What is the primary rationale for teaching breathing and relaxation exercises in childbirth classes?

Correct Answer: C

Rationale: Breathing and relaxation exercises are taught in childbirth classes primarily to help break the fear-tension-pain cycle. This cycle occurs when a woman becomes anxious about labor and delivery, which leads to tension in her body, resulting in increased pain during contractions. By learning and practicing breathing and relaxation techniques, mothers can reduce their anxiety levels, which in turn helps to decrease tension and ultimately lower pain levels during labor. Option A, "Mothers refrain from yelling," is incorrect because the primary purpose of breathing and relaxation exercises is not to control vocalization but rather to manage pain and anxiety during childbirth. While these exercises may help mothers stay calm and focused, their main goal is not to prevent yelling. Option B, "Breathing exercises are less exhausting," is also incorrect because the main reason for teaching these exercises is not to reduce physical exhaustion. While proper breathing techniques can help conserve energy during labor, the primary goal is to manage pain and anxiety, not solely to lessen physical fatigue. Option D, "They promote maternal-newborn bonding," is not the primary rationale for teaching breathing and relaxation exercises in childbirth classes. While these exercises can certainly help mothers feel more connected to their newborns during the birthing process, their main purpose is to assist women in managing the physical and emotional challenges of labor. In conclusion, the correct answer is C because the primary rationale for teaching breathing and relaxation exercises in childbirth classes is to break the fear-tension-pain cycle, which can help mothers cope with labor more effectively.

Correct Answer: B

Rationale: In late labor, it is crucial for the nurse to evaluate the progress of labor first before taking any action. This is because the urge to move bowels can be a sign of fetal descent and impending birth. By evaluating the progress of labor, the nurse can determine if the client is fully dilated and if the baby is descending properly, which are essential factors for successful delivery. Option A, offering the client a bedpan, is not the priority because it does not address the underlying issue of the client feeling the need to move her bowels. It is important to determine if this urge is actually due to the baby descending rather than the need for bowel movement. Option C, notifying the physician, is not the first step because the nurse should assess the situation and provide immediate care based on their assessment. The physician can be notified after the evaluation of labor progress has been completed. Option D, encouraging the patient to push, is also not the correct first step because pushing should only be done when the client is fully dilated and ready to deliver. Encouraging pushing prematurely can lead to complications and should be avoided until the client is fully evaluated. In conclusion, evaluating the progress of labor is the most appropriate first step when a client feels the need to move her bowels late in labor. This allows the nurse to determine if the urge is related to the baby's descent and if delivery is imminent.

Correct Answer: A

Rationale: A: The relationship between decelerations and contractions is the correct answer because fetal heart decelerations are often associated with contractions during labor. It is essential for the nurse to assess how the decelerations correspond to the timing and intensity of contractions to determine if they are indicative of fetal distress or if they are benign. Understanding this relationship helps the nurse make informed decisions about the course of action to take during labor and delivery. B: The maternal blood pressure is incorrect because while monitoring the maternal blood pressure is important for overall maternal health during labor, it is not directly related to fetal heart decelerations. Fetal heart decelerations are primarily related to the fetal well-being and response to labor, rather than maternal blood pressure. C: The gestational age of the fetus is incorrect because while knowing the gestational age is important for overall prenatal care, it does not directly impact fetal heart decelerations. The assessment of fetal heart decelerations is more focused on the fetal response to labor and any signs of distress rather than the gestational age of the fetus. D: The placement of the fetal heart electrode is incorrect because while ensuring proper placement of monitoring devices is crucial for accurate assessment of fetal well-being, it is not the primary factor to consider when noting fetal heart decelerations. The focus should be on understanding the relationship between decelerations and contractions to assess the fetal response to labor accurately.

Correct Answer: A

Rationale: During the next contraction for a woman at 10 cm dilation, 100% effacement, and +3 station, the nurse should encourage the woman to push. This is the correct answer because at this stage of labor, the woman is fully dilated, effaced, and the baby is at a station that indicates it is ready to be born. Encouraging the woman to push will help to facilitate the descent and delivery of the baby. Option B, providing firm fundal pressure, is incorrect because fundal pressure should only be used in specific situations and can be harmful if not done correctly. In this case, the woman is already fully dilated and effaced, so fundal pressure is not necessary. Option C, moving the client into a squat, is also incorrect. While squatting can sometimes help with labor progress, it is not typically recommended at this stage of labor when the woman is fully dilated and ready to push. Option D, assessing for signs of rectal pressure, is not necessary at this stage of labor. The woman is already fully dilated and effaced, so the focus should be on pushing to deliver the baby rather than assessing for further signs of progress. In conclusion, encouraging the woman to push during the next contraction is the most appropriate action to take at this stage of labor for a woman who is fully dilated, effaced, and at +3 station.

Correct Answer: D

Rationale: Option D is the correct answer because it indicates that the woman is likely in active labor and should proceed to the hospital. Contractions that are about a minute long and are so intense that the woman is unable to talk through them are typically a sign that labor is progressing. This is because these strong, regular contractions are a key indication that the cervix is dilating and labor is advancing. Option A is incorrect because contractions that are 5 to 20 minutes apart are considered to be in the early stages of labor, known as the latent phase. While these contractions may be uncomfortable, they are not typically strong enough or close enough together to indicate active labor. Option B is also incorrect because a pink discharge on the toilet tissue could be a sign of bloody show, which can occur as the cervix begins to dilate. However, this alone is not a definitive indicator of active labor and should be considered along with other signs and symptoms. Option C is incorrect because experiencing cramping for a few hours could be a sign of early labor or false labor (Braxton Hicks contractions). However, without more specific information about the intensity and regularity of the contractions, it is difficult to determine if this is a sign of active labor. In summary, option D is the correct answer because it describes strong, regular contractions that are a minute long and prevent the woman from talking through them, indicating that she is likely in active labor and should proceed to the hospital.