A nurse midwife is examining a client who is primigravida at 42 weeks of gestation and states that she believes she is in labor. Which of the following findings confirm to the nurse that the client is in labor?
Amniotic fluid in the vaginal vault
Cervical dilation
Brownish vaginal discharge
Report of pain above the umbilicus
The Correct Answer is B
Choice A rationale
Amniotic fluid in the vaginal vault is not a definitive sign of labor. It indicates that the membranes have ruptured, which can occur before or during labor. However, some clients may not have their membranes ruptured until the late stages of labor or during delivery.
Choice B rationale
Cervical dilation is a definitive sign of labor. It indicates that the cervix is opening and thinning to allow the passage of the fetus. Cervical dilation is measured in centimeters from 0 to 10, with 10 being fully dilated and ready for delivery.
Choice C rationale
Brownish vaginal discharge is not a definitive sign of labor. It may indicate the presence of the bloody show, which is the mucus plug that seals the cervix during pregnancy. The bloody show may be expelled before or during labor, but it does not necessarily mean that labor has started.
Choice D rationale
Report of pain above the umbilicus is not a definitive sign of labor. It may indicate the presence of Braxton Hicks contractions, which are irregular and painless contractions that occur throughout pregnancy. They are also known as false labor contractions, as they do not cause cervical dilation or effacement.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Maternal serum alpha-fetoprotein (MSAFP) is a protein produced by the fetal liver and yolk sac. It crosses the placenta and enters the maternal blood. High levels of MSAFP may indicate neural tube defects such as spina bifida or anencephaly in the fetus. Low levels of MSAFP may indicate chromosomal abnormalities such as Down syndrome or trisomy 18 in the fetus.
Choice B rationale
Fetal lung maturity is not assessed by MSAFP. Fetal lung maturity is assessed by measuring the lecithin/sphingomyelin (L/S) ratio or the phosphatidylglycerol (PG) level in the amniotic fluid. These tests are usually done in the third trimester of pregnancy.
Choice C rationale
Rh incompatibility is not identified by MSAFP. Rh incompatibility is a condition where the mother has Rh-negative blood and the fetus has Rh-positive blood. This can cause hemolytic disease of the newborn (HDN) if the mother develops antibodies against the fetal red blood cells. Rh incompatibility is identified by testing the mother's blood type and antibody screen, and the father's blood type if available.
Choice D rationale
MSAFP does not assess various markers of fetal well-being. MSAFP is only one of the markers that can be used in the maternal serum screening test, which is also known as the quad screen or the triple screen. The other markers are human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A. These markers can help detect the risk of certain birth defects or genetic disorders in the fetus, but they are not definitive tests. Fetal well-being can be assessed by other tests such as fetal movement count, nonstress test, biophysical profile, or Doppler ultrasound.
Correct Answer is A
Explanation
Choice A rationale
As labor begins, the cervix starts to soften, shorten and thin (efface). This process is often expressed in percentages¹. This is a sign of true labor².
Choice B rationale
The station of the presenting part refers to the position of the baby's head in relation to the mother's pelvis. While it can indicate progress in labor, it is not a definitive sign of true labor.
Choice C rationale
Rupture of the membranes, or water breaking, can occur before or during labor. However, it is not a reliable sign of true labor as it can also occur in preterm labor or even without contractions.
Choice D rationale
The pattern of contractions can be a sign of labor. True labor contractions are regular, increase in intensity, and do not ease up with change in activity or position². However, contractions alone are not a definitive sign of true labor as they can also occur in false labor (Braxton Hicks contractions).
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