Nokea
Which maternal factor may inhibit fetal descent during labor?
- A. A full bladder
- B. Decreased peristalsis
- C. Rupture of membranes
- D. Reduction in internal uterine size
Correct Answer: A
Rationale: A full bladder can inhibit fetal descent during labor by obstructing the pathway for the baby to descend through the birth canal. A distended bladder can physically block the baby's head from moving down and putting pressure on the cervix, which is necessary for the progress of labor. It is important for pregnant individuals to empty their bladder regularly during labor to optimize the conditions for fetal descent and facilitate a smoother delivery process.
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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.
The onset of labor is multifactorial. These reasons include which of the following? Select all that apply.
- A. Increase in progesterone
- B. Increase in estrogen
- C. Increase in human chorionic gonadotropin
- D. Aging of placenta
Correct Answer: B
Rationale: Increase in progesterone, estrogen, aging of placenta, and fetal hormones are the factors contributing to the onset of labor.
If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold's maneuvers, what presenting part do you anticipate palpating in a vaginal exam?
- A. brow
- B. breech
- C. face
- D. occiput
Correct Answer: D
Rationale: If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold's maneuvers, it means the baby is presenting in an extended position with the occiput being the lead point of the presenting part during a vaginal exam. This position is known as occiput posterior. The fetal occiput is the back of the head, and it is the optimal position for vaginal delivery as the smallest diameter of the baby's head will be presenting at the cervix, facilitating an easier descent through the birth canal.
Uncontrolled maternal hyperventilation during labor results in
- A. metabolic acidosis.
- B. metabolic alkalosis.
- C. respiratory acidosis.
- D. respiratory alkalosis.
Correct Answer: D
Rationale: Uncontrolled maternal hyperventilation during labor leads to excessive elimination of carbon dioxide, causing a decrease in the partial pressure of arterial carbon dioxide (PaCO2). This results in respiratory alkalosis, as the pH of the blood increases due to a decrease in PaCO2. Metabolic acidosis (Option A) would be associated with conditions such as lactic acidosis, while metabolic alkalosis (Option B) would involve excessive loss of acid or gain of base, but in this case, the primary effect is on the respiratory system. Respiratory acidosis (Option C) would be characterized by an increase in PaCO2 leading to a decrease in pH, which is the opposite of what occurs in maternal hyperventilation.
A fetus is in the occiput anterior position. During the cardinal movement of extension, which events are occurring? Select all that apply.
- A. The fetal head lines up with the pelvic outlet.
- B. The occiput passes under the symphysis pubis.
- C. The fetal head is engaged.
- D. The head is delivered.
Correct Answer: A
Rationale: During extension, the fetal head lines up with the pelvic outlet, and the occiput passes under the symphysis pubis.