What is a direct influence on cervical dilation? Select all that apply.

Correct Answer: A

Rationale: The correct answer is A: positioning of the pregnant person. The position of the pregnant person can directly influence cervical dilation by affecting the alignment of the uterus and baby, allowing for optimal pressure on the cervix. Proper positioning can facilitate the descent of the baby's head onto the cervix, promoting dilation. Summary of why other choices are incorrect: B: The strength of uterine contractions indirectly influences cervical dilation by aiding in the effacement and descent of the baby, but it does not directly impact dilation. C: The length of time since ROM (rupture of membranes) can affect the risk of infection but does not directly influence cervical dilation. D: Fetal presentation refers to the position of the baby in the uterus and can affect labor progress, but it does not directly impact cervical dilation.

Correct Answer: D

Rationale: The correct answer is D: when pushing begins. The second stage of labor begins when the cervix is fully dilated, and the mother starts pushing to deliver the baby. This stage ends with the birth of the baby. Option A is incorrect because the second stage begins after birth. Option B is incorrect as it refers to the transition phase, not the second stage. Option C is incorrect because the cervix being fully dilated and effaced marks the beginning of the second stage, not the end of it.

Correct Answer: C

Rationale: The correct answer is C because a blood pressure of 142/88 is considered high and abnormal during the first stage of labor. This could indicate hypertension, which can have serious implications for both the mother and the baby. High blood pressure can lead to complications such as preeclampsia. A, B, and D are incorrect because: A: Patient moaning with contractions is a common response to labor pains and does not necessarily indicate an abnormal finding. B: Contractions 3 minutes apart lasting 60 seconds are within the normal range for the first stage of labor. D: A respiratory rate of 22 is also within the normal range and is not indicative of any abnormal findings during the first stage of labor.

Correct Answer: B

Rationale: During the third stage of labor, the correct answer is B because it describes the typical experiences of the birthing person during this stage. Cramping signifies uterine contractions, a gush of fresh vaginal bleeding indicates the delivery of the placenta, and lengthening of the umbilical cord indicates separation from the placenta. The other options are incorrect as they do not align with the physiological processes of the third stage of labor. A is incorrect as the fetus is delivered in the second stage, not the third. C is incorrect as dyspnea (difficulty breathing) is not a common symptom during the third stage. D is incorrect as increased blood pressure and pain are not typical experiences during this stage.

Correct Answer: B

Rationale: The correct answer is B. In the fourth stage of labor, the nurse should respect the rapid psychologic changes by taking the lead from the parents regarding interruption of bonding. This is important because it allows the parents to establish a strong bond with their newborn without feeling pressured or rushed. By following the parents' cues, the nurse can support their emotional needs and facilitate a positive bonding experience. Choices A, C, and D are incorrect because they do not prioritize the parents' emotional needs and may disrupt the bonding process. Inviting the family to see the newborn (Choice A) may add stress to the situation. Asking multiple questions about taking pictures (Choice C) may be intrusive. Taking the newborn to the nursery (Choice D) may interfere with the bonding process and discourage parental involvement.