Which explains why infants who are delivered via cesarean section before the start of labor have more difficulty transitioning to extrauterine life?

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Question 1 of 5

Which explains why infants who are delivered via cesarean section before the start of labor have more difficulty transitioning to extrauterine life?

Correct Answer: D

Rationale: The correct answer is D because residual amniotic fluid in the lungs can lead to a condition called transient tachypnea of the newborn (TTN), making spontaneous respirations difficult. This occurs more commonly in infants born via cesarean section before the onset of labor as they may not have had the opportunity to expel the fluid through the vaginal passage. A: Warm IV fluids can help maintain normal body temperature. B: Regional anesthesia may not directly cause respiratory depression in the infant. C: Maternal left tilt position is used to improve blood flow during labor, not relevant to respiratory issues in the newborn.

Question 2 of 5

Why is precipitous labor most often seen in multiparous women?

Correct Answer: C

Rationale: Step 1: In multiparous women, the uterus has gone through labor before, making muscle coordination more efficient. Step 2: Efficient muscle coordination helps in effective contractions, leading to faster labor progress. Step 3: Multiparous women have experienced labor before, allowing the uterus to contract more effectively. Step 4: This efficiency in muscle coordination is why precipitous labor is more often seen in multiparous women. Summary: A: The weakening of the cervix after each delivery is not a direct cause of precipitous labor. B: The ability of the cervix to dilate and efface simultaneously does not explain why precipitous labor is more common in multiparous women. D: The difficulty in knowing when labor begins is not a reason for the occurrence of precipitous labor in multiparous women.

Question 3 of 5

A gravida 3, para 2 is attempting a vaginal birth without the use of pain medicine or anesthesia. Following spontaneous rupture of membranes, the patient’s cervical exam was 5 cm dilated, 60% effaced, -2 station. Which therapeutic intervention is appropriate for this patient?

Correct Answer: C

Rationale: The correct answer is C: Sitting on birthing ball. This position helps to open up the pelvis, allowing for optimal fetal positioning and descent. It also helps relieve pressure on the cervix, promoting dilation. Ambulation (A) may slow down labor progress, squatting (B) can increase pressure on the cervix and hinder descent, and resting on hands and knees (D) may not be as conducive to gravity-assisted descent.

Question 4 of 5

During an oxytocin induction, which assessment finding is most concerning to the labor and delivery nurse?

Correct Answer: B

Rationale: The correct answer is B because a uterine resting tone of 30 mm Hg indicates excessive uterine activity, which can lead to uterine hyperstimulation and fetal distress during an oxytocin induction. A higher resting tone suggests the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choices A, C, and D are incorrect because a uterine resting tone of 17 mm Hg is within the normal range, contractions every 3 minutes lasting 60 seconds and every 5 minutes lasting 60 seconds are typical patterns during labor induction, and they do not necessarily indicate complications.

Question 5 of 5

Which woman is the best candidate for a trial of labor after cesarean (TOLAC)?

Correct Answer: B

Rationale: The correct answer is B: A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD. This candidate is the best choice for a trial of labor after cesarean (TOLAC) because a low-transverse incision has the lowest risk of uterine rupture during labor compared to classical, T-shaped, or vertical incisions. Additionally, the indication for the previous cesarean section being cephalopelvic disproportion (CPD) suggests that the pelvis may have been the limiting factor in the previous delivery, making a TOLAC a reasonable option. The other choices have higher risks of uterine rupture (classical incision, T-shaped incision) or indications that may increase the likelihood of complications during TOLAC (prematurity, late decelerations).

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