A prenatal patient asks the nurse how the baby can possibly come ...

[abern]

A prenatal patient asks the nurse how the baby can possibly come out through her vagina, because a vagina is not nearly as big as a baby. How does the nurse best answer this patient's question? The vagina:
 
  1. Usually tears as it stretches during childbirth..
  2. Is designed to allow a baby come through..
  3. Changes due to pregnancy hormones, and stretches more..
  4. Dilates and effaces in labor so the baby can get out..

Question 2

The nurse is completing the gestational age assessment on a newborn while in the mother's postpartum room. During the assessment, the mother asks what aspects of the baby are being checked. The nurse's best response is:
 
  1. I'm checking to make sure the baby has all of its parts.
  2. This assessment looks at both physical aspects and the nervous system.
  3. This assessment checks the baby's brain and nerve function.
  4. Don't worry. We perform this check on all the babies.

[jesse.fleming]

Answer to Question 1

3
Rationale 1: Vaginal tears are not routine in childbirth. The vagina stretches during childbirth because of hormonal changes, creating deeper rugae.
Rationale 2: Although this is a true statement, it is not the best, most thorough response.
Rationale 3: The hormones of pregnancy create deeper rugae of the vagina to facilitate stretching during birth.
Rationale 4: The cervix, not the vagina, dilates and effaces.

Answer to Question 2

2
Rationale 1: The assessment immediately after birth assesses for grossly intact physiology (such as presence of the anus, location of the urethra, number of cord vessels, gender of genitalia, etc.).
Rationale 2: The gestational age assessment evaluates both external physical characteristics and neurologic or neuromuscular development.
Rationale 3: The gestational age assessment evaluates both external physical characteristics and neurologic or neuromuscular development.
Rationale 4: Nurses must always use therapeutic communication, and giving a don't worry answer dismisses the patient's question or concern.