A pregnant woman presents with severe lower abdominal pain and vaginal bleeding. On examination, she has a tender, distended abdomen. Which of the following conditions is the most likely cause of these symptoms?

Correct Answer: C

Rationale: Uterine rupture is a serious obstetric emergency that involves a tear or rupture of the uterine wall during pregnancy. In this scenario, the pregnant woman with severe lower abdominal pain, vaginal bleeding, and a tender, distended abdomen is showing signs consistent with uterine rupture. These symptoms are typically not seen with other conditions listed.

Correct Answer: A

Rationale: In the case of a woman in active labor with placenta previa, the priority nursing intervention is to prepare for an immediate cesarean section. Placenta previa is a condition in which the placenta covers part or all of the cervix, which can lead to severe bleeding during labor and delivery. The risk of hemorrhage is significant, making a cesarean section the safest option for both the mother and the baby in this situation. It is crucial to act promptly to prevent complications and ensure the well-being of both the mother and the baby. Administering intravenous oxytocin to augment labor or inserting a Foley catheter to monitor urine output would not address the immediate risk of hemorrhage associated with placenta previa. Implementing bed rest and continuous fetal monitoring may be part of the overall care plan but not the priority intervention in this urgent situation.

Correct Answer: A

Rationale: A woman experiencing irregular and ineffective uterine contractions with prolonged cervical dilation may indicate labor dystocia, also known as abnormal labor progression. To address this issue, the nursing intervention that should be implemented is to encourage the mother to ambulate and change positions frequently. This can help optimize fetal positioning and encourage descent through the birth canal by using gravity to aid in the progression of labor. Changing positions can also potentially improve the quality and effectiveness of contractions, leading to more successful cervical dilation and labor progress. Encouraging ambulation and position changes are non-invasive, patient-centered interventions that can be helpful in managing labor dystocia before considering more invasive interventions like cesarean section.

Correct Answer: A

Rationale: Assisting the mother into a hands-and-knees position should be prioritized to facilitate fetal rotation and optimize labor progress in the case of persistent occiput posterior fetal position. This position helps in promoting fetal rotation to a more favorable position for delivery by allowing the baby's head to move into the anterior position. It can help alleviate back pain and may help reduce the duration of labor. This simple maneuver can sometimes correct the malposition without the need for interventions like instrumental delivery. It is a non-invasive and effective technique that can be easily implemented by healthcare providers to support the progression of labor.

Correct Answer: B

Rationale: Oxytocin release is responsible for the mild cramping and uterine contractions experienced by the new mother while breastfeeding. When a baby suckles at the breast, it stimulates nerve endings that signal the release of oxytocin from the posterior pituitary gland. Oxytocin is a hormone that plays a crucial role in stimulating the contraction of the uterine muscles, helping the uterus to contract back to its pre-pregnancy size. This process, known as uterine involution, is essential for postpartum recovery and preventing excessive bleeding. Therefore, the new mother's experience of mild cramping and uterine contractions while breastfeeding is a normal physiological response mediated by the release of oxytocin.