Answer to Question 1
ANS: A
Women with SCI above the level of T6 may be able to deliver vaginally because the uterus may retain enough intrinsic motility to create effective contractions. The nurse manager should ask about the level of the SCI. The nurse should not assure the office nurse that vaginal delivery is possible without this information. A woman with an SCI probably would not do well in a water birth due to impaired mobility. The nurse should also not tell the office nurse that vaginal birth is impossible without further information.
Answer to Question 2
ANS: A
The uterus is supported by several ligaments. The round ligaments expand in diameter and length during pregnancy and may be associated with sharp pain if they are stretched tight during sudden movement, such as with sneezing, coughing, or position changes. The nurse should reassure the woman that this is not concerning and explain the phenomenon. There is no need for the woman to count contractions, be placed on bedrest, or come in to the clinic that day.