How long is the expected length of the third stage of labor?

Correct Answer: B

Rationale: During the third stage of labor, the placenta is delivered. This stage typically lasts around 5-30 minutes. Choice A suggests 60 minutes or less, which is too long for the third stage of labor, making it incorrect. Choice C states 1 hour for a multiparous person and 2 hours for a nulliparous person. This is incorrect because it overestimates the length of the third stage of labor. The third stage of labor is usually shorter and should not exceed 30 minutes. Choice D suggests 3 hours for a multiparous person and 4 hours for a nulliparous person. This is significantly longer than the expected length of the third stage of labor. Waiting for 3-4 hours for the delivery of the placenta can increase the risk of complications for the mother. Therefore, choice B, 30 minutes or less, is the correct answer. It aligns with the typical duration of the third stage of labor and ensures a safe and timely delivery of the placenta without prolonging the process unnecessarily.

Correct Answer: B

Rationale: In the fourth stage of labor, which is the immediate postpartum period, the mother experiences rapid psychologic changes as she transitions into motherhood. It is crucial for the nurse to respect these changes and support the mother in bonding with her newborn. Choice B is the correct answer because it emphasizes the importance of taking cues from the parents regarding the level of interruption they are comfortable with during this critical bonding period. This approach respects the mother's autonomy and allows her to lead the interaction with her newborn. Choice A, inviting the family to come in and see the newborn, may not be appropriate in the fourth stage of labor as the mother needs time to bond with her baby without external distractions. It is important to prioritize the mother's needs and preferences during this time. Choice C, asking multiple questions about taking pictures of the newborn, may distract the mother from bonding with her baby and could potentially overwhelm her with unnecessary decisions. It is essential to keep the focus on the mother-infant bonding process during this critical postpartum period. Choice D, taking the newborn to the nursery to encourage the parents to rest, may disrupt the bonding process between the mother and her baby. It is important to promote skin-to-skin contact and early bonding to facilitate the development of a strong parent-child relationship. Overall, choice B is the most appropriate option as it prioritizes the mother's emotional needs and allows her to dictate the level of interaction during the crucial fourth stage of labor.

Correct Answer: D

Rationale: During the COVID-19 pandemic, restrictions were put in place in hospitals to limit the number of support persons allowed in the labor and delivery room. This meant that many laboring patients were unable to have their usual support person present. As a result, patients who were not able to have support during labor experienced increased levels of stress, anxiety, and depression. This lack of support can have a negative impact on the overall birth experience and mental health outcomes for the patient. Choice A is incorrect because labor support can come from a variety of sources, not just the significant other. While the significant other is a common source of support, other options include doulas, midwives, family members, or friends. Choice B is incorrect because laboring patients do benefit from support from outside sources. Research has shown that having a support person present during labor can lead to better outcomes for both the patient and the baby. Choice C is incorrect because the pandemic did have an impact on birth outcomes. The restrictions put in place during the pandemic changed the way care was delivered and limited the support available to patients, which could have affected the overall birth experience. Overall, choice D is the correct answer because patients who experienced a lack of support during the pandemic's restrictions were more likely to experience depression and other negative mental health outcomes. Labor support is crucial during the birthing process, and the pandemic highlighted the importance of ensuring patients have access to the support they need during labor and delivery.

Correct Answer: A

Rationale: Accelerations on a fetal heart rate (FHR) tracing are indicative of a reassuring pattern. Accelerations are temporary increases in the FHR above the baseline, typically in response to fetal movement or stimulation. This is a positive sign of fetal well-being as it shows a healthy autonomic nervous system response. Marked variability, while it may seem like a good sign, is actually associated with fetal distress. Variability refers to the fluctuations in the FHR and a marked variability indicates an exaggerated response which can be a sign of hypoxia or other issues. Prolonged decelerations are concerning as they indicate a decrease in the FHR that lasts longer than 2 minutes but less than 10 minutes. This could be a sign of fetal distress and requires immediate intervention. Absent variability is also a worrisome finding on an FHR tracing. Variability is a sign of the fetal autonomic nervous system function, so the absence of variability can indicate fetal distress or a compromised nervous system. In summary, accelerations are a reassuring pattern on an FHR tracing as they indicate a healthy autonomic nervous system response, while marked variability, prolonged decelerations, and absent variability are all concerning findings that may indicate fetal distress.

Correct Answer: A

Rationale: Applying a fetal scalp electrode is the most accurate way to monitor the FHR because it provides a direct measurement of the fetal heart rate. The electrode is placed on the baby's scalp during labor, allowing for continuous and real-time monitoring of the FHR. This method is considered more accurate than external methods because it eliminates potential interference from maternal movements or body tissues. Monitoring with an external ultrasound, while commonly used, may not always provide the most accurate measurement of the FHR. The external ultrasound relies on sound waves to detect the fetal heartbeat through the mother's abdomen, which can sometimes be affected by maternal factors such as obesity or fetal position. Using the Doppler monitor for intermittent auscultation involves listening to the fetal heart rate at specific intervals during labor. While this method can be effective in certain situations, it is not as continuous or accurate as using a fetal scalp electrode. Auscultating with a fetoscope is another method of listening to the fetal heart rate intermittently. However, like the Doppler monitor, this method does not provide continuous monitoring and may not be as accurate as using a fetal scalp electrode. In summary, applying a fetal scalp electrode is the most accurate way to monitor the FHR because it allows for continuous and direct measurement of the fetal heart rate without interference from maternal factors.