A nurse is assessing a client who is at 38 weeks of gestation. Upon admission 2 hr ago the client had irregular contractions, was dilated 2 cm, and was at -1 cm station. Which of the following findings indicates progression in labor?
The client reports urinary frequency.
The client has increased blood-tinged vaginal mucus.
The client's station is at 3 cm.
The client's contractions ease with walking
The Correct Answer is B
A. Urinary frequency is common in pregnancy but does not indicate labor progression.
B. Increased blood-tinged vaginal mucus (bloody show) indicates cervical dilation and labor progression.
C. Station is measured in centimeters but ranges from -3 to +3 relative to the ischial spines, so "3 cm" station is unclear and likely incorrect terminology.
D. Contractions easing with walking suggest false labor rather than progression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administering methylergonovine (Methergine) intramuscularly is appropriate for treating postpartum hemorrhage, as it stimulates uterine contractions to help control bleeding.
B. The knee-chest position is not indicated for postpartum hemorrhage and does not address the underlying cause.
C. Oxygen may be necessary if the client is unstable, but 2 L/min via nasal cannula is not the primary intervention and may not be sufficient in a critical situation.
D. Dextrose water is not appropriate for fluid resuscitation during hemorrhage; isotonic fluids like normal saline or lactated Ringer’s are preferred to restore volume.
Correct Answer is C
Explanation
A. The car seat should remain rear-facing until at least age 2, or until the child reaches the maximum height and weight limit specified by the manufacturer, not just until 12 months.
B. The retainer (chest) clip should be positioned at the level of the infant's armpits, not the abdomen, to ensure proper restraint.
C. Positioning the car seat at a 45° angle helps keep the infant’s airway open and reduces the risk of aspiration or airway obstruction.
D. For rear-facing seats, the harness straps should be at or below the baby's shoulders, not above.
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