the most appropriate choice as it recognizes the diverse emotional responses that can accompany the experience of becoming a parent.
A woman has chosen a trial of labor after cesarean. Which findings indicate the best understanding of the nurse’s teaching by the patient?
- A. "It is safer for me to be induced at 39 weeks so that my labor can be controlled and monitored carefully.”
- B. "I will need to arrive to the hospital the night before my induction so that my cervix can be ripened with prostaglandins.”
- C. "If I do not go into labor on my own, I will have to have a cesarean section since Pitocin is contraindicated for me.”
- D. "A balloon catheter may be used to manually ripen my cervix, if necessary”
Correct Answer: D
Rationale: The correct understanding is that cervical ripening may be necessary before induction, and a balloon catheter can be used for this purpose. This is part of the education provided to patients who opt for a trial of labor after cesarean.
Which assessment finding indicates that cervical dilation and/or effacement has occurred?
- A. Onset of irregular contractions
- B. Cephalic presentation at 0 station
- C. Bloody mucus drainage from vagina
- D. Fetal heart tones (FHTs) present in the lower right quadrant
Correct Answer: C
Rationale: Bloody mucus drainage from the vagina, also known as "bloody show," is a common sign that indicates cervical dilation and/or effacement has occurred in anticipation of labor. This occurs as the mucus plug, which seals the cervix during pregnancy, is released as the cervix begins to soften, dilate, and efface in preparation for childbirth. This physical change in the cervix is a significant indicator that labor is approaching. The other options listed do not directly indicate cervical changes associated with labor progression like the presence of bloody mucus drainage does.
The nurse has just performed a sterile vaginal examination on her patient and reports the examination as 4 cm, 50%, –1. What does this represent?
- A. Effacement, station, and dilation
- B. Dilation, station, and fetal lie
- C. Dilation, effacement, and status of membranes
- D. Dilation, effacement, and station
Correct Answer: D
Rationale: The examination reflects the dilation, effacement, and station of the cervix.
The nurse has just performed a sterile vaginal examination on her patient and reports the examination as 4 cm, 50%, –1. What does this represent?
- A. Effacement, station, and dilation
- B. Dilation, station, and fetal lie
- C. Dilation, effacement, and status of membranes
- D. Dilation, effacement, and station
Correct Answer: D
Rationale: The examination reflects the dilation, effacement, and station of the cervix.