Nokea
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
- A. Extension
- B. Engagement
- C. Internal rotation
- D. External rotation
Correct Answer: B
Rationale: The correct answer is B: Engagement. Engagement occurs when the largest diameter of the fetal presenting part passes through the pelvic inlet, indicating the descent of the fetal head into the pelvis. This is a crucial step in labor progress as it signifies the baby's readiness for birth.
A: Extension occurs during the second stage of labor when the baby's head passes through the birth canal.
C: Internal rotation is the movement of the baby's head within the pelvis to align with the maternal pelvis.
D: External rotation happens after the baby's head is delivered to allow for the shoulders to rotate for birth.
In summary, engagement is the correct answer as it specifically refers to the largest diameter of the fetal presenting part passing the pelvic inlet, setting the stage for the progression of labor.
You may also like to solve these questions
The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all that apply.)
- A. Progesterone levels become higher than estrogen levels.
- B. Natural oxytocin in conjunction with other substances plays a role
- C. Stretching, pressure, and irritation of the uterus and cervix increase
- D. The secretion of prostaglandins from the fetal membranes decreases.
Correct Answer: B
Rationale: The correct answer is B: Natural oxytocin in conjunction with other substances plays a role in the initiation of labor. Oxytocin is a key hormone that stimulates uterine contractions during labor. Its release is crucial for the progression of labor. Other substances, such as prostaglandins, also play a role in initiating labor by softening the cervix and promoting contractions.
Rationale:
1. Oxytocin is a well-known hormone that directly stimulates uterine contractions, leading to the initiation of labor.
2. Prostaglandins are also important in preparing the cervix for labor and promoting contractions, which contradicts option D.
3. Progesterone levels decreasing and estrogen levels increasing typically signal the onset of labor, which contradicts option A.
4. Factors like stretching, pressure, and irritation of the uterus and cervix are more related to the progression of labor rather than the initiation, which contradicts option C.
In summary
A sterile vaginal examination completed on a patient revealed the presenting part to be the mentum. What is this presentation known as?
- A. Face presentation
- B. Breech presentation
- C. Vertex presentation
- D. Shoulder presentation
Correct Answer: A
Rationale: The correct answer is A: Face presentation. In this presentation, the mentum (chin) of the baby is the presenting part. This is a relatively rare presentation where the baby's head is extended, resulting in the face being the first part to be delivered. In a face presentation, the baby's head is hyperextended rather than flexed as in a vertex presentation. B: Breech presentation is when the baby's buttocks or feet are the presenting part. C: Vertex presentation is when the baby's head is the presenting part with the occiput leading the way. D: Shoulder presentation is when the baby's shoulder is the presenting part, which is a potentially dangerous situation requiring immediate medical intervention.
An infant was born 1 minute ago and the Apgar score is being assigned. The infant has blue extremities, minimal flexion, a weak cry, a heart rate of 110 beats per minute, and coughs and pulls away when suctioned. How many points should be assigned? Record your answer using a whole number:
- A. 3
- B. 2
- C. 1
Correct Answer: A
Rationale: The correct answer is A (3 points). The Apgar score assesses newborns' overall health shortly after birth. Each category (appearance, pulse, grimace, activity, and respiration) is scored from 0 to 2. In this case, the infant exhibits central cyanosis (blue extremities), weak muscle tone (minimal flexion), a weak cry, a heart rate of 110 bpm (slightly below normal), and responsive to suctioning (coughs, pulls away) indicating some respiratory effort. Therefore, the infant would receive 1 point for appearance (cyanosis), 1 point for pulse (110 bpm), 1 point for grimace (weak cry), totaling 3 points. Choices B, C, and D are incorrect as they do not accurately reflect the infant's condition and Apgar scoring criteria.
What is a direct influence on cervical dilation? Select all that apply.
- A. positioning of the pregnant person
- B. strength of uterine contractions
- C. length of time since ROM
- D. fetal presentation
Correct Answer: A
Rationale: The correct answer is A because the positioning of the pregnant person affects the alignment of the baby's head in the pelvis, directly influencing cervical dilation. Proper positioning helps the baby apply pressure to the cervix, promoting dilation. In contrast, the strength of uterine contractions (B) affects labor progress but not cervical dilation specifically. The length of time since ruptured membranes (C) may increase infection risk but does not directly impact dilation. Fetal presentation (D) affects the descent of the baby, not cervical dilation.
During the third stage of labor, what may the birthing person experience?
- A. expulsion of their fetus with vaginal bleeding
- B. cramping, gush of fresh vaginal bleeding, lengthening of the umbilical cord
- C. frequent episodes of dyspnea
- D. increased blood pressure and pain due to expulsive efforts
Correct Answer: B
Rationale: During the third stage of labor, the birthing person may experience cramping, a gush of fresh vaginal bleeding, and lengthening of the umbilical cord. This is due to the delivery of the placenta. Cramping helps expel the placenta, fresh vaginal bleeding is normal after delivery, and the lengthening of the umbilical cord indicates that the placenta is detaching. Choices A, C, and D are incorrect as they do not accurately describe the typical experiences during the third stage of labor.