Answer to Question 1
1,3,4,5
Rationale 1: Attitude refers to the relationship of the fetal parts to one another. Military attitude is an unflexed neck; normal fetal attitude is flexion of the neck. Military attitude creates a larger head diameter fitting through the pelvis. This patient is experiencing a problem between the maternal pelvis and the presenting part.
Rationale 2: Lie refers to the relationship between the cephalocaudal axis of the mother and the cephalocaudal axis of the fetal body; longitudinal lie is normal.
Rationale 3: Hydrocephalus can lead to macrocephaly, or an abnormally large head. Macrocephalic babies might not fit through the bony pelvis, and could require birth by cesarean. This patient is experiencing a problem between the maternal pelvis and the presenting part.
Rationale 4: Station refers to how low in the pelvis the baby's presenting part is; -2 station is high in the pelvis. Contractions should be strong to cause fetal descent and cervical dilation. Mild contractions will not move the baby down or open the cervix. This patient is experiencing a problem between the maternal pelvis and the presenting part.
Rationale 5: The presenting part is the fetal part coming through the cervix. The occiput or back of the baby's head is the most common and most effective presenting part. A shoulder presentation cannot deliver vaginally, and will require a cesarean birth. This patient is experiencing a problem between the maternal pelvis and the presenting part.
Answer to Question 2
4
Rationale 1: This is a true statement. Parents might believe there is something wrong if they are not taught about pseudomenstruation.
Rationale 2: This is a true statement, and is often a concern of parents.
Rationale 3: Most pediatrician offices, HMOs, hospitals, and physician groups have a nurse line staffed 24 hours a day, 7 days a week, to respond to parents' questions and concerns. When this service exists, parents should be made aware of it and provided with the phone number.
Rationale 4: Each model of car seat is installed differently in different makes of car. Directions for car seats should be followed carefully. Car dealerships often offer a car seat-installation instruction service. Using a car seat that is installed incorrectly can be more dangerous than not using a car seat at all.