Answer to Question 1
ANS: C
During the more intense phases of labor, women may draw inward in an attempt to cope with the increasing demands of their labor. Also, there are cultural differences in the way people respond to silence and conversation. Because this woman appears to be concentrating on her own body and labor and not responding to the nurse, the preceptor should gently ask the new nurse to refrain from all but necessary communication. This shows respect for the work the woman is doing. It is also a good idea to let the new nurse know that this is probably not a personal rejection, but it is more important to respect the woman's need for quiet.
Answer to Question 2
ANS: B
Frequent position changes and walking are beneficial in helping to promote the descent of the fetus during labor. The nurse should encourage the woman to try several positions (squatting, leaning over a piece of furniture, hands and knees position) and walking to try to enhance the progression of her labor. The other actions are not warranted.