A woman at 40 weeks gestation calls the labor unit to see whether or not she should go to the hospital to be evaluated.
Which of the following statements by the woman indicates that she is probably in labor and should proceed to the hospital?
The contractions are 5 to 20 minutes apart.
The contractions are regular, about a minute long and I am unable to talk through them.
I saw a pink discharge on the toilet tissue when I went to the bathroom.
I have had cramping for the past 4 hours.
The Correct Answer is B
Choice A rationale
Contractions spaced 5 to 20 minutes apart can indicate early labor, but regular and intense contractions closer together suggest active labor. This does not indicate imminent hospital visit.
Choice B rationale
Regular contractions lasting about a minute and causing inability to talk through them are strong indicators of active labor, suggesting the need for hospital evaluation.
Choice C rationale
Seeing a pink discharge (bloody show) indicates the cervix is starting to dilate but does not necessarily mean active labor is present. It's not the most immediate sign to proceed to hospital.
Choice D rationale
Cramping for 4 hours can be a sign of early labor, but it lacks the regularity and intensity of active labor contractions. This does not suggest an immediate need for hospital visit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Fetal sleep cycles cause temporary decreased variability in FHR, typically lasting 20 minutes or less. FHR baseline remains normal. Normal FHR variability is 6-25 bpm.
Choice B rationale
Head compression during contractions leads to early decelerations in FHR, not decreased variability. Early decelerations are a normal response to pressure on the fetal head.
Choice C rationale
Fetal hypoxemia causes decreased variability but usually persists for longer than 20 minutes. It indicates compromised oxygen supply, requiring immediate intervention.
Choice D rationale
Umbilical cord compression leads to variable decelerations in FHR rather than decreased variability. These decelerations vary in onset, duration, and intensity.
Correct Answer is D
Explanation
Choice A rationale
Valsalva maneuver involves forced expiration against a closed airway, increasing intrathoracic pressure and commonly used to expel the fetus during the second stage of labor.
Choice B rationale
Ferguson’s reflex involves the release of oxytocin due to vaginal and cervical stretching, leading to stronger contractions during the second stage of labor.
Choice C rationale
Lightening refers to the descent of the fetus into the pelvis before labor begins, reducing pressure on the diaphragm and making breathing easier.
Choice D rationale
Molding is the slight overlapping of cranial bones, allowing the fetal head to change shape and fit through the birth canal during labor.
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