A fetus is positioned in a longitudinal lie with its head in the fundus with both hips and knees flexed. Which presentation is this known as?

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: 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.

Correct Answer: D

Rationale: The correct answer is D: Document the findings. In this scenario, the patient is in active labor with a Category I FHR tracing, optimal contractions, and progressing cervical dilation. Documenting the findings is important to maintain an accurate record of the patient's progress, which is crucial for monitoring labor and ensuring appropriate care. Encouraging ambulation (choice A) may be unnecessary or even unsafe given the frequency and strength of contractions. Initiating oxytocin (choice B) is not indicated as the patient is already in active labor. Assisting the patient to a warm bath (choice C) may provide comfort but is not the priority at this stage. Therefore, documenting the findings is the next best action to ensure proper documentation and monitoring of the patient's progress.

Correct Answer: D

Rationale: The correct answer is D because residual amniotic fluid in the lungs can lead to a condition called transient tachypnea of the newborn (TTN), making spontaneous respirations difficult. This occurs more commonly in infants born via cesarean section before the onset of labor as they may not have had the opportunity to expel the fluid through the vaginal passage. A: Warm IV fluids can help maintain normal body temperature. B: Regional anesthesia may not directly cause respiratory depression in the infant. C: Maternal left tilt position is used to improve blood flow during labor, not relevant to respiratory issues in the newborn.

Correct Answer: B

Rationale: The correct answer is B: The fetus must be at least 34 weeks gestation. This is important because before using vacuum or forceps, the fetus should be mature enough to withstand the extraction process. Premature infants may not have fully developed skull bones to withstand the pressure, increasing the risk of injury. Explanation for other choices: A: The woman’s bladder is empty - While it's ideal for the bladder to be empty to prevent injury during the procedure, it's not a criteria that must be verified prior to vacuum or forceps use. C: There is a Category I tracing - Fetal heart rate monitoring is important during labor, but the tracing being Category I does not specifically correlate with the need for vacuum or forceps. D: The cervix must be completely dilated - While full cervical dilation is necessary for vaginal delivery, it is not a specific criteria to verify before vacuum or forceps use.