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: Flexion is the correct answer. During labor, fetal head flexion allows the smallest anterior-posterior diameter of the head to enter the pelvis first, reducing the risk of cephalopelvic disproportion. Station refers to the level of the presenting part in the maternal pelvis, not the head orientation. Descent is the downward movement of the fetus in the birth canal, not related to head position. Engagement occurs when the widest part of the presenting part reaches the level of the maternal ischial spines, not specifically related to the orientation of the fetal head.
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What should the nurse consider when the birthing person has a decrease in blood pressure after the placenta is delivered?
- A. The birthing person is in pain.
- B. Place the newborn skin-to-skin.
- C. The bladder is distended
- D. Check for possible hemorrhage.
Correct Answer: E
Rationale: Based on the scenario, the decrease in blood pressure post-placenta delivery indicates potential hemorrhage, a common complication. The nurse should assess for signs of bleeding, such as excessive vaginal bleeding or tachycardia. Prompt intervention is crucial to prevent further complications. Other choices are less relevant - pain alone does not directly cause a decrease in blood pressure, skin-to-skin contact is important but not the priority in this situation, and a distended bladder can be addressed later. Assessing for possible hemorrhage is the most critical action to take in this scenario.
The nurse is assessing a patient in the active phase of labor. What should the nurse expect during this phase?
- A. The patient is sociable and excite
- B. The patient is requesting pain medication.
- C. The patient begins to experience the urge to push.
- D. The patient experiences loss of control and irritability.
Correct Answer: C
Rationale: During the active phase of labor, contractions become stronger and more frequent, leading to cervical dilation. This is when the patient typically experiences the urge to push as the cervix reaches around 7-10 cm dilation. This signifies progress towards the second stage of labor. Choices A, B, and D are incorrect as they do not specifically align with the characteristics of the active phase of labor. A patient may exhibit a range of emotions and behaviors during labor, but the key indicator of the active phase is the urge to push due to cervical dilation.
To determine if the patient is in true labor, the nurse would assess for changes in
- A. cervical dilation.
- B. amount of bloody show.
- C. fetal position and station.
- D. pattern of uterine contractions.
Correct Answer: D
Rationale: The correct answer is D: pattern of uterine contractions. This is because the pattern of contractions is a key indicator of true labor. True labor contractions are regular, increasing in frequency, duration, and intensity. Assessing the pattern helps differentiate true labor from false labor.
A: Cervical dilation is important but may not necessarily indicate true labor as it can occur in false labor as well.
B: The amount of bloody show is a sign of cervical changes, but it alone does not confirm true labor.
C: Fetal position and station are important for labor progress but do not definitively confirm true labor.
In summary, assessing the pattern of uterine contractions is crucial in determining true labor as it provides direct insight into the progression and intensity of contractions, distinguishing it from false labor.
What changes in hormones initiate labor?
- A. decreased progesterone, decreased estrogen, absence of oxytocin
- B. increased progesterone, decreased estrogen, absence of oxytocin
- C. increased progesterone, decreased estrogen, presence of oxytocin
- D. decreased progesterone, increased estrogen, effects of oxytocin
Correct Answer: D
Rationale: The correct answer is D because decreased progesterone, increased estrogen, and the effects of oxytocin are the hormonal changes that initiate labor. Progesterone inhibits contractions, so its decrease allows labor to begin. Estrogen promotes uterine sensitivity to oxytocin, which stimulates contractions. Oxytocin is released in response to labor contractions and helps to strengthen contractions.
A: Incorrect because decreased progesterone is needed for labor to start, estrogen needs to increase, and oxytocin is present during labor.
B: Incorrect because increased progesterone inhibits labor, estrogen should increase, and oxytocin is present during labor.
C: Incorrect because progesterone should decrease, estrogen should increase, and oxytocin is present during labor.
The primary difference between the labor of a nullipara and that of a multipara is
- A. total duration of labor.
- B. level of pain experience
- C. amount of cervical dilation.
- D. sequence of labor mechanisms.
Correct Answer: A
Rationale: The correct answer is A: total duration of labor. Nullipara refers to a woman giving birth for the first time, while multipara refers to a woman who has given birth multiple times. The primary difference between their labors is the total duration. Nulliparas typically have longer labors due to the body's first experience with childbirth. The other choices (B, C, D) are not the primary difference between nullipara and multipara labors. Pain experience, cervical dilation, and labor mechanisms can vary based on individual factors, but the key distinction lies in the overall duration of labor based on parity.
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