The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between contractions. Which statement is the appropriate rationale for assessing maternal vital signs between contractions raNtheRr thaIn aGt anBot.heCr inMterval? U S N T O

Correct Answer: D

Rationale: The correct answer is D: Maternal circulating blood volume increases temporarily during contractions. 1. During contractions, the uterus contracts, temporarily reducing blood flow to the placenta and increasing blood volume in the maternal circulation. 2. This temporary increase in blood volume can affect vital signs, such as blood pressure and heart rate. 3. Assessing maternal vital signs between contractions provides a more accurate baseline reading. 4. Choice A is incorrect because vital signs taken during contractions may be affected by the temporary increase in blood volume. 5. Choice B is incorrect as assessing fetal heart rate is a separate priority and not directly related to maternal vital signs. 6. Choice C is incorrect as maternal blood flow to the heart is not reduced during contractions.

Correct Answer: B

Rationale: The correct answer is B: Flexion. Flexion of the fetal head is crucial for the smallest anterior-posterior diameter to enter the pelvis first. This position optimizes the fit of the fetal head through the maternal pelvis, reducing the risk of complications during labor. Station (A) refers to the level of the presenting part in the pelvis, descent (C) is the downward movement of the fetus, and engagement (D) is when the widest diameter of the fetal head passes through the maternal pelvic inlet. However, these factors do not specifically address the orientation of the fetal head to ensure the smallest diameter enters the pelvis.

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.