A female patient who is 37 weeks and 5 days gestation is having contractions every 3 minutes.

The fetus has an estimated fetal weight of 9 lbs and is in the left occiput posterior (LOP) position.

The nurse is concerned about the five P’s and their effect on the patient’s labor.

Which P is the concern from the patient’s history?

Passenger.

Passage.

Powers.

Psyche.

Answer and Explanation

The Correct Answer is A

Choice A rationale
The “Passenger” refers to the fetus and its position, size, and presentation. In this case, the fetus has an estimated weight of 9 lbs and is in the left occiput posterior (LOP) position. These factors can complicate labor by making it more difficult for the fetus to navigate through the birth canal, potentially leading to prolonged labor and increased risk of interventions.
Choice B rationale
The “Passage” refers to the birth canal, including the pelvis and soft tissues. While the passage is an important factor in labor, the primary concern in this scenario is the size and position of the fetus, which falls under the “Passenger” category.
Choice C rationale
The “Powers” refer to the strength and frequency of uterine contractions. Although the patient is having contractions every 3 minutes, the main concern here is the fetal size and position, which are more directly related to the "Passenger"4.
Choice D rationale
The “Psyche” refers to the psychological state of the mother, including her stress levels and emotional well-being. While important, the primary concern in this scenario is the physical factors related to the fetus, which are categorized under the "Passenger"4.

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Correct Answer is B

Explanation

Choice A rationale
Early decelerations are characterized by a gradual decrease and return to baseline of the fetal heart rate that coincides with the peak of a contraction. They are typically benign and related to fetal head compression.
Choice B rationale
Late decelerations are characterized by a gradual decrease and return to baseline of the fetal heart rate that occurs after the peak of a contraction. They are associated with uteroplacental insufficiency and require prompt intervention to improve fetal oxygenation.
Choice C rationale
Variable decelerations are characterized by an abrupt decrease in fetal heart rate that varies in duration, intensity, and timing relative to contractions. They are often caused by umbilical cord compression and may require interventions to relieve the compression.
Choice D rationale
Prolonged decelerations are characterized by a decrease in fetal heart rate that lasts longer than 2 minutes but less than 10 minutes. They indicate a more severe and sustained disruption in fetal oxygenation and require immediate intervention.

A. Occiput anterior. B. Occiput posterior. C. Breech. D. Transverse.

Correct Answer is A

Explanation

Choice A rationale
The occiput anterior (OA) position is considered the optimal fetal position for vaginal birth. In this position, the baby’s head is down, and the back of the head (occiput) is facing the mother’s front. This position allows for the most efficient passage through the birth canal.
Choice B rationale
The occiput posterior (OP) position, where the baby’s head is down but facing the mother’s back, can lead to a longer and more painful labor. It is not considered optimal for vaginal birth.
Choice C rationale
Breech positions, where the baby’s buttocks or feet are positioned to come out first, are not optimal for vaginal birth and often require a cesarean section due to the increased risk of complications.
Choice D rationale
The transverse position, where the baby is lying sideways across the uterus, is not suitable for vaginal birth. This position typically requires a cesarean section to safely deliver the baby.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client in labor at term. The nurse reviews the external monitor tracing below. The nurse identifies that the deceleration pattern seen indicates which of the following?

Correct Answer is B

Explanation

During the delivery, which fetal position would be considered optimal for a vaginal birth?

Correct Answer is A

Explanation

A nurse is caring for a client who is pregnant. The client’s vital signs are as follows: Temperature 37.2°C (98.9°F), Pulse rate 80/min, Respiratory rate 16/min, Blood Pressure 120/69 mm Hg. What should the nurse monitor next?

A nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented as -2 station. Which of the following interpretations of this finding should the nurse make?

The nursing preceptor asks the nursing student how to determine the intensity of contractions before placing the client on the electronic fetal monitor. What is the best explanation?

A nurse is caring for a client who is in the first stage of labor. Which of the following best describes the pathophysiology of early decelerations?

The labor and delivery nurse is caring for a client in active labor. The nurse notes the fetal heart rate baseline is 175 bpm, moderate variability, accelerations are absent and no decelerations noted. How should the nurse describe this tracing to the medical provider?

A nurse is creating the plan of care for a client in active labor. Which of the following actions should the nurse include in the plan of care?

A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client’s umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?