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Which fetal position increases the likelihood of a longer and more painful labor?
- A. Left occiput posterior
- B. Left occiput anterior
- C. Right occiput anterior
- D. Right occiput transverse
Correct Answer: A
Rationale: The correct answer is A: Left occiput posterior. In this position, the baby's head is facing the mother's sacrum, making labor longer and more painful due to the baby's position causing more pressure on the mother's back and pelvis. Left occiput anterior (B) and Right occiput anterior (C) are favorable positions for a smoother labor. Right occiput transverse (D) can also lead to a longer and more complicated labor, but not as much as Left occiput posterior.
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The nurse is providing care to a patient in the active phase of the first stage of labor. The patient is crying out loudly with each contraction. What is the nurse's most respectful approach for this patient?
- A. Ask the patient's labor coach if this is a usual expression of pain for her.
- B. Refer to the patient's chart to determine any orders for pain medication.
- C. Tell the patient that she is disturbing the other laboring patients on the unit.
- D. Encourage the patient to try to suppress her noisiness during contractions.
Correct Answer: A
Rationale: Step-by-step rationale for why Answer A is correct:
1. Asking the patient's labor coach shows respect for the patient's support person and acknowledges their insight into the patient's usual behavior.
2. It allows the nurse to gather information about the patient's pain expression without assuming or judging the situation.
3. This approach promotes patient-centered care and involves the patient's primary support system in decision-making.
4. It fosters open communication and partnership between the nurse, patient, and labor coach, enhancing the overall quality of care.
Summary:
- Option B is incorrect because pain medication should not be assumed without assessing the patient's current pain level first.
- Option C is incorrect as it lacks empathy and disregards the patient's emotional state during labor.
- Option D is incorrect as it suggests suppressing a natural response to pain, which may not be beneficial for the patient's coping mechanism.
Which patient presentation is an acceptable indication for serial oxytocin induction of labor?
- A. Multiple fetuses
- B. Polyhydramnios
- C. History of long labors
- D. Past 42 weeks of gestation
Correct Answer: D
Rationale: Rationale:
1. Past 42 weeks of gestation increases the risk of stillbirth.
2. Oxytocin can help initiate labor to reduce the risk.
3. Induction at this stage is considered safe and beneficial.
4. Other choices are not direct indications for oxytocin induction and may have different management strategies.
Summary:
- A: Multiple fetuses and polyhydramnios may require different approaches.
- B: History of long labors may not necessarily indicate the need for oxytocin induction.
The nurse is monitoring a patient in the active stage of labor. Which conditions associated with fetal compromise should the nurse monitor? (Select all that apply.)
- A. Maternal hypotension
- B. Fetal heart rate of 140 to 150 bpm
- C. Meconium-stained amniotic fluid
- D. Maternal fever"”38°C (100.4°F) or higher
Correct Answer: A
Rationale: The correct answer is A: Maternal hypotension. Maternal hypotension can lead to decreased perfusion to the placenta, compromising fetal oxygenation. Other choices are incorrect. B: A fetal heart rate of 140 to 150 bpm is within the normal range during labor. C: Meconium-stained amniotic fluid may indicate fetal distress but is not a direct condition associated with fetal compromise. D: Maternal fever can indicate infection but does not directly indicate fetal compromise in the active stage of labor.
The pregnant patient expresses a desire to schedule birth during the baby's father's furlough
- A. The nurse explains that prior to induction of labor, it is essential to determine which clinical finding?
- B. Dilated cervix
- C. Fetal lung maturity
- D. Rupture of membranes
Correct Answer: C
Rationale: The correct answer is C: Fetal lung maturity. It is essential to determine fetal lung maturity before induction of labor to ensure that the baby's lungs are developed enough to breathe outside the womb. This is important for the baby's well-being and can help prevent complications.
Rationale:
1. Fetal lung maturity is crucial for the baby's ability to breathe independently.
2. Inducing labor without ensuring fetal lung maturity can lead to respiratory distress syndrome in the newborn.
3. A dilated cervix is important for labor progression but does not directly impact the baby's lung maturity.
4. Rupture of membranes may indicate potential labor but does not address the baby's lung development.
Which of the following describes the purpose of Leopold's maneuvers?
- A. To assess cervical dilation and effacement.
- B. To determine fetal presentation and position.
- C. To measure the frequency of contractions.
- D. To estimate the weight of the fetus.
Correct Answer: B
Rationale: The purpose of Leopold's maneuvers is to determine the fetal presentation and position. Step 1 assesses the fundal height and shape, indicating the fetal part. Step 2 locates the back or limbs. Step 3 determines the presenting part in the pelvis. Step 4 confirms the presenting part and its mobility. This method helps in identifying the optimal fetal position for delivery. Assessing cervical dilation and effacement (Choice A) is typically done through vaginal examination. Measuring the frequency of contractions (Choice C) and estimating the weight of the fetus (Choice D) are not objectives of Leopold's maneuvers.