With regard to primary and secondary powers, the maternity nurse should know that:
Primary powers are responsible for effacement and dilation of the cervix.
Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation.
Pushing in the second stage of labor is more effective if the woman can hold her breath to control some of her involuntary need to push, as the nurse directs.
Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnancies.
Correct Answer : A,C,D
Choice A rationale
Primary powers refer to the involuntary uterine contractions that occur during the first stage of labor. These contractions are responsible for two key processes: effacement, which is the shortening and thinning of the cervix, and dilation, which is the enlargement or widening of the cervical opening, preparing the birth canal.
Choice B rationale
Scarring of the cervix, known as cervical dystocia, is a significant complication that can severely impede or entirely prevent cervical dilation. The fibrotic tissue is less compliant and less responsive to the forces of uterine contractions, often leading to a protracted or arrested labor pattern, requiring intervention.
Choice C rationale
Pushing in the second stage of labor is optimally effective when it mimics the woman's natural urge to push, often described as the "ferguson reflex.”. Prolonged breath-holding (Valsalva maneuver) should be discouraged as it decreases maternal cardiac output and uterine-placental perfusion, potentially causing fetal distress.
Choice D rationale
In nulliparous (first-time pregnant) women, the cervix effaces (thins) completely before significant dilation begins. In multiparous women (subsequent pregnancies), effacement and dilation often occur concurrently, meaning they progress together throughout the first stage of labor, leading to faster total labor duration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Sleeping on the abdomen is contraindicated in later pregnancy as it is physically impossible due to the enlarged uterus and poses a risk of direct pressure on the fetus, which is detrimental to comfort and could potentially impede circulation if pressure were applied.
Choice B rationale
The side-lying position, especially the left side, optimizes uteroplacental perfusion by minimizing pressure from the gravid uterus on the vena cava, preventing supine hypotensive syndrome, and improving maternal cardiac output, which enhances fetal oxygenation and is the recommended sleeping position.
Choice C rationale
Lying on the back, even with knees slightly elevated, allows the heavy uterus to compress the inferior vena cava and aorta (supine hypotensive syndrome), significantly reducing venous return to the heart and decreasing blood flow and oxygen delivery to the fetus, which is not recommended.
Choice D rationale
Elevating the head on pillows primarily helps with maternal heartburn or shortness of breath but does not change the position of the uterus relative to the major blood vessels (aorta and vena cava) and therefore does not effectively address the risk of impaired fetal circulation seen in the supine position.
Correct Answer is C
Explanation
Choice A rationale
Neural tube defects, such as spina bifida or anencephaly, occur during primary neurulation, which is a process primarily completed in the very early embryonic period, specifically between 3 and 4 weeks of gestation. By 16 weeks, the neural tube is closed and this feature is past its most sensitive period for teratogenesis.
Choice B rationale
The most critical period for the development of the external ears is during the embryonic period, weeks 4 through 9 of gestation. While development continues, the major structural formation is complete before 16 weeks, making it less susceptible to major structural defects at this later gestational age.
Choice C rationale
The palate shelves fuse at approximately 10 to 12 weeks gestation, but the full consolidation and final development of the hard and soft palate structures continues. This structure remains sensitive to disruption and functional abnormalities, such as cleft palate, well into the late first and early second trimesters, around 16 weeks.
Choice D rationale
Major structural development of the heart, including septation and formation of the great vessels, is most sensitive to teratogens between weeks 3 and 8 of gestation. By 16 weeks, the heart structure is largely complete, and its vulnerability shifts from structural defects to primarily growth restriction or functional issues.
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.