A 35-year-old gravida 1, para 0 is admitted to the labor and delivery unit. She reports intense rectal pressure. Which stage of labor is probable?

Correct Answer: B

Rationale: The correct answer is B: Second stage. This stage of labor is characterized by full dilation of the cervix and ends with the delivery of the baby. The intense rectal pressure reported by the patient indicates that the baby is descending through the birth canal, which is a hallmark sign of the second stage. In contrast, the first stage, latent (choice A) is characterized by early labor contractions and cervical dilation up to 6 cm. The third stage (choice C) is the delivery of the placenta, and the fourth stage (choice D) is the immediate postpartum period. The key here is recognizing the specific symptom of intense rectal pressure, which aligns with the second stage of labor.

Correct Answer: B

Rationale: The optimal position for a woman in the second stage of labor is lateral recumbent. This position allows gravity to aid in the descent of the baby, reduces pressure on the vena cava, and promotes better blood flow to the uterus. It also helps prevent perineal tears and facilitates fetal rotation. A: Supine position can compress the vena cava, reducing blood flow to the uterus. C: Lithotomy position is not recommended as it can lead to increased perineal trauma. D: Squatting may not be ideal as it can be tiring for the mother and may not provide optimal support for delivery.

Correct Answer: B

Rationale: The correct answer is B: Complete breech. In a complete breech presentation, the fetus is positioned with its head in the fundus, hips flexed, and knees flexed. This position is unique to the complete breech presentation. A: Frank breech would have the hips flexed, but the knees extended. C: Vertex position is when the head is down towards the birth canal. D: Transverse is when the fetus is lying horizontally across the uterus. Therefore, based on the description provided in the question, the correct answer is B as it matches the specific presentation described.

Correct Answer: A

Rationale: The correct order of cardinal movements of labor is: 1. Engagement 2. Descent 3. Flexion 4. Internal rotation 5. Extension 6. Restitution 7. External rotation Engagement occurs first as the fetal presenting part enters the maternal pelvis. Descent is the second cardinal movement, where the fetus moves down the birth canal. Flexion follows, allowing the smallest diameter of the fetal head to present. Internal rotation positions the fetus for delivery. Extension occurs next, facilitating the passage of the head through the birth canal. Restitution aligns the fetal head with the shoulders. External rotation allows the shoulders to rotate for delivery. Therefore, Descent is the correct first cardinal movement in the sequence. Other choices like Expulsion, Extension, and External rotation occur later in the process and are not in the correct order.

Correct Answer: C

Rationale: The correct answer is C: Have the patient slow down her breathing. When a patient is 8 cm dilated and experiences circumoral numbness and dizziness, these are signs of hyperventilation caused by rapid breathing. Hyperventilation can lead to respiratory alkalosis, which can have serious implications for both the mother and baby. By having the patient slow down her breathing, it can help restore the balance of oxygen and carbon dioxide levels in the blood, reducing the risk of complications. Calling the healthcare provider immediately (choice A) may cause delay in addressing the immediate issue. Increasing intravenous fluid (choice B) is not indicated as the symptoms are not suggestive of hypovolemia. Having her start pushing (choice D) is not advisable as she is not fully dilated, and pushing prematurely can lead to complications.