The laboring client asks the nurse how the labor contractions ...

[Frost2351]

The laboring client asks the nurse how the labor contractions work to dilate the cervix. The best response by the nurse is that labor contractions facilitate cervical dilation by:
 
  a. promoting blood flow to the cervix.
  b. contracting the lower uterine segment.
  c. enlarging the internal size of the uterus.
  d. pulling the cervix over the fetus and amniotic sac.

Question 2

The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?
 
  a. Strong evidence from unbiased observational studies
  b. Evidence from randomized clinical trials showed inconsistent results
  c. Consistent evidence from well-performed randomized clinical trials
  d. Evidence for at least one critical outcome from randomized clinical trials had serious flaws

[kxciann]

Answer to Question 1

ANS: D
Effective uterine contractions pull the cervix upward at the same time the fetus and amniotic sac are pushed downward. Blood flow decreases to the uterus during a contraction. The contractions are stronger at the fundus. The internal size becomes smaller with the contractions; this helps push the fetus down.

Answer to Question 2

ANS: B
Evidence from randomized clinical trials with important limitations indicates that the evidence is of moderate quality. Strong evidence from unbiased observational studies and consistent evidence from well-performed randomized clinical trials indicates high quality. Evidence for at least one critical outcome from randomized clinical trials that has serious flaws indicates low quality.