What is an appropriate action by the doula?

Correct Answer: A

Rationale: A doula's primary role is to provide physical, emotional, and informational support to pregnant individuals before, during, and after childbirth. Giving a back massage is an appropriate action for a doula because it can help alleviate discomfort, reduce stress, and promote relaxation during labor. This physical support can also help the individual cope with contractions and promote a sense of well-being. Assessing fetal heart rate (Choice B) is typically the responsibility of a healthcare provider, such as a midwife or obstetrician. This task requires specialized training and equipment to accurately monitor the baby's well-being during labor. Doulas are not qualified to interpret fetal heart rate patterns and should not attempt to do so. Assessing blood pressure (Choice C) is also a task that falls within the scope of practice of healthcare providers. Monitoring blood pressure is crucial for assessing the individual's overall health and detecting any potential complications during labor. Doulas do not have the training or equipment required to accurately measure blood pressure. Regulating IV (Choice D) involves administering intravenous fluids, medications, or other substances to support the individual during labor. This task should only be performed by trained medical professionals, such as nurses or doctors, who have the necessary knowledge and skills to safely manage IV therapy. Doulas do not have the qualifications to regulate IVs and should not attempt to do so. In conclusion, giving a back massage is an appropriate action for a doula because it aligns with their role of providing physical comfort and support during labor. Assessing fetal heart rate, blood pressure, and regulating IVs are tasks that should be left to healthcare professionals with the appropriate training and expertise.

Correct Answer: A

Rationale: The correct sequence of cardinal moves of labor is internal rotation, extension, external rotation (Choice A). First, internal rotation is when the baby's head rotates to face the mother's back in order to navigate through the pelvis more easily. This is followed by extension, where the baby's head is able to pass under the pubic bone. Finally, external rotation occurs as the baby's head rotates back to its original position to facilitate delivery. Choice B (Descent, extension, external rotation) is incorrect because descent is not one of the cardinal moves of labor. Descent refers to the movement of the baby's head through the birth canal, but it is not a specific cardinal move in the sequence. Choice C (Flexion, internal rotation, extension) is incorrect because flexion, or the baby tucking their chin to their chest, is not one of the cardinal moves of labor. While flexion can occur during labor, it is not part of the specific sequence of cardinal moves. Choice D (Internal rotation, external rotation, expulsion) is incorrect because it skips the crucial step of extension, which is necessary for the baby to pass through the birth canal. Without extension, the baby's head cannot navigate under the pubic bone for delivery. In conclusion, the correct sequence of cardinal moves of labor is internal rotation, extension, external rotation, making Choice A the correct answer.

Correct Answer: C

Rationale: The correct answer is C: Flexed. When a fetus is in a flexed position, it means that the head is bent towards the chest, which is also known as the chin-on-chest position. This position is considered the optimal fetal attitude for vaginal delivery as it allows for easier passage through the birth canal. Choice A: Extended is incorrect because an extended fetal attitude refers to the head being in a position where it is tilted back, away from the chest. This position can make it more difficult for the baby to pass through the birth canal during delivery. Choice B: Neutral is incorrect because a neutral fetal attitude indicates that the baby's head is in a straight, neutral position with neither flexion nor extension. This position is less common and may not be ideal for vaginal delivery. Choice D: Variable is incorrect because a variable fetal attitude means that the baby's head can be in various positions, including flexed, extended, or neutral. This position can make it difficult to predict the optimal position for delivery and may increase the risk of complications during childbirth. In summary, the correct answer is C: Flexed because it represents the chin-on-chest position, which is the ideal fetal attitude for vaginal delivery. Choices A, B, and D are incorrect because they do not describe the specific position of the fetus's head in relation to the chest during childbirth.

Correct Answer: A

Rationale: In a single footling breech position, one leg is extended through the cervix and vagina while the other leg is flexed at the hip and knee. This position is considered more dangerous than a frank breech because the extended leg can easily become trapped during delivery, leading to complications such as umbilical cord prolapse or head entrapment. In a double footling breech position, both legs are extended through the cervix and vagina, making it even more risky than a single footling breech. This position increases the likelihood of cord prolapse and head entrapment, making it a high-risk presentation that often requires a cesarean section for delivery. A frank breech position is when both legs are flexed at the hips and knees, with the feet near the baby's head. This position is considered the safest type of breech presentation for vaginal delivery as the baby's buttocks present first, reducing the risk of cord prolapse and head entrapment. Therefore, the correct answer is A: single footling breech position because it describes a breech presentation where one leg is extended through the cervix and vagina, posing a higher risk during delivery compared to a frank breech position.

Correct Answer: C

Rationale: Fetal heart rate variability is an essential parameter indicating the health and well-being of the fetus. Fetal heart rate variability is influenced by various factors, including fetal sleep cycles. Choice A, hypoxia, would actually result in an increase in fetal heart rate variability as the fetus tries to compensate for the lack of oxygen by increasing its heart rate variability. Choice B, alkalosis, would also lead to an increase in fetal heart rate variability as the body tries to restore the acid-base balance by altering the heart rate variability. Choice D, fetal activity, typically causes an increase in fetal heart rate variability as the fetus moves around, leading to changes in heart rate variability. However, fetal sleep cycles have been shown to decrease fetal heart rate variability. During periods of fetal sleep, the heart rate tends to stabilize, leading to a decrease in variability. This is because the autonomic nervous system activity decreases during sleep, resulting in a more consistent heart rate pattern. Therefore, the correct answer is C: Fetal sleep cycles.