Which of the following nonpharmacological interventions recommended by nurse midwives may help a client at full term to go into labor? Select all that apply.

Correct Answer: C

Rationale: Performing yoga exercises is a nonpharmacological intervention recommended by nurse midwives to help a client at full term go into labor. Yoga exercises can help promote relaxation, reduce stress, and increase circulation, all of which can potentially help stimulate labor. Additionally, certain yoga poses can help open up the pelvis and encourage the baby to move into the optimal position for birth. Engaging in sexual intercourse is also a commonly recommended nonpharmacological intervention to help induce labor. Sexual intercourse can help release oxytocin, a hormone that can stimulate contractions. Additionally, semen contains prostaglandins which can help soften the cervix. Ingesting evening primrose oil is not typically recommended as a method to induce labor. While evening primrose oil is sometimes used to help ripen the cervix, there is limited scientific evidence to support its effectiveness in stimulating labor. Massaging the breast and nipples is not a commonly recommended method to induce labor. While nipple stimulation can help release oxytocin and stimulate contractions, it should be done under the supervision of a healthcare provider due to the potential risks of overstimulation and uterine hyperstimulation.

Correct Answer: D

Rationale: A vaginal examination provides the best information about the status of labor because it allows healthcare providers to directly assess the cervix for dilation, effacement, and station of the baby. This information is crucial in determining the progress of labor and deciding on the appropriate course of action. Leopold's maneuvers (choice A) are a series of four movements used to assess the position of the fetus in the uterus. While they can provide some information about the baby's position, they do not give as much detail about the status of labor as a vaginal examination. Fundal contractility (choice B) refers to the strength and regularity of contractions, which is important in labor progress. However, this information alone does not provide a comprehensive picture of the status of labor as it does not give information on cervical dilation and effacement. Assessment of the fetal heart (choice C) is important for monitoring the well-being of the baby during labor, but it does not provide direct information about the progress of labor in terms of cervical changes. In conclusion, a vaginal examination is the best choice for assessing the status of labor as it provides direct and detailed information about cervical dilation, effacement, and station of the baby, which are crucial in managing labor effectively.

Correct Answer: A

Rationale: A: After all vaginal exams Assessing the fetal heart rate after all vaginal exams is crucial during labor because these exams can potentially cause changes in the fetal heart rate. Vaginal exams can stimulate the cervix and cause temporary changes in the baby's heart rate. Therefore, it is important to monitor the fetal heart rate immediately after these exams to ensure the baby's well-being. B: Before giving the mother any analgesics While it is important to monitor the fetal heart rate before giving the mother any analgesics, this is not the most critical time for assessment. Analgesics may affect the mother's pain perception and level of consciousness but do not directly impact the fetal heart rate. Monitoring the fetal heart rate after vaginal exams is more critical to ensure immediate safety. C: Periodically at the end of a contraction Monitoring the fetal heart rate periodically at the end of a contraction is important for assessing the baby's response to uterine contractions. However, this alone may not provide a comprehensive picture of the baby's well-being throughout labor. Assessing the fetal heart rate after all vaginal exams allows for immediate detection of any changes that may impact the baby's health. D: Every 1 hour during the latent phase of a low-risk labor Monitoring the fetal heart rate every hour during the latent phase of a low-risk labor is a good practice to ensure the baby's well-being over time. However, waiting for an hour between assessments may miss critical changes that can occur suddenly, especially after vaginal exams. Immediate assessment after vaginal exams is crucial for timely interventions if needed.

Correct Answer: B

Rationale: When the nurse palpates the buttocks above the spines, she is feeling for the fetal back, which indicates the fetal position. In this scenario, the correct answer is B: LSP with presenting part at -1 station. A: LOA with presenting part at -1 station is incorrect because LOA stands for Left Occiput Anterior, which means the back of the baby's head is facing towards the mother's left side. However, feeling the buttocks above the spines suggests the back is on the mother's right side, ruling out LOA. C: LMP with presenting part at +1 station is incorrect because LMP stands for Left Mentoposterior, which means the baby's face is facing towards the mother's left side. Palpating the buttocks above the spines indicates the back is on the right side, ruling out LMP. D: LSA with presenting part at +1 station is incorrect because LSA stands for Left Sacrum Anterior, which means the baby's sacrum is facing towards the mother's left side. Palpating the buttocks above the spines suggests the back is on the mother's right side, ruling out LSA. In summary, the correct answer is B: LSP with presenting part at -1 station because the nurse is feeling the buttocks above the spines, indicating the fetal back is on the mother's right side, and the presenting part is at -1 station.

Correct Answer: D

Rationale: In the second stage of labor, the cervix is fully dilated and effaced to allow for the baby to descend through the birth canal. Choice A and B are both incorrect because they indicate that the cervix is not fully effaced or dilated, which is characteristic of the first stage of labor. Choice C is also incorrect because it states that the cervix is fully dilated but not effaced. In reality, the cervix needs to be both fully dilated and effaced in order for the baby to pass through. Choice D is the correct answer because it accurately describes the second stage of labor. The cervix is fully dilated and effaced, and the baby is low enough to be visible or felt during a vaginal examination. This stage typically involves active pushing and the eventual birth of the baby.