In which stage and phase of labor is the client who is at 7 cm of cervical dilation and 100% effacement, with the fetus at 1 station and intact amniotic membranes, and reporting the urge to push?

Second stage, active phase

First stage, active phase

First stage, latent phase

Second stage, latent phase

Answer and Explanation

The Correct Answer is B

A. Second stage, active phase – Incorrect; the second stage begins at 10 cm dilation, not 7 cm.
B. First stage, active phase – Correct; the active phase of the first stage occurs from 6-10 cm dilation and includes increased discomfort and pressure.
C. First stage, latent phase – Incorrect; the latent phase occurs 0-5 cm dilation, before active labor.
D. Second stage, latent phase – Incorrect; the second stage starts at 10 cm when pushing begins.

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Correct Answer is C

Explanation

A. Lightening – Correct; "lightening" occurs when the fetal head descends into the pelvis, reducing pressure on the diaphragm, making it easier to breathe.

B. Decreasing chest diameter – Incorrect; the chest diameter does not decrease; instead, the diaphragm moves upward due to uterine growth.

C. Decreased carbon dioxide production – Incorrect; CO₂ production remains stable during pregnancy.

D. Hyperventilation – Incorrect; while pregnancy increases respiratory effort, the client is experiencing relief, not hyperventilation.

A. Picture book about hospitals B. Toy hammer and pounding board C. Stuffed animal D. Set of building blocks

Correct Answer is C

Explanation

A. Picture book about hospitals – Incorrect; a picture book may help older children but is not as effective for a 2-year-old experiencing separation anxiety.

B. Toy hammer and pounding board – These toys can be good for physical activity, but they might not be calming during a stressful tantrum.

C. Stuffed animal – Correct; comfort objects help reduce anxiety and provide security in an unfamiliar environment.

D. Set of building blocks – Incorrect; blocks help with fine motor development but do not directly address stress relief as well as other options.

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In which stage and phase of labor is the client who is at 7 cm of cervical dilation and 100% effacement, with the fetus at 1 station and intact amniotic membranes, and reporting the urge to push?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a prenatal clinic is caring for a client who is at 12 weeks of gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A nurse is caring for a 2-year-old child who is hospitalized and throws a tantrum when his parent leaves. Which of the following toys should the nurse provide to alleviate the child's stress?

Correct Answer is C

Explanation

A nurse is caring for a client in labor. The nurse determines that the client is beginning in the second stage of labor when which of the following assessments is noted?

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A 34-year-old gravida 3, para 2 is experiencing severe back pain with each contraction. She is extremely uncomfortable and upset because she never had this type of pain with her other labors. What interventions are most likely to help in this situation?

Which of the following terms is used to describe the thinning and shortening of the cervix that occurs just before and during labor?