Chapter 33

The first stage of labor ends when:

• the presenting part of the baby is visible

• contractions are less than 10 minutes apart

• the mother experiences her first contraction

• the amniotic sac ruptures and labor pains begin

A 23-year-old woman, who is 24 weeks pregnant with her first baby, complains of edema to her hands, a headache, and visual disturbances. When you assess her vital signs, you note that her blood pressure is 160/94 mm Hg. She is MOST likely experiencing:

• eclampsia

• preeclampsia

• a hypertensive crisis

• chronic water retention

You are transporting a woman who is

8 months pregnant. To prevent supine hypotensive syndrome, how should you position this patient?

• On her right side

• Supine

• Semi-Fowler’s

• On her left side

Immediately after delivery of the infant’s head, you should:

• suction the baby’s mouth and then nose

• suction the baby’s nose and then mouth

• assess the baby’s breathing effort and skin color

• check the position of the umbilical cord

Upon delivery of the baby’s head, you note that the umbilical cord is wrapped around its neck. You should:

• immediately clamp and cut the cord

• make one attempt to slide the cord over the head

• keep the cord moist and transport as soon as possible

• give the mother high-flow oxygen and transport rapidly

The need for and extent of newborn resuscitation is based on:

• the 1-minute Apgar score

• the gestational age of the newborn

• the newborn’s response to oxygen

• respiratory effort, heart rate, and color

The 1-minute Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min, a pink body but blue hands and feet, and rapid respirations. The baby cries when the soles of its feet are flicked and resists attempts to straighten its legs. You should assign an Apgar score of:

• 4

• 6

• 8

• 9

The MOST effective way to prevent cardiopulmonary arrest in a newborn is to:

• rapidly increase its body temperature

• allow it to remain slightly hypothermic

• ensure adequate oxygenation and ventilation

• start CPR if the heart rate is less than 100 beats/min

While assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. She tells you that she feels the urge to push. You should:

• cover the arm with a sterile towel and transport immediately

• encourage her to keep pushing as you prepare for rapid transport

• insert your gloved fingers into the vagina and try to turn the baby

• instruct the mother to keep pushing and give her high-flow oxygen

A newborn is considered to be “term” if it is born after ____ weeks and before ____ weeks.

• 34, 37

• 37, 42

• 38, 44

• 39, 43