The nursing, intructor is explaining the cardinal movements of labor to the nursing students. The instructor explains that the initial descent of the fetus into the pelvis to zero station is which one of the cardinal movements of labor.

Flexion

Engagement

Extension

Expulsion

Answer and Explanation

The Correct Answer is B

A) Flexion:
Flexion is a movement where the fetal head bends forward during labor, which allows the smallest diameter of the head to pass through the birth canal. It is an important part of the labor process but does not refer to the initial descent of the fetus into the pelvis. Flexion typically occurs once the fetus begins to descend into the pelvis.

B) Engagement:
Engagement refers to the initial descent of the fetal head into the pelvis and the passage of the largest part of the fetal head (the biparietal diameter) into the maternal pelvis. This occurs when the fetal head reaches zero station at the level of the ischial spines and is the first cardinal movement of labor. It marks the point at which the presenting part of the fetus enters the pelvic inlet and begins the process of descent.

C) Extension:
Extension is the movement of the fetal head as it exits the birth canal after engagement and descent. The head moves from a flexed position (chin to chest) to an extended position (chin moving away from the chest) as it passes through the birth canal. This movement occurs after engagement and is a part of the expulsion phase, not the initial descent.

D) Expulsion:
Expulsion is the final phase of labor, which occurs after the fetal head has been delivered. It involves the delivery of the rest of the body (shoulders, torso, and legs) following the birth of the head. This is the final cardinal movement, which takes place after engagement, descent, flexion, internal rotation, extension, and external rotation.

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Correct Answer is B

Explanation

Naegele's Rule is a method used to estimate the due date of a pregnancy. It involves the following steps:

Start with the first day of the client's last menstrual period (LMP).
Add one year.
Subtract three months.
Add seven days.

Using the client's LMP of September 17:

Start with September 17.
Add one year: September 17, the following year.
Subtract three months: June 17 of the following year.
Add seven days: June 24.

A. Check fetal heart rate B. instruct her to bare down with the next contraction C. Place her legs in stirrups D. Test a sample of the amniotic fluid for meconium

Correct Answer is A

Explanation

A) Check fetal heart rate:
The first priority when a woman's membranes spontaneously rupture is to assess fetal well-being. The nurse should immediately check the fetal heart rate (FHR) after the rupture of membranes to evaluate for any signs of fetal distress. If there are any concerns regarding the FHR, further interventions may be needed, such as adjusting the maternal position or preparing for a possible emergent delivery. Monitoring the FHR will help guide subsequent decisions regarding care.

B) Instruct her to bear down with the next contraction:
While the second stage of labor involves pushing, it is important to wait for the appropriate signs of readiness before instructing the mother to bear down. The nurse should ensure the cervix is fully dilated and that fetal descent is progressing appropriately. Rushing into pushing too early or without proper readiness can lead to maternal and fetal complications.

C) Place her legs in stirrups:
Placing the mother’s legs in stirrups is typically done once she is in the active phase of pushing (typically when the cervix is fully dilated and fetal descent is ready). It is not the first priority immediately after the membranes rupture. The nurse should first assess the fetal heart rate and ensure the woman is comfortable and ready to push before assuming the lithotomy position or placing her legs in stirrups.

D) Test a sample of the amniotic fluid for meconium:
Testing the amniotic fluid for meconium should be done if there is concern that the amniotic fluid may be stained, as meconium in the amniotic fluid can be a sign of fetal distress. However, the first action after the membranes rupture is to check the fetal heart rate. If the FHR is normal, further actions, like testing the fluid, may follow, but the priority remains assessing fetal well-being.

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The nursing, intructor is explaining the cardinal movements of labor to the nursing students. The instructor explains that the initial descent of the fetus into the pelvis to zero station is which one of the cardinal movements of labor.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client at their first prenatal appointment. The client reports that the first day of their last menstrual period was September 17. Which of the following accurately represents the client's estimated date of birth using Naegele's Rule?

Correct Answer is B

Explanation

As a woman enters the second stage of labor, her membranes spontaneously rupture. What action should the nurse take?

Correct Answer is A

Explanation

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