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
Polyhydramnios, an excessive amount of amniotic fluid, is associated with an increased risk of premature rupture of membranes and umbilical cord prolapse. While it can cause uterine overdistention, leading to hypotonic dysfunction, it is not a primary risk factor for uterine rupture. The excess fluid does not directly weaken the uterine wall.
Choice B rationale
Gestational diabetes can lead to macrosomia, a fetus with a birth weight greater than 4.0 kg. While a large fetus can cause a difficult delivery and increase the risk for shoulder dystocia, the primary risk for uterine rupture is related to a scarred uterus from a previous cesarean section, not fetal size alone.
Choice C rationale
Hypotonic uterine dysfunction is characterized by weak, infrequent, or ineffective contractions during active labor. The uterine muscle is not contracting with sufficient force to cause cervical change. This condition primarily prolongs labor but does not increase the risk of uterine rupture, as the uterine wall is not under excessive strain.
Choice D rationale
Uterine rupture is a serious complication, and the risk is significantly elevated with oxytocin induction, especially in patients with a history of a previous cesarean section. Oxytocin stimulates powerful uterine contractions, and if the dose is not carefully titrated, it can overstimulate the uterus, potentially causing the old scar to tear under the intense pressure.
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.
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