When does the active phase of labor begin according to ACOG?

Correct Answer: A

Rationale: The active phase of labor according to ACOG begins at 6 cm dilation. At this point, contractions become stronger and more frequent, leading to faster cervical dilation. This stage signifies significant progress towards delivery. Choice B (3 cm) is incorrect as it falls within the early phase of labor. Choice C (5 cm) is also incorrect as it is near the beginning of the active phase but not the specific transition point. Choice D (10 cm) is incorrect as it marks full dilation and the transition to the second stage of labor.

Correct Answer: D

Rationale: The correct answer is D because decreased progesterone, increased estrogen, and the effects of oxytocin are the hormonal changes that initiate labor. Progesterone inhibits contractions, so its decrease allows labor to begin. Estrogen promotes uterine sensitivity to oxytocin, which stimulates contractions. Oxytocin is released in response to labor contractions and helps to strengthen contractions. A: Incorrect because decreased progesterone is needed for labor to start, estrogen needs to increase, and oxytocin is present during labor. B: Incorrect because increased progesterone inhibits labor, estrogen should increase, and oxytocin is present during labor. C: Incorrect because progesterone should decrease, estrogen should increase, and oxytocin is present during labor.

Correct Answer: E

Rationale: Based on the scenario, the decrease in blood pressure post-placenta delivery indicates potential hemorrhage, a common complication. The nurse should assess for signs of bleeding, such as excessive vaginal bleeding or tachycardia. Prompt intervention is crucial to prevent further complications. Other choices are less relevant - pain alone does not directly cause a decrease in blood pressure, skin-to-skin contact is important but not the priority in this situation, and a distended bladder can be addressed later. Assessing for possible hemorrhage is the most critical action to take in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Prepare them for possible strains on relationships. This guidance is important as the arrival of a newborn can bring significant changes to the dynamics of a relationship. By preparing new parents for possible strains on relationships, the nurse can help them navigate challenges together. A: Incorrect. Roles are likely to change at home with the addition of a newborn, so it is important to address this rather than dismissing it. B: Incorrect. Stressors may actually increase with the arrival of a newborn, so it is not accurate to say stresses will be over. C: Incorrect. Ignoring household changes can lead to added stress, so it is not advisable to tell parents not to stress over them. In summary, option D is correct as it addresses the potential strains on relationships that new parents may face, while the other options do not acknowledge the reality of sociologic changes that can occur.

Correct Answer: D

Rationale: The correct answer is D because patients who experienced a support ban during the pandemic were more likely to suffer from depression due to lack of emotional and physical support. This is supported by research showing the positive impact of labor support on maternal mental health and birth outcomes. Choice A is incorrect as labor support can also be provided by healthcare professionals. Choice B is incorrect as laboring patients benefit from emotional and physical support during childbirth. Choice C is incorrect as pandemic requirements did impact birth outcomes, especially for patients who lacked support.