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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Cephalohematoma occurring from an operative vaginal delivery increased a newborn’s risk of developing which of the following complications?
- A. Bulging fontanels
- B. Developmental delays
- C. Jaundice
- D. Macrocephaly
Correct Answer: C
Rationale: Cephalohematomas are a common complication from operative vaginal deliveries. The accumulation of blood between the infant's skull and periosteum increases the risk of jaundice because of the breakdown of red blood cells, which can overwhelm the infant's immature liver and lead to hyperbilirubinemia.
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.
A woman presents to labor and delivery at 37 weeks plus 6 days gestation with complaints of constant abdominal pain and dark red bleeding that started 30 minutes ago. Upon examination, the woman’s abdomen is consistently rigid and tender. Fetal heart tones are noted to be in the 70s. Which are these findings are associated with?
- A. Placental abruption
- B. Placental accreta
- C. Placenta previa
- D. Placenta succenturiata
Correct Answer: A
Rationale: Placental abruption is characterized by sudden onset of abdominal pain, dark red bleeding, and a rigid, tender abdomen. This condition can compromise fetal oxygenation and requires immediate medical intervention to prevent further complications.
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 is assessing the duration of a patient’s labor contractions. Which method does the nurse implement to assess the duration of labor contractions?
- A. Assess the strongest intensity of each contraction.
- B. Assess uterine relaxation between two contractions.
- C. Assess from the beginning to the end of each contraction.
- D. Assess from the beginning of one contraction to the beginning of the next.
Correct Answer: C
Rationale: The nurse implements method C, which involves assessing the duration of contractions from the beginning to the end of each contraction. Duration refers to how long each contraction lasts from the start of the tightening sensation until it subsides. This assessment helps the nurse monitor the progress of labor, determine the effectiveness of contractions in dilating the cervix, and identify any potential issues such as prolonged or insufficient contractions that may affect labor progression. Assessing the duration of contractions is a key component of monitoring the labor process and ensuring safe delivery for both the mother and the baby.