During delivery, the nurse notes the baby's head has just been delivered.
The nurse concludes that the baby has just gone through which of the following cardinal movements of labor?
Extension.
Expulsion.
Internal rotation.
Flexion.
The Correct Answer is A
Choice A rationale
The cardinal movement of extension occurs when the baby's head is delivered. After internal rotation, the fetus's head is in a posterior-facing position. The head must then "extend" as it passes under the pubic symphysis, allowing the nape of the neck to pivot and the face to emerge from the birth canal.
Choice B rationale
Expulsion is the final cardinal movement of labor. It occurs after the delivery of the baby's head. The anterior shoulder is delivered first, followed by the posterior shoulder, and then the rest of the baby's body is expelled from the birth canal.
Choice C rationale
Internal rotation is a cardinal movement that occurs earlier in the labor process. The fetal head, which is typically in a transverse position upon entering the pelvic inlet, rotates approximately 90 degrees to align with the anteroposterior diameter of the maternal pelvis, allowing it to descend further.
Choice D rationale
Flexion is a cardinal movement that occurs as the fetal head descends into the pelvis. The fetal chin tucks to the chest, presenting the smallest diameter of the head to the pelvic inlet. This movement is essential for a smooth descent through the birth canal.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While many inductions of labor are performed for medical reasons, such as preeclampsia or post-term pregnancy, not all are. Elective inductions, performed for non-medical reasons, are also common, although they are associated with certain risks. The decision to induce labor is a medical one, but the indication is not always strictly medical, making this statement inaccurate.
Choice B rationale
A trial of labor (TOL) is a term used specifically for patients who have had a prior cesarean section and are attempting a vaginal delivery. It is also known as a TOLAC (Trial of Labor After Cesarean). Induction of labor is a broader term and refers to stimulating contractions before the spontaneous onset of labor. The two terms are not synonymous.
Choice C rationale
Induction of labor is a process initiated by methods like oxytocin infusion or prostaglandin gels. Internal and external version are procedures used to change the fetal presentation (e.g., from breech to cephalic) and are not methods for initiating labor. These procedures may be followed by induction, but they are not the induction methods themselves.
Choice D rationale
The Bishop score is a scoring system used to predict the likelihood of a successful induction of labor. It assesses five components: cervical dilation, effacement, consistency, position, and fetal station. A higher Bishop score (typically 8 or greater) indicates a more favorable cervix and a greater chance of successful induction, making this a crucial assessment tool.
Correct Answer is D
Explanation
Choice A rationale
Ritodrine is a beta-mimetic tocolytic that can cause maternal and fetal tachycardia. Betamethasone does not reduce this side effect. The primary purpose of betamethasone is to enhance fetal lung maturity. Tachycardia from ritodrine is a known side effect that is managed by monitoring and dosage adjustment, not by administering corticosteroids.
Choice B rationale
The purpose of betamethasone is not to suppress uterine contractions. Betamethasone is a corticosteroid that enhances the production of surfactant in the fetal lungs. Tocolytic medications like nifedipine or magnesium sulfate are used to suppress uterine contractions in preterm labor, allowing time for the betamethasone to take effect.
Choice C rationale
Magnesium sulfate therapy can cause respiratory depression as a side effect. Betamethasone does not maintain maternal respiratory effort or ventilation during this treatment. Calcium gluconate is the antidote for magnesium toxicity. The role of betamethasone is specific to fetal lung maturity, not maternal respiratory support during magnesium sulfate administration.
Choice D rationale
Betamethasone is a corticosteroid that stimulates the production and release of surfactant in the fetal lungs. Surfactant is a substance that reduces surface tension in the alveoli, preventing them from collapsing and improving gas exchange. Administering this medication to the mother improves fetal lung maturity and reduces the risk of respiratory distress syndrome in preterm infants.
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