A patient in labor is experiencing back labor and complains of severe back pain. Which position is likely to provide the most comfort?

Correct Answer: B

Rationale: The correct answer is B: Hands and knees position. This position helps relieve pressure on the lower back by allowing the baby to shift away from the mother's spine, reducing back pain. It also promotes optimal fetal positioning for labor progress. A: Supine with knees bent may worsen back labor by putting pressure on the spine. C: Lying flat on the left side does not actively alleviate back pain or assist with fetal positioning. D: Sitting upright in a chair may not provide the same relief as the hands and knees position since it doesn't encourage the baby to shift position away from the back.

Correct Answer: B

Rationale: The correct answer is B: Hands and knees position. This position helps relieve back pain during labor by promoting optimal fetal positioning, reducing pressure on the back, and allowing gravity to assist in the descent of the baby. It also opens up the pelvic outlet, making it easier for the baby to navigate through the birth canal. Incorrect choices: A: Supine position can worsen back pain as it puts pressure on the lower back and restricts blood flow to the uterus. C: Lithotomy position can exacerbate back pain as it involves lying on the back with legs in stirrups, which can increase pressure on the back. D: Squatting position may not be ideal for relieving back pain in this scenario as it can put additional strain on the back muscles and may not provide optimal support for the laboring individual.

Correct Answer: B

Rationale: The correct answer is B: "You can have the epidural now since you are in active labor." At 6cm dilation, the patient is typically considered to be in active labor, making it an appropriate time to offer an epidural for pain relief. Administering the epidural at this stage can help manage the pain effectively and provide relief during the remainder of labor. Other choices are incorrect because waiting until 8cm dilation (Choice A) may cause unnecessary suffering, administering after the second stage (Choice C) is too late for pain relief, and giving it during the latent phase (Choice D) is not ideal as the patient may not be in active labor yet.

Correct Answer: C

Rationale: The correct answer is C: Assess the fetal heart rate. This is important to ensure the baby's well-being during the pushing phase. By monitoring the fetal heart rate, the nurse can detect any signs of distress or complications, allowing for prompt intervention if needed. Encouraging the patient to push (A) is appropriate once the fetal well-being is confirmed. While preparing the delivery room (B) is important, it is not the immediate priority. Administering pain relief (D) can be considered after assessing the fetal heart rate and ensuring the baby's safety.

Correct Answer: A

Rationale: The correct answer is A: Administer an epidural block. At 7 cm dilation, the patient is in active labor and an epidural can provide effective pain relief without affecting the ability to push during the second stage of labor. Epidural blocks work by numbing the lower part of the body, reducing pain sensation while allowing the patient to remain alert and able to push effectively when the time comes. Non-pharmacological methods (B) may not provide sufficient relief at this stage. Narcotic analgesics (C) can pass through the placenta and affect the baby. Encouraging the patient to push (D) prematurely can lead to exhaustion and prolonged labor.