A 32-year-old woman is dilated 4 cm. The health care provider states that she has a roomy pelvis and the baby is in a right occiput anterior (ROA) position at +1 station. Her contractions are occurring every 10 minutes, lasting 30 to 40 seconds, and palpate mild in intensity. She is calm and relaxed. Given these data, which essential component of labor is unexpected and likely to slow the progress of labor at this time?

Passageway

Powers

Psyche

Passenger

Answer and Explanation

The Correct Answer is B

A. Passageway – Incorrect; the provider states she has a roomy pelvis, meaning the passageway is adequate.

B. Powers – Correct; contractions are infrequent (every 10 minutes), short (30-40 sec), and mild, which may not be strong enough to promote cervical dilation and descent of the fetus.

C. Psyche – Incorrect; the patient is calm and relaxed, which supports labor progression.

D. Passenger – Incorrect; the baby is in an optimal (ROA) position and at +1 station, indicating normal progression.

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Correct Answer is D

Explanation

A. Hypnosis, imagery, and slow chest breathing – Incorrect; while these techniques can help with general labor pain, they may not be effective for severe back pain due to fetal positioning.
B. Comfort measures, intermittent labor support by the nurse, and reassurance that the pain is temporary – Incorrect; while support is important, it does not directly relieve back pain.
C. Effleurage, ambulation, and frequent position changes – Incorrect; these may help, but they do not directly address back labor.
D. Counterpressure with a fist or tennis ball to the lower back – Correct; back labor is often caused by occiput posterior fetal positioning, and counterpressure helps relieve pain by applying direct pressure to the sacrum.

A. Lightening B. Decreasing chest diameter C. Decreased carbon dioxide production D. Hyperventilation

Correct Answer is A

Explanation

A. Lightening – Correct; "lightening" occurs when the fetal head descends into the pelvis, reducing pressure on the diaphragm, making it easier to breathe.

B. Decreasing chest diameter – Incorrect; the chest diameter does not decrease; instead, the diaphragm moves upward due to uterine growth.

C. Decreased carbon dioxide production – Incorrect; CO₂ production remains stable during pregnancy.

D. Hyperventilation – Incorrect; while pregnancy increases respiratory effort, the client is experiencing relief, not hyperventilation.

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Naxlex Comprehensive Predictor Exams

A 34-year-old gravida 3, para 2 is experiencing severe back pain with each contraction. She is extremely uncomfortable and upset because she never had this type of pain with her other labors. What interventions are most likely to help in this situation?

Correct Answer is D

Explanation

A client who is at 39 weeks of gestation tells the nurse, "It has been hard to take a deep breath throughout the pregnancy, but in the past week, I feel like I can breathe again." The nurse should recognize that the client is experiencing the effects of which of the following?

Correct Answer is A

Explanation

How is the frequency of uterine contractions measured?

Which of the following are NOT considered presumptive signs of pregnancy? (Select all that apply.)

A woman asks the nurse during a prenatal office visit, "What pain relief method is best during labor?" What answer by the nurse best answers the question?

The germ layers of the embryo are: (Select all that apply.)

In which stage and phase of labor is the client who is at 7 cm of cervical dilation and 100% effacement, with the fetus at 1 station and intact amniotic membranes, and reporting the urge to push?

A nurse is assisting in the care of a client who is 4 hr postpartum. Which of the following interventions should the nurse perform after finding that the client's uterus is not firm? (Select all that apply.)

A 30-year-old primigravida who is 18 weeks pregnant, reports feeling fluttering in her lower abdomen. She states it feels like the baby is moving. This is known as:

A nurse is collecting data from a client who is 8 hr postpartum. Where should the nurse expect to find the fundus?