The patient has delivered a 4,200g fetus. The physician performed a midline episiotomy, which extended into a third-degree laceration. The patient asks the nurse where she tore. Which response is best? "The episiotomy extended and tore:
1. "Through your rectal mucosa."
2. "Up near your urethra."
3. "Into the muscle layer."
4. "Through your rectal sphincter."
Correct Answer: 4
Rationale 1: A fourth-degree laceration is through the rectal mucosa.
Rationale 2: A periurethral laceration is near the urethra.
Rationale 3: A first-degree laceration involves only the skin. A second-degree laceration involves skin and muscle.
Rationale 4: A third-degree laceration includes the rectal sphincter.
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