A primigravida has just been examined. The examination revealed engagement of the fetal head. The nurse is aware that this means which of the following?

Correct Answer: A

Rationale: The correct answer is A: The biparietal diameter of the fetal head is at the level of the ischial spines. Engagement of the fetal head occurs when the largest transverse diameter of the presenting part (usually the biparietal diameter) reaches or passes through the pelvic inlet, specifically at the level of the ischial spines. This signifies descent of the fetal head into the maternal pelvis, indicating progress towards labor. Choice B (The biparietal diameter of the fetal head is at –2 station) is incorrect as station refers to the level of the presenting part in relation to the ischial spines, not engagement. Choice C (The fetal head is well flexed) is incorrect as engagement does not necessarily indicate the position of the fetal head. Choice D (The fetal head is unable to pass under the pubic arch) is incorrect as engagement actually signifies that the fetal head is in the optimal position to pass through the pelvis during labor.

Correct Answer: A

Rationale: The correct answer is A: Face presentation. In this presentation, the mentum (chin) of the baby is the presenting part. This is a relatively rare presentation where the baby's head is extended, resulting in the face being the first part to be delivered. In a face presentation, the baby's head is hyperextended rather than flexed as in a vertex presentation. B: Breech presentation is when the baby's buttocks or feet are the presenting part. C: Vertex presentation is when the baby's head is the presenting part with the occiput leading the way. D: Shoulder presentation is when the baby's shoulder is the presenting part, which is a potentially dangerous situation requiring immediate medical intervention.

Correct Answer: B

Rationale: The correct answer is B: Cervical dilation is occurring. This is a definitive sign of true labor as it indicates that the cervix is opening up in preparation for childbirth. Contractions alone may not always indicate true labor, especially if they are irregular. Pain decreasing when walking (choice A) is not a definitive sign of true labor. The fetal membranes rupturing (choice C) is a sign of labor but not definitive on its own. The fetal head at –1 station (choice D) can indicate descent but is not as definitive as cervical dilation.

Correct Answer: D

Rationale: The correct answer is D. A doula provides nonpharmacological pain relief during labor by offering emotional support, comfort measures, breathing techniques, and massage. This helps the mother cope with labor pain naturally. Choices A and C involve medical interventions that are typically performed by healthcare providers. Choice B is the role of a healthcare professional trained in assessing fetal well-being.