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Which of the following is a function of a doula during labor?
- A. Administration of oral pain medications
- B. Assess fetal heart rate
- C. Perform vaginal examination with the mother’s permission
- D. Provide nonpharmacological pain relief
Correct Answer: D
Rationale: The correct answer is D: Provide nonpharmacological pain relief. A doula's role is to offer emotional support, comfort measures, and advocacy during labor. Providing nonpharmacological pain relief techniques such as massage, breathing exercises, and positioning is within the scope of a doula's practice. This helps the mother cope with labor discomfort without the use of medication.
Choice A is incorrect because doulas do not administer medications. Choice B is incorrect as assessing fetal heart rate is typically done by healthcare providers. Choice C is incorrect as performing vaginal examinations is not a part of a doula's role.
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When does the second stage of labor begin?
- A. at birth
- B. when the early phase ends
- C. when the cervix is completely dilated and effaced
- D. when pushing begins
Correct Answer: D
Rationale: The correct answer is D: when pushing begins. The second stage of labor begins when the cervix is fully dilated, and the mother starts pushing to deliver the baby. This stage ends with the birth of the baby. Option A is incorrect because the second stage begins after birth. Option B is incorrect as it refers to the transition phase, not the second stage. Option C is incorrect because the cervix being fully dilated and effaced marks the beginning of the second stage, not the end of it.
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. Apgar scoring assesses the newborn's overall condition at 1 and 5 minutes after birth. In this case, the infant's Apgar score should be 3 because the baby displays signs of mild distress with blue extremities, weak cry, and minimal flexion. The heart rate of 110 BPM and response to suctioning indicate some normal function. Each category (color, heart rate, reflex irritability, muscle tone, and respiratory effort) can score up to 2 points, totaling 10 points. Blue extremities and weak cry correspond to 1 point each, while minimal flexion corresponds to 0 points. The heart rate (110 BPM) and response to suctioning indicate 2 points each, totaling 3 points. Therefore, the correct score is 3 points. Choices B, C, and D are incorrect as they do not accurately reflect the severity of the infant's condition based on the Apgar
The patient with which vaginal exam is most at risk for an umbilical cord prolapse?
- A. 1-2 cm dilated, 70% effaced, -1 station
- B. 5 cm dilated, 60% effaced, -3 station
- C. 7-8 cm dilated, 80% effaced, -2 station
- D. 9 cm dilated, 100% effaced, 0 station
Correct Answer: B
Rationale: The correct answer is B because a patient who is 5 cm dilated, 60% effaced, and at -3 station is most at risk for umbilical cord prolapse. At this stage, the presenting part of the baby is relatively high in the pelvis, increasing the likelihood of the cord slipping past and becoming compressed against the cervix during contractions. This can lead to decreased blood flow and oxygen supply to the baby, posing a serious risk. Choices A, C, and D are less likely to result in cord prolapse due to the lower station of the baby in the pelvis, reducing the chance of cord compression.
A woman who is 39 weeks pregnant presents to the labor and delivery unit stating that she thinks she is in labor. Her contractions are irregular at 7 to 10 minutes apart. Which sign is definitive for true labor?
- A. Pain decreases when walking.
- B. Cervical dilation is occurring.
- C. The fetal membranes rupture.
- D. The fetal head is at –1 station.
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation is occurring. This is a definitive sign of true labor as it indicates that the cervix is opening up in preparation for childbirth. Contractions alone may not always indicate true labor, especially if they are irregular. Pain decreasing when walking (choice A) is not a definitive sign of true labor. The fetal membranes rupturing (choice C) is a sign of labor but not definitive on its own. The fetal head at –1 station (choice D) can indicate descent but is not as definitive as cervical dilation.