A fetus is positioned in the occiput anterior position. The nurse determines that the fetus is positioned in which way?

Correct Answer: B

Rationale: In labor and delivery, understanding fetal positioning is crucial for assessing progress and ensuring a safe delivery. In this scenario, the correct answer is B) The fetal head is closest to the vaginal opening and the occiput is directed toward the maternal symphysis. This position, occiput anterior, is the most favorable for a vaginal delivery as the baby's head is presenting first, making it easier for the baby to navigate through the birth canal. The occiput being directed towards the maternal symphysis indicates that the baby's back is positioned towards the mother's front, which is an ideal presentation for a smooth delivery. Option A is incorrect because the fetal shoulder's position is not the determining factor in this scenario; it is the head's relationship to the vaginal opening that matters. Option C states that the fetal head is closest to the uterine fundus, which is not indicative of the occiput anterior position. Option D is incorrect as it describes the occiput posterior position, which can lead to a more challenging delivery. Understanding fetal positions is essential for nurses and healthcare providers in labor and delivery settings to monitor progress, anticipate potential complications, and provide appropriate care during childbirth. Knowledge of fetal positioning helps in optimizing maternal and fetal outcomes and ensuring a safe and successful delivery process.

Correct Answer: B

Rationale: Episiotomy is a common procedure during childbirth aimed at widening the vaginal opening to facilitate delivery and prevent uncontrolled tearing. Option B is correct because a midline episiotomy, performed along the midline of the perineum, is associated with a higher risk of extending into third- and fourth-degree lacerations, which can lead to more severe complications and longer healing times. Option A is incorrect because episiotomy is not a mandatory procedure for all vaginal births. It is only performed when the healthcare provider deems it necessary. Option C is incorrect because a mediolateral episiotomy, which is made at an angle to the perineum, is actually more challenging to repair compared to a midline episiotomy due to its angled nature. Option D is incorrect because while midline episiotomies are associated with more severe lacerations, they are not necessarily linked to increased blood loss compared to other types of episiotomies. Educationally, understanding the different types of episiotomies and their associated risks is crucial for nurses and healthcare providers working in labor and delivery settings. It allows them to provide accurate information to patients, ensuring informed decision-making and appropriate care during childbirth.

Correct Answer: A

Rationale: Hydration helps to dilute endogenous oxytocin, which can reduce uterine contractions and relax the uterus. Hypertonic labor involves excessive uterine contractions, and hydration can counteract this by regulating contractions and improving perfusion, which ultimately aids in a more coordinated and effective labor progression.

Correct Answer: C

Rationale: The correct answer is C) Maintain infusion at 6 mU/min. In this scenario, the fetal heart tracing shows a baseline of 130, moderate variability, and no accelerations or decelerations, indicating reassuring fetal status. Additionally, uterine contractions every 2 minutes for the last 30 minutes suggest effective labor progress. Maintaining the oxytocin infusion at 6 mU/min is the best action because there are currently no signs of fetal distress or hyperstimulation. Increasing the dose (option A) could lead to uterine hyperstimulation, compromising fetal oxygenation. Delaying the next increase (option B) may not be necessary since the current status is reassuring. Discontinuing the oxytocin infusion (option D) could halt labor progress, which is not indicated in this situation. Educationally, this scenario highlights the importance of assessing fetal well-being through continuous monitoring, understanding appropriate oxytocin dosing, and recognizing signs of uterine hyperstimulation. It emphasizes the nurse's critical role in optimizing maternal and fetal outcomes during labor induction.

Correct Answer: C

Rationale: Cephalohematomas are a common complication from operative vaginal deliveries. The accumulation of blood between the infant's skull and periosteum increases the risk of jaundice because of the breakdown of red blood cells, which can overwhelm the infant's immature liver and lead to hyperbilirubinemia.