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Which physiologic event is the key indicator of the commencement of true labor?
- A. Bloody show
- B. Cervical dilation and effacement
- C. Fetal descent into the pelvic inlet
- D. Uterine contractions every 7 minutes
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation and effacement. This is because true labor is defined by progressive cervical changes, including dilation (opening of the cervix) and effacement (thinning of the cervix). These changes indicate that the body is preparing for childbirth. A: Bloody show may occur during early labor but is not a definitive indicator. C: Fetal descent into the pelvic inlet is a later event in labor. D: Uterine contractions every 7 minutes are not necessarily indicative of true labor as they need to be regular, increasing in frequency, intensity, and duration.
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The nurse who elects to practice in the area of obstetrics often hears discussion regarding the four Ps. What are the four Ps that interact during childbirth? (Select all that apply.)
- A. Powers
- B. Passage
- C. Position
- D. Passenger
Correct Answer: A
Rationale: The correct answer is A: Powers. In obstetrics, the four Ps that interact during childbirth are Powers (contractions), Passage (birth canal), Passenger (fetus), and Psyche (mother's psychological state). Powers refer to the force generated by contractions to push the baby through the birth canal. Passage is the route the baby takes during birth. Passenger is the baby itself. Position is not one of the four Ps in childbirth. It is crucial for nurses in obstetrics to understand how these four Ps work together to facilitate a safe and successful delivery.
Which is the cervical exam that most indicates the use of misoprostol?
- A. 1 cm dilated, 20% effaced, -3 station, firm and posterior
- B. 3-4 cm dilated, 50% effaced, -2 station, firm and midposition
- C. 5 cm dilated, 80% effaced, 0 station, soft and midposition
- D. 6 cm dilated, 100% effaced, +1 station, soft and anterior
Correct Answer: A
Rationale: The correct answer is A: 1 cm dilated, 20% effaced, -3 station, firm and posterior. Misoprostol is commonly used for cervical ripening in preparation for labor induction. This choice indicates an unfavorable cervix, which would benefit from cervical ripening agents like misoprostol. The cervix is minimally dilated (1 cm), partially effaced (20%), high (-3 station), firm, and posterior. This profile suggests that the cervix is not yet ripe and may require assistance in ripening for labor induction.
Choice B: 3-4 cm dilated, 50% effaced, -2 station, firm and midposition - this indicates a more favorable cervix for labor and would not typically require misoprostol for cervical ripening.
Choice C: 5 cm dilated, 80% effaced, 0 station, soft and midposition - this indicates an even more favorable cervix for labor,
What makes up the powers of labor and birth?
- A. contractions and pushing efforts
- B. pelvis and pelvic floor tissues
- C. fetal position, attitude, lie, and presentation
- D. oxytocin
Correct Answer: A
Rationale: The correct answer is A (contractions and pushing efforts) because they are the main physiological components of labor and birth. Contractions help to thin and dilate the cervix, while pushing efforts help the baby descend through the birth canal. Pelvis and pelvic floor tissues (B) play a role in the mechanics of birth but do not make up the powers of labor. Fetal position, attitude, lie, and presentation (C) are important factors influencing labor progress but do not constitute the powers of labor. Oxytocin (D) is a hormone that stimulates contractions but is not a direct component of the powers of labor.
What makes up the powers of labor and birth?
- A. contractions and pushing efforts
- B. pelvis and pelvic floor tissues
- C. fetal position, attitude, lie, and presentation
- D. oxytocin
Correct Answer: A
Rationale: The correct answer is A: contractions and pushing efforts. During labor and birth, contractions help to dilate the cervix and push the baby down the birth canal. Pushing efforts from the mother help to expel the baby out. Pelvis and pelvic floor tissues (choice B) provide the passage for the baby but do not actively contribute to the powers of labor. Fetal position, attitude, lie, and presentation (choice C) refer to the baby's position and orientation in the womb, which can affect the progress of labor but do not constitute the powers of labor. Oxytocin (choice D) is a hormone that stimulates contractions but is not the sole component of the powers of labor and birth.
The nurse is caring for a laboring patient with multiple family members in the room. How can the nurse address this situation?
- A. Educate the family that the pain the laboring person is experiencing is normal.
- B. Ask them all to leave the room.
- C. Explain that if the laboring person got an epidural, she would be more comfortable
- D. Assume the laboring person wants the family in the room
Correct Answer: B
Rationale: The correct answer is B because having multiple family members in the room during labor can be overwhelming and hinder the progress of labor. It is important for the laboring person to have privacy, focus, and reduce stress for a smoother labor experience. Asking the family members to leave the room ensures a calm and supportive environment for the laboring person.
Incorrect Choices:
A: Educating the family about pain normalcy is helpful, but privacy and focus are more crucial during labor.
C: Mentioning epidural may not be appropriate as it is the laboring person's decision and may not be the best option for everyone.
D: Assuming the laboring person wants family in the room without considering their preference may not be the best approach for their comfort and progress in labor.