The nurse who elects to practice in the area of obstetrics often hears discussion regarding the four Ps. What are the four Ps that interact during childbirth? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A: Powers. In obstetrics, the four Ps that interact during childbirth are Powers (contractions), Passage (birth canal), Passenger (fetus), and Psyche (mother's psychological state). Powers refer to the force generated by contractions to push the baby through the birth canal. Passage is the route the baby takes during birth. Passenger is the baby itself. Position is not one of the four Ps in childbirth. It is crucial for nurses in obstetrics to understand how these four Ps work together to facilitate a safe and successful delivery.

Correct Answer: A

Rationale: The correct answer is A: A nitrazine test is the most conclusive test. The rationale for this is as follows: 1. Nitrazine test detects the pH level of the fluid. Amniotic fluid is alkaline while urine is acidic. 2. Amniotic fluid will turn the nitrazine paper blue, indicating a pH level greater than 6.5, while urine will not change the color significantly. 3. This test is reliable and can help differentiate between amniotic fluid and urine leakage. Summary of other choices: B: Although nitrazine paper changes color due to the acidic nature of amniotic fluid, it is not a comprehensive test on its own. C: Ferning test is not commonly used in practice and may not be as reliable as the nitrazine test. D: Noting if fluid is leaking from the perineal area does not provide a conclusive determination of whether it is amniotic fluid or urine.

Correct Answer: A

Rationale: The correct answer is A: 3 points. Apgar scoring assesses the newborn's overall condition at 1 and 5 minutes after birth. In this case, the infant's Apgar score should be 3 because the baby displays signs of mild distress with blue extremities, weak cry, and minimal flexion. The heart rate of 110 BPM and response to suctioning indicate some normal function. Each category (color, heart rate, reflex irritability, muscle tone, and respiratory effort) can score up to 2 points, totaling 10 points. Blue extremities and weak cry correspond to 1 point each, while minimal flexion corresponds to 0 points. The heart rate (110 BPM) and response to suctioning indicate 2 points each, totaling 3 points. Therefore, the correct score is 3 points. Choices B, C, and D are incorrect as they do not accurately reflect the severity of the infant's condition based on the Apgar

Correct Answer: A

Rationale: The correct answer is A because engagement of the fetal head means the widest part of the head (biparietal diameter) is at the level of the ischial spines, indicating the head has descended into the pelvis. Choice B is incorrect as -2 station refers to the presenting part being 2 cm above the ischial spines, not at the level. Choice C is incorrect because engagement does not necessarily mean the head is well flexed. Choice D is incorrect as the ability of the head to pass under the pubic arch is not determined solely by engagement.

Correct Answer: C

Rationale: The correct answer is C: Initiate external fetal monitoring. In this scenario, the patient is at 36 weeks of gestation with a history of placenta previa and moderate vaginal bleeding, indicating a high-risk situation. External fetal monitoring allows for continuous assessment of the fetal heart rate and uterine contractions, which is crucial for identifying signs of fetal distress or complications related to placenta previa. This monitoring can help guide timely interventions and decision-making to ensure the safety of the mother and baby. Performing a vaginal examination (A) may increase the risk of bleeding in cases of placenta previa. Artificial rupture of membranes (B) can also lead to increased bleeding and should be avoided in this situation. Encouraging ambulation (D) is not recommended due to the risk of exacerbating bleeding and potential complications.