A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit.

The fetal heart rate has been normal.

Contractions are 10 to 15 minutes apart, 20 to 30 seconds in duration, and of mild intensity.

Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact.

The nurse should expect the woman to be:

Discharged home with a sedative.

Admitted and prepared for cesarean birth.

Admitted for extended observation.

Discharged home to await the onset of true labor.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Mild contractions and minimal cervical dilation suggest false labor. Administering a sedative helps the patient rest and wait for true labor onset. Sedatives can include sleep-inducing medications.
Choice B rationale
Cesarean birth is not indicated for a primigravida with mild contractions and minimal cervical dilation. This intervention is reserved for more serious obstetric complications.
Choice C rationale
Extended observation is unnecessary for mild contractions and unchanged cervical status. It is more appropriate for patients showing signs of true labor or complications.
Choice D rationale
True labor onset requires regular, increasing intensity contractions and cervical changes. Discharging the patient allows her to await true labor onset at home comfortably.

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Correct Answer is D

Explanation

Choice A rationale
Valsalva maneuver involves forced expiration against a closed airway, increasing intrathoracic pressure and commonly used to expel the fetus during the second stage of labor.
Choice B rationale
Ferguson’s reflex involves the release of oxytocin due to vaginal and cervical stretching, leading to stronger contractions during the second stage of labor.
Choice C rationale
Lightening refers to the descent of the fetus into the pelvis before labor begins, reducing pressure on the diaphragm and making breathing easier.
Choice D rationale
Molding is the slight overlapping of cranial bones, allowing the fetal head to change shape and fit through the birth canal during labor.

A. Paceritation. B. Shoulder dystocia. C. Infection. D. Meconium aspiration.

Correct Answer is C

Explanation

Choice A rationale
Paceritation is a term not commonly recognized in obstetrics. It lacks clinical relevance and does not correlate with increased risk during labor when membranes rupture.
Choice B rationale
Shoulder dystocia occurs during delivery when the baby's shoulder gets stuck after the head is delivered. It is unrelated to ruptured membranes and does not increase the associated risk.
Choice C rationale
Infection risk increases significantly after membranes rupture due to potential bacterial entry into the uterine cavity. Normal WBC count is 4,000-11,000 cells/mcL.
Choice D rationale
Meconium aspiration occurs when the newborn inhales meconium-stained amniotic fluid, typically in post-term pregnancies or fetal distress. It is not directly linked to ruptured membranes.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The slight overlapping of cranial bones or shaping of the fetal head during labor is called:

Correct Answer is D

Explanation

When planning the care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman’s risk for has increased.

Correct Answer is C

Explanation

A woman at 40 weeks gestation calls the labor unit to see whether or not she should go to the hospital to be evaluated. Which of the following statements by the woman indicates that she is probably in labor and should proceed to the hospital?

Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy. These include (select all that apply):

A physician writes the following order: administer ampicillin 1 g IV every 4 hours until delivery for a newly admitted client with ruptured membranes. The client had positive vaginal and rectal cultures for GBS+ at 36 weeks gestation. Which of the following is a rationale for this order?

The nurse has received a report regarding her patient in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and -2. The nurse’s interpretation of this assessment is that:

The nurse caring for a client in labor observes the external fetal monitor tracing showing that there are accelerations with moderate variability. Which of the following actions is most appropriate?

A woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is:

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2019. What is the client’s expected date of birth (EDB)?

The client has been having contractions every 5 minutes for 7 hours. Which factor would the nurse use to determine if this is true labor?