Pregnant patients can usually tolerate the normal blood loss associated with childbirth because of which physiologic adaptation to pregnancy?

Correct Answer: C

Rationale: The correct answer is C: Increased blood volume. During pregnancy, a woman's blood volume increases by about 30-50% to support the growing fetus and prepare for potential blood loss during childbirth. This increased blood volume helps pregnant patients tolerate the normal blood loss associated with childbirth without experiencing severe complications like hypovolemic shock. Rationale: A: A higher hematocrit would not directly contribute to increased blood volume and would not help in tolerating blood loss during childbirth. B: Increased leukocytes are part of the immune response and are not directly related to blood volume or tolerance to blood loss. D: A lower fibrinogen level would not directly contribute to increased blood volume and would not help in tolerating blood loss during childbirth. Summary: Choice C is correct because increased blood volume is a crucial physiologic adaptation during pregnancy that enables pregnant patients to tolerate the normal blood loss associated with childbirth. Choices A, B, and D are incorrect as they are not directly related to this

Correct Answer: C

Rationale: The correct answer is C because during the active phase of labor, the cervix dilates from 4 to 7 centimeters, and the patient typically experiences the urge to push as the baby descends further down the birth canal. This indicates progress in labor and readiness for the second stage. Choices A, B, and D are incorrect as they do not specifically align with the characteristics of the active phase of labor. Choice A is not necessarily indicative of the active phase, choice B may happen at any stage of labor, and choice D is more characteristic of transition phase rather than the active phase.

Correct Answer: A

Rationale: The correct answer is A: total duration of labor. Nullipara refers to a woman giving birth for the first time, while multipara refers to a woman who has given birth multiple times. The primary difference between their labors is the total duration. Nulliparas typically have longer labors due to the body's first experience with childbirth. The other choices (B, C, D) are not the primary difference between nullipara and multipara labors. Pain experience, cervical dilation, and labor mechanisms can vary based on individual factors, but the key distinction lies in the overall duration of labor based on parity.

Correct Answer: B

Rationale: The correct answer is B: Notify the health care provider. In the case of a transverse lie, the fetus is positioned sideways in the uterus, which can lead to complications during labor. Notifying the health care provider is crucial as they will need to assess the situation and determine the appropriate course of action, such as attempting to manually rotate the fetus or preparing for a cesarean section if necessary. Performing a vaginal exam (choice A) may not be safe or effective in this situation. Initiating parenteral therapy (choice C) and applying oxygen (choice D) are not the priority interventions in the case of a transverse lie.

Correct Answer: D

Rationale: The correct answer is D: pattern of uterine contractions. This is because the pattern of contractions is a key indicator of true labor. True labor contractions are regular, increasing in frequency, duration, and intensity. Assessing the pattern helps differentiate true labor from false labor. A: Cervical dilation is important but may not necessarily indicate true labor as it can occur in false labor as well. B: The amount of bloody show is a sign of cervical changes, but it alone does not confirm true labor. C: Fetal position and station are important for labor progress but do not definitively confirm true labor. In summary, assessing the pattern of uterine contractions is crucial in determining true labor as it provides direct insight into the progression and intensity of contractions, distinguishing it from false labor.