A nurse is caring for four laboring patients. Match each patient's description to the correct stage of labor:

Patient A is experiencing regular contractions every 2-3 minutes with complete cervical dilation and begins involuntary pushing efforts.

Patient B has mild, irregular contractions and reports only slight cervical effacement and dilation.

Patient C has just delivered her baby and is now experiencing mild contractions with a gush of blood.

Patient D is resting comfortably, reporting relief after delivery, with uterine firmness and lochia present.

Patient A-Second stage Patient B-First stage (latent phase Patient C-Third stage Patient D-Fourth stage

Patient A-First stage Patient B-Second stage Patient C-Third stage Patient D-Fourth stage

Patient A-Second stage Patient B-Fourth stage Patient C-First stage Patient D-Third stage

Patient A-Third stage Patient B-Second stage Patient C-Fourth stage Patient D-First stage (transition phase)

Answer and Explanation

The Correct Answer is A

A. Patient A is in the second stage because complete cervical dilation and involuntary pushing characterize this stage. Patient B is in the latent phase of the first stage, with mild, irregular contractions and minimal cervical change. Patient C is in the third stage, which involves delivery of the placenta and associated bleeding. Patient D is in the fourth stage, the immediate postpartum period, where the client is resting, the uterus is firm, and lochia is present.

B. Patient A-First stage, Patient B-Second stage, Patient C-Third stage, Patient D-Fourth stage: This sequence incorrectly places Patient A in the first stage despite complete cervical dilation and pushing, and misclassifies Patient B’s early labor as second stage.

C. Patient A-Second stage, Patient B-Fourth stage, Patient C-First stage, Patient D-Third stage: This arrangement mismatches stages with clinical signs; Patient B is still in early labor, not postpartum, and Patient C has already delivered, indicating the third stage, not first stage.

D. Patient A-Third stage, Patient B-Second stage, Patient C-Fourth stage, Patient D-First stage (transition phase): Patient A is actively pushing (second stage), and the other patients’ stages do not match their described symptoms or postpartum status.

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Free Nursing Study Resources

Correct Answer is ["A","D","E","F"]

Explanation

A. Explain that initial fetal movements, known as "quickening," typically occur between 16 and 20 weeks of pregnancy, so she may begin feeling movement soon: Quickening usually begins during this window, with variation depending on maternal factors. At 18 weeks, it is normal for a primigravida not to have felt movement yet, and reassurance is appropriate.

B. Inform her that absence of fetal movement at this stage always indicates fetal distress: Fetal distress cannot be determined at 18 weeks based on lack of perceived movement. Many women, especially first-time mothers, do not recognize fetal activity until closer to 20 weeks, so this statement would cause unnecessary alarm.

C. Instruct her to immediately come to the hospital for fetal monitoring due to lack of movement at 18 weeks: Immediate monitoring is unnecessary at this gestational age. Fetal movements may not yet be detectable, and intervention is only indicated if movement is absent after 20–22 weeks or if previously felt movements decrease later in pregnancy.

D. Advise her to increase hydration and rest in a quiet environment to better detect fetal movement: Resting in a calm setting and ensuring good hydration can make subtle movements easier to perceive. These strategies help the mother tune into early fetal activity without causing anxiety.

E. Suggest keeping a daily record of fetal movements starting around 24 weeks to monitor fetal well-being: Kick counts and fetal movement tracking are recommended beginning around 24–28 weeks, once movements become regular and strong enough to monitor consistently.

F. Reassure her that first-time mothers often feel fetal movement closer to 20 weeks, which is normal: Primigravidas usually perceive fetal movements later than multiparas because they are less familiar with the sensations. Reassurance at this stage helps reduce anxiety while setting realistic expectations.

A. Lordosis refers to a straightening of the spine to accommodate fetal weight, which reduces flexibility and causes back pain. B. Lordosis is caused by compression of spinal nerves from the expanding uterus and is typically a sign of neurologic compromise. C. Increased lumbar lordosis is a compensatory change in spinal curvature that shifts the center of gravity forward to balance the enlarging uterus. D. Lordosis develops due to increased thoracic spine curvature and leads to shoulder pain in late pregnancy.

Correct Answer is C

Explanation

A. Lordosis refers to a straightening of the spine to accommodate fetal weight, which reduces flexibility and causes back pain: Lordosis is an increased inward curvature of the lumbar spine, not a straightening. The curvature helps maintain balance rather than reducing flexibility.

B. Lordosis is caused by compression of spinal nerves from the expanding uterus and is typically a sign of neurologic compromise: Lordosis is a normal musculoskeletal adaptation during pregnancy, not a sign of nerve compression or neurologic compromise.

C. Increased lumbar lordosis is a compensatory change in spinal curvature that shifts the center of gravity forward to balance the enlarging uterus: The forward shift in center of gravity increases strain on lumbar muscles and ligaments, contributing to common pregnancy-related lower back pain.

D. Lordosis develops due to increased thoracic spine curvature and leads to shoulder pain in late pregnancy: Lordosis involves the lumbar spine, not the thoracic spine, and is associated with lower back pain, not shoulder pain.

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Naxlex Comprehensive Predictor Exams

Read the case scenario and Select All That Apply Using your clinical judgment, how should the nurse respond to this patient? Select All the best responses. (Select All that Apply.)

Correct Answer is ["A","D","E","F"]

Explanation

A pregnant client in her third trimester complains of lower back pain. The nurse explains that this discomfort is common due to postural changes. Which of the following best explains the role of lordosis in pregnancy-related back pain?

Correct Answer is C

Explanation

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