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 (A uterine resting tone of 30 mm Hg) because a high uterine resting tone indicates uterine hyperstimulation, which can lead to uterine rupture, fetal distress, and compromised blood flow to the placenta. A higher resting tone of 30 mm Hg is concerning compared to the normal range of 12-18 mm Hg. Choice A (A uterine resting tone of 17 mm Hg) is within the normal range, so it is not as concerning as a higher resting tone. Choices C (Contractions every 3 minutes lasting 60 seconds) and D (Contractions every 5 minutes lasting 60 seconds) describe the frequency and duration of contractions, which are important but are not as immediately concerning as a high uterine resting tone.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Increased estrogen levels lead to softening of the cervix, causing the mucus plug to be expelled. 2. Contractions usually start after the mucus plug is expelled, not before. 3. The mucus plug is typically expelled before the membranes rupture. 4. Effacement and dilation of the cervix prepare the body for labor but are not directly related to the expulsion of the mucus plug. In summary, Choice A is correct as increased estrogen leads to the expulsion of the mucus plug, indicating impending labor. Choices B, C, and D are incorrect as they do not accurately explain the relationship between the mucus plug and impending labor.

Correct Answer: A

Rationale: The active phase of labor according to ACOG begins at 6 cm dilation. At this point, contractions become stronger and more frequent, leading to faster cervical dilation. This stage signifies significant progress towards delivery. Choice B (3 cm) is incorrect as it falls within the early phase of labor. Choice C (5 cm) is also incorrect as it is near the beginning of the active phase but not the specific transition point. Choice D (10 cm) is incorrect as it marks full dilation and the transition to the second stage of labor.

Correct Answer: C

Rationale: The correct answer is C: 1 hour for a multiparous person, 2 hours for a nulliparous person. This is based on the typical duration of the third stage of labor, which involves the delivery of the placenta. In general, the third stage is expected to last around 5-30 minutes. However, for safety reasons and to allow for variations in individual cases, it is recommended to extend the time frame to 1 hour for multiparous individuals (those who have given birth before) and 2 hours for nulliparous individuals (those giving birth for the first time). This extended time frame ensures that healthcare providers have enough time to monitor and intervene if necessary without rushing the delivery of the placenta. Other choices are incorrect because they provide either too short (A and B) or too long (D) timeframes for the third stage of labor, which could lead to inadequate monitoring or unnecessary interventions.

Correct Answer: D

Rationale: The correct answer is D because decreased progesterone, increased estrogen, and the effects of oxytocin are the hormonal changes that initiate labor. Progesterone inhibits contractions, so its decrease allows labor to begin. Estrogen promotes uterine sensitivity to oxytocin, which stimulates contractions. Oxytocin is released in response to labor contractions and helps to strengthen contractions. A: Incorrect because decreased progesterone is needed for labor to start, estrogen needs to increase, and oxytocin is present during labor. B: Incorrect because increased progesterone inhibits labor, estrogen should increase, and oxytocin is present during labor. C: Incorrect because progesterone should decrease, estrogen should increase, and oxytocin is present during labor.