What indicates that a woman is in true labor?

Correct Answer: C

Rationale: Contractions becoming stronger is a key indicator that a woman is in true labor. Stronger contractions are a sign that the uterus is effectively working to dilate the cervix and move the baby down the birth canal. This progression is necessary for labor to continue and for the baby to be born. Contractions becoming more frequent, as mentioned in option A, can occur in both true and false labor. However, frequency alone is not a definitive indicator of true labor. False labor contractions can also become more frequent without leading to actual labor. Contractions becoming milder, as mentioned in option B, is actually a sign of false labor. True labor contractions typically become stronger and more intense as labor progresses, not milder. Mild contractions are usually not effective in dilating the cervix and moving the baby down. The fact that the client sleeps through contractions, as mentioned in option D, is a sign that the contractions are not strong or intense enough to disrupt her sleep. In true labor, contractions are usually strong enough to be uncomfortable and prevent the mother from sleeping through them. Sleeping through contractions is more characteristic of false labor.

Correct Answer: B

Rationale: When the baby's presenting part reaches the ischial spines, it signifies engagement. Engagement is when the widest diameter of the fetal presenting part (usually the biparietal diameter of the fetal head) reaches the level of the maternal ischial spines. This is an important milestone in labor as it indicates that the fetus is descending into the pelvis in preparation for birth. Floating (choice A) refers to when the baby's presenting part is not yet engaged and is still freely movable above the maternal pelvis. Once the presenting part reaches the ischial spines, the baby is no longer considered to be floating. Inlet entry (choice C) is not a term commonly used in obstetrics. It does not accurately describe the specific event of the baby's presenting part reaching the ischial spines. Crowning (choice D) occurs during the second stage of labor when the baby's head distends the vaginal opening. It is the final stage before the birth of the baby, not the same as engagement at the ischial spines. In summary, when the baby's presenting part reaches the ischial spines, it signifies engagement, which is an important milestone in labor. Floating, inlet entry, and crowning are not accurate descriptions of this specific event in labor.

Correct Answer: B

Rationale: Internal rotation is the correct answer because it is a cardinal movement that occurs while the baby is still in utero. During labor and delivery, the baby must move through the birth canal in a specific sequence of movements known as the cardinal movements of labor. Internal rotation refers to the movement of the baby's head as it turns to align with the mother's pelvis during the process of descent through the birth canal. This movement is necessary for the baby to navigate through the pelvis and be born successfully. Flexion, on the other hand, is another cardinal movement that occurs during labor and delivery but not while the baby is still in utero. Flexion refers to the baby's chin tucking towards its chest as it descends through the birth canal. This movement helps the smallest diameter of the baby's head to pass through the pelvis. Extension is another cardinal movement that occurs during labor and delivery but not while the baby is still in utero. Extension refers to the baby's head stretching back as it crowns and is born. This movement helps the baby's head to pass under the pubic arch. External rotation is also a cardinal movement that occurs during labor and delivery but not while the baby is still in utero. External rotation refers to the baby's head turning back to its original position after the shoulders have been born. This movement helps the shoulders to be born successfully. In summary, internal rotation is the correct answer because it is a cardinal movement that occurs while the baby is still in utero, specifically during the descent through the birth canal. Flexion, extension, and external rotation are also cardinal movements of labor and delivery but occur at different stages of the birthing process.

Correct Answer: C

Rationale: Early decelerations are typically seen during the second stage of labor. This is because early decelerations are caused by head compression during contractions, which commonly occurs as the baby descends into the birth canal during the pushing phase of labor. Choice A, Latent phase, is incorrect because early decelerations are not typically seen during the early stages of labor when contractions are usually mild and not as intense. Choice B, Epidural insertion, is incorrect because early decelerations are not directly related to the administration of an epidural. While epidurals can sometimes lead to fetal heart rate changes, early decelerations specifically relate to head compression during contractions. Choice D, Placental delivery, is incorrect because early decelerations are usually resolved before the delivery of the placenta. Early decelerations are considered a normal response to fetal head compression and are not necessarily indicative of any complications during the delivery of the placenta. In conclusion, the correct answer is C, Second stage, because early decelerations are commonly seen during this stage of labor when the baby is descending into the birth canal and experiencing head compression during contractions.

Correct Answer: B

Rationale: During the second stage of labor, which is the pushing stage, it is crucial to monitor the fetal heart rate regularly to ensure the well-being of the baby. The recommended frequency for assessing the fetal heart rate during this stage is every 5 minutes. The correct answer is B (Every 5 minutes) because this frequency allows healthcare providers to closely monitor any changes in the baby's heart rate, which can indicate distress or complications. By checking every 5 minutes, any concerning patterns can be identified promptly, and appropriate interventions can be implemented quickly to ensure the safety of both the mother and baby. Choice A (Every 10 minutes) is incorrect because waiting 10 minutes between assessments may lead to missing important changes in the fetal heart rate. During the second stage of labor, things can progress rapidly, and 10 minutes may be too long to wait before reassessing the baby's well-being. Choice C (Every 15 minutes) is also incorrect because this interval is too long to detect potential issues promptly. Waiting 15 minutes between assessments increases the risk of missing critical changes in the fetal heart rate that may require immediate action. Choice D (Every 20 minutes) is the least preferable option because waiting 20 minutes between assessments is even more prolonged and increases the likelihood of missing important changes in the baby's heart rate. This delay could result in a delay in necessary interventions to ensure the safety of the baby. In summary, the recommended frequency of assessing the fetal heart rate during the second stage of labor is every 5 minutes to allow for close monitoring and prompt identification of any concerning changes that may require immediate action.