A nurse is caring for a patient in the first stage of labor and assesses that the patient is 6 cm dilated, 75% effaced, and the baby is at 0 station.
Based on these findings, the nurse would document that the patient is in what phase of the first stage of labor?
Transition.
Active.
Latent.
Progressive.
The Correct Answer is B
Choice A rationale
The transition phase is the final phase of the first stage of labor. It is characterized by cervical dilation from 8 cm to 10 cm. This phase is typically intense and short, marked by strong, frequent contractions, and is often when the patient may feel the urge to push. The current assessment of 6 cm dilation indicates the patient has not yet reached this phase.
Choice B rationale
The active phase of labor is defined by cervical dilation from 6 cm to 10 cm. The patient's assessment of 6 cm dilation places them squarely in the active phase. During this phase, contractions become stronger, longer, and more frequent, leading to a steady progression of cervical effacement and dilation until the cervix is fully dilated.
Choice C rationale
The latent phase is the earliest part of the first stage of labor. It is characterized by gradual cervical changes, with dilation from 0 to 5 cm. Contractions are typically mild and irregular. Since the patient is 6 cm dilated, they have already progressed beyond the latent phase into the active phase of labor.
Choice D rationale
Progressive is not a recognized phase of labor. Labor is divided into three main stages. The first stage has three phases: latent, active, and transition. The second stage is pushing and delivery, and the third stage is delivery of the placenta. The term progressive simply describes the forward movement of labor, not a specific phase.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A fern pattern on a microscope slide is the definitive diagnostic sign of premature rupture of membranes (PPROM). This occurs when amniotic fluid, which contains sodium chloride, dries on the slide, forming a crystalline, fern-like pattern. This positive "ferning" test confirms the presence of amniotic fluid, indicating that the membranes have ruptured.
Choice B rationale
White vaginal discharge is a common finding during pregnancy and is not indicative of PPROM. This discharge, known as leukorrhea, is a result of increased estrogen production and blood flow to the vaginal area. It is a normal physiological change and does not signify ruptured membranes.
Choice C rationale
A negative fetal fibronectin test indicates a low probability of preterm birth within the next one to two weeks. It does not diagnose PPROM. While PPROM often leads to preterm birth, the fFN test is a predictive tool for labor, whereas ferning is a direct diagnostic test for membrane rupture.
Choice D rationale
The pH of vaginal fluid is typically acidic, ranging from 3.8 to 4.5. Amniotic fluid, however, is alkaline, with a pH of 7.0 to 7.5. Therefore, a vaginal fluid pH of 4.5 would be considered normal and would not indicate the presence of alkaline amniotic fluid, which would raise the pH to above 6.5.
Correct Answer is D
Explanation
Choice A rationale
The term "flexed attitude" describes the posture of the fetus, not its position relative to the pelvic inlet. The engagement of the presenting part is a measure of station, which indicates how low the fetus has descended into the pelvis. A fetus can be flexed without being engaged.
Choice B rationale
A transverse lie describes the fetal axis being perpendicular to the maternal spine. The attitude refers to the relationship of the fetal parts to one another, such as the position of the head relative to the chest. A fetus can have a flexed attitude in a longitudinal or transverse lie.
Choice C rationale
Breech presentation is when the fetal buttocks or feet present first into the pelvis. Attitude describes the posture of the fetal limbs and head. While a fetus in breech presentation can have a flexed attitude, the terms describe different aspects of the fetus's position and posture.
Choice D rationale
The flexed attitude is the normal and most common fetal posture during labor. This position is characterized by the fetal chin resting on its chest, with the arms and legs crossed over the abdomen. This posture allows the smallest diameter of the fetal head to present to the pelvic inlet, facilitating descent.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.