During an oxytocin induction, which assessment finding is most concerning to the labor and delivery nurse?

Correct Answer: B

Rationale: The correct answer is B because a uterine resting tone of 30 mm Hg indicates excessive uterine activity, which can lead to uterine hyperstimulation and fetal distress during an oxytocin induction. A higher resting tone suggests the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choices A, C, and D are incorrect because a uterine resting tone of 17 mm Hg is within the normal range, contractions every 3 minutes lasting 60 seconds and every 5 minutes lasting 60 seconds are typical patterns during labor induction, and they do not necessarily indicate complications.

Correct Answer: A

Rationale: The correct answer is A because the mucus plug is expelled due to increased estrogen levels before contractions start. Estrogen stimulates the production of mucus that forms the plug, which is then released as a result of hormonal changes signaling the body to prepare for labor. This process occurs before labor contractions begin. Choice B is incorrect because the mucus plug is typically expelled before the membranes rupture during labor. Choice C is incorrect because effacement and dilation of the cervix do not directly cause the expulsion of the mucus plug. Choice D is incorrect because labor can begin even if the mucus plug has not been expelled, and the plug itself does not create a space for the fetus.

Correct Answer: A

Rationale: The active phase of labor begins at 6 cm dilation according to ACOG guidelines. At this point, the cervix is significantly dilated, signaling the transition to active labor. This stage is crucial as it signifies the acceleration of labor progress and typically involves stronger contractions leading to efficient cervical dilation. Choices B, C, and D are incorrect as they do not align with the established criteria for the active phase of labor. Choice B (3 cm) is too early for active labor, choice C (5 cm) is close but not quite at the threshold for active labor, and choice D (10 cm) is actually the full dilation stage, not the beginning of active labor. Hence, choice A (6 cm) is the correct answer.

Correct Answer: C

Rationale: The correct answer is C because the expected length of the third stage of labor, which is the delivery of the placenta, is typically around 1 hour for a multiparous person (someone who has given birth before) and around 2 hours for a nulliparous person (someone who is giving birth for the first time). This is based on the normal physiological process of the uterus contracting to expel the placenta. Choice A and B are incorrect as they provide specific time limits that are not generally applicable to all individuals. Choice D is incorrect as it suggests longer durations which are beyond the typical range for the third stage of labor.

Correct Answer: D

Rationale: The correct answer is D because during labor, progesterone levels decrease, estrogen levels increase, and oxytocin plays a key role in initiating contractions. Progesterone inhibits contractions, so its decrease is necessary for labor to start. Estrogen helps stimulate uterine contractions. Oxytocin, released from the brain, triggers and enhances contractions. Option A is incorrect because an absence of oxytocin would not initiate labor. Option B is incorrect because increased progesterone would inhibit labor. Option C is incorrect because oxytocin is needed to initiate labor.