A nurse is coaching a woman during the second stage of labor. Which of the following should the nurse encourage the client to do at this time?
Hold her breath while pushing during contractions
Begin pushing as soon as the cervix has dilated to 8cm
Push with contractions and rest between them
Pant while pushing
The Correct Answer is C
A. Holding her breath while pushing during contractions: Prolonged breath-holding increases intrathoracic pressure, reduces venous return, and can decrease uteroplacental perfusion. This may compromise fetal oxygenation and increase maternal fatigue, particularly during repeated pushing efforts.
B. Begin pushing as soon as the cervix has dilated to 8 cm: Initiating pushing before full cervical dilation increases the risk of cervical edema and lacerations. Effective bearing down requires complete dilation to allow fetal descent without maternal or cervical trauma.
C. Push with contractions and rest between them: Coordinating pushing with uterine contractions maximizes expulsive force while rest periods allow maternal recovery and fetal reoxygenation. This pattern supports efficient fetal descent and reduces exhaustion during the second stage of labor.
D. Pant while pushing: Panting is used during the transition phase or when pushing should be delayed, such as with an urge to push before full dilation. During the active second stage, panting interferes with effective bearing-down efforts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Have the primary care physician for the child sign the consent form: The primary care physician cannot legally provide consent for an emergent surgical procedure unless they are acting as the attending surgeon with proper legal authority. This may delay care.
B. Delay medical care until the child's next of kin can be contacted: Delaying emergency surgery in a child with suspected appendicitis can lead to complications such as perforation, peritonitis, or sepsis. Immediate intervention takes priority over obtaining consent when parents are unreachable.
C. Document failed attempts to obtain consent to allow emergency care: In emergencies where life or health is at risk, care can proceed without parental consent under implied consent laws. Thorough documentation of attempts to reach the parents protects the healthcare team legally while allowing the child to receive timely, necessary care.
D. Have the babysitter sign the consent form even if she does not have signed papers to do so: A babysitter does not have legal authority to consent for surgery unless formally designated by a parent or legal guardian. Signing without proper authority could create legal and ethical issues.
Correct Answer is B
Explanation
A. Active immunity is produced when the immunoglobulins of one person are transferred to another: This describes passive immunity, not active immunity. Active immunity occurs when an individual’s own immune system is stimulated to produce antibodies and memory cells in response to an antigen or vaccine.
B. Passive immunity can be obtained by injection of exogenous immunoglobulins: Passive immunity involves the direct transfer of antibodies from another source, such as pooled immunoglobulin injections, maternal antibodies via placenta, or breast milk. It provides immediate but temporary protection without generating memory cells.
C. Active immunity can be transferred from mothers to infants via colostrum or the placenta: Maternal antibody transfer to the fetus or newborn is a form of passive immunity, as the infant receives ready-made antibodies rather than producing them independently.
D. Passive immunity is acquired when a person's own immune system generates the immune response: This describes active immunity, not passive. Passive immunity bypasses the individual’s immune system, providing immediate defense without stimulating long-term adaptive immunity.
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