Arrange the seven cardinal movements of labor, in order.

Correct Answer: A

Rationale: The correct order of cardinal movements of labor is: 1. Engagement 2. Descent 3. Flexion 4. Internal rotation 5. Extension 6. Restitution 7. External rotation Engagement occurs first as the fetal presenting part enters the maternal pelvis. Descent is the second cardinal movement, where the fetus moves down the birth canal. Flexion follows, allowing the smallest diameter of the fetal head to present. Internal rotation positions the fetus for delivery. Extension occurs next, facilitating the passage of the head through the birth canal. Restitution aligns the fetal head with the shoulders. External rotation allows the shoulders to rotate for delivery. Therefore, Descent is the correct first cardinal movement in the sequence. Other choices like Expulsion, Extension, and External rotation occur later in the process and are not in the correct order.

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.

Correct Answer: C

Rationale: Step 1: In multiparous women, the uterus has gone through labor before, making muscle coordination more efficient. Step 2: Efficient muscle coordination helps in effective contractions, leading to faster labor progress. Step 3: Multiparous women have experienced labor before, allowing the uterus to contract more effectively. Step 4: This efficiency in muscle coordination is why precipitous labor is more often seen in multiparous women. Summary: A: The weakening of the cervix after each delivery is not a direct cause of precipitous labor. B: The ability of the cervix to dilate and efface simultaneously does not explain why precipitous labor is more common in multiparous women. D: The difficulty in knowing when labor begins is not a reason for the occurrence of precipitous labor in multiparous women.