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. The four Ps of childbirth are Powers, Passage, Passenger, and Psyche. Powers refer to the contractions of the uterus and the pushing efforts of the mother during labor. Passage involves the birth canal through which the baby passes. Passenger refers to the fetus and its position during labor. Psyche relates to the psychological aspects of labor. In this case, Powers directly interact during childbirth by facilitating the progress of labor. Passage, Position, and Passenger are important factors as well, but they do not directly interact during childbirth like Powers do.

Correct Answer: A

Rationale: The correct answer is A. The nurse should perform a nitrazine test to determine if the fluid leaking is amniotic fluid. Here's the rationale: 1. Nitrazine test is specifically designed to differentiate amniotic fluid from urine. 2. Amniotic fluid is alkaline, causing the nitrazine paper to turn blue when it comes into contact with it. 3. Urine, on the other hand, does not change the color of the nitrazine paper. 4. This test is quick, easy to perform, and provides a conclusive result in differentiating amniotic fluid from other fluids. In summary: - Choice B incorrectly describes the color change mechanism of nitrazine paper. - Choice C refers to ferning, which is not as conclusive as the nitrazine test. - Choice D does not provide a definitive method for determining if the leaking fluid is amniotic fluid.

Correct Answer: A

Rationale: The correct answer is A (3 points). The Apgar score assesses newborns' overall health shortly after birth. Each category (appearance, pulse, grimace, activity, and respiration) is scored from 0 to 2. In this case, the infant exhibits central cyanosis (blue extremities), weak muscle tone (minimal flexion), a weak cry, a heart rate of 110 bpm (slightly below normal), and responsive to suctioning (coughs, pulls away) indicating some respiratory effort. Therefore, the infant would receive 1 point for appearance (cyanosis), 1 point for pulse (110 bpm), 1 point for grimace (weak cry), totaling 3 points. Choices B, C, and D are incorrect as they do not accurately reflect the infant's condition and Apgar scoring criteria.

Correct Answer: A

Rationale: The correct answer is A: The biparietal diameter of the fetal head is at the level of the ischial spines. Engagement of the fetal head occurs when the largest transverse diameter of the presenting part (usually the biparietal diameter) reaches or passes through the pelvic inlet, specifically at the level of the ischial spines. This signifies descent of the fetal head into the maternal pelvis, indicating progress towards labor. Choice B (The biparietal diameter of the fetal head is at –2 station) is incorrect as station refers to the level of the presenting part in relation to the ischial spines, not engagement. Choice C (The fetal head is well flexed) is incorrect as engagement does not necessarily indicate the position of the fetal head. Choice D (The fetal head is unable to pass under the pubic arch) is incorrect as engagement actually signifies that the fetal head is in the optimal position to pass through the pelvis during labor.

Correct Answer: C

Rationale: The correct answer is C: Initiate external fetal monitoring. The nurse should initiate external fetal monitoring to assess the fetus's heart rate and uterine contractions, given the patient's history of placenta previa and vaginal bleeding. This helps to monitor the well-being of the fetus and detect any signs of distress. Performing a vaginal examination (Choice A) may aggravate the placenta previa and increase the risk of bleeding. Artificial rupture of membranes (Choice B) is contraindicated in cases of placenta previa due to the risk of increased bleeding. Encouraging ambulation (Choice D) is not advisable in this situation as it may also worsen bleeding.