The nurse is teaching a pregnant patient about true labor contractions.
The nurse evaluates that the patient understands the explanation when which statement is made?
"True labor contractions will subside when I walk around.”.
"True labor contractions continue and get stronger even if I relax and take a shower.”.
"True labor contractions remain irregular but become stronger.”.
"True labor contractions cause discomfort only at the top of my uterus.”.
The Correct Answer is B
Choice A rationale
True labor contractions are characterized by their persistence and increasing intensity, unlike Braxton Hicks or false labor contractions which often subside with ambulation or a change in activity. This is due to the sustained release of oxytocin and prostaglandins, which stimulate continuous uterine muscle activity, leading to cervical change.
Choice B rationale
A key differentiator of true labor contractions is that they do not diminish with comfort measures like relaxation or taking a shower. These contractions are caused by physiological changes at the myometrial cellular level that are not easily influenced by external stimuli, and their progressive nature is essential for cervical effacement and dilation.
Choice C rationale
True labor contractions follow a predictable pattern, becoming regular in frequency, duration, and intensity over time. This is in contrast to false labor contractions, which remain irregular. The increasing regularity is a result of the synchronized rhythmic firing of myometrial cells as the labor process advances.
Choice D rationale
True labor contractions typically originate in the back and radiate to the lower abdomen, often described as a cramping or tightening sensation that encompasses the entire uterus. Discomfort localized only to the top of the uterus is more characteristic of Braxton Hicks contractions, which do not contribute to cervical change.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
General anesthesia, particularly with halogenated inhalational agents, can cause uterine atony. These agents act as uterine smooth muscle relaxants, which can prevent the uterus from contracting effectively after birth. A relaxed, or atonic, uterus is the most common cause of postpartum hemorrhage because it cannot compress the blood vessels at the placental site, leading to uncontrolled bleeding.
Choice B rationale
A pudendal block provides anesthesia to the perineum, vulva, and lower vagina by injecting an anesthetic into the pudendal nerves near the ischial spines. It does not affect the uterine muscle or its contractility. Therefore, a pudendal block would not contribute to uterine atony or increase the risk of postpartum hemorrhage from a relaxed uterus.
Choice C rationale
An epidural provides regional anesthesia by blocking nerve impulses in the lower spinal segments. While high concentrations of anesthetic agents can have a mild effect on uterine contractility, modern low-dose epidurals typically do not significantly impair uterine muscle tone. The risk of postpartum hemorrhage from uterine atony is not as high with epidural anesthesia as it is with general anesthesia.
Choice D rationale
Local anesthesia, such as a perineal infiltration for an episiotomy or repair, involves injecting an anesthetic directly into the tissues of the perineum. This localized effect does not circulate systemically in a way that would relax the uterine smooth muscle. Therefore, local anesthesia would not contribute to a relaxed uterus or postpartum hemorrhage.
Correct Answer is C
Explanation
Step 1 is: Identify the start and end of the first stage of labor. The first stage begins with the onset of regular uterine contractions and ends with full cervical dilation (10 cm) and effacement (100%). The patient's contractions started at 3 a.m., and she arrived at the hospital at 8: a.m. with 5 cm dilation. She delivered at 3: p.m. but her labor progression is noted up to 2 p.m. with an overwhelming need to push which indicates she was likely in the second stage of labor.
Step 2 is: The first stage of labor is from 3 a.m. (onset of regular contractions) to the overwhelming need to push at 2 p.m., which indicates the end of the first stage and the beginning of the second stage.
Step 3 is: Calculate the duration. From 3 a.m. to 2 p.m. is 11 hours. The final calculated answer is 11 hours.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.