ATI RN
External Maternal Monitoring Questions
Question 1 of 5
A 40-week pregnant woman is admitted to the labor and delivery unit and is in active labor. Her cervix is 8 cm dilated, and she is experiencing strong contractions. What is the next priority action?
Correct Answer: C
Rationale: The correct answer is C: Assess the fetal heart rate. This is the next priority action because monitoring the fetal heart rate is crucial to ensure the well-being of the baby during labor. It helps in identifying any signs of fetal distress and guides the healthcare provider in making timely interventions to prevent complications. Administering an epidural block (choice A) can be considered later once the fetal well-being is ensured. Performing a vaginal examination (choice B) may not be necessary at this moment as the woman is already in active labor and has progressed to 8 cm dilation. Preparing for delivery (choice D) should only be done after assessing the fetal well-being to ensure a safe delivery.
Question 2 of 5
A patient in labor is requesting an epidural but has a history of a previous back surgery. What is the most important assessment before proceeding with the epidural?
Correct Answer: C
Rationale: The correct answer is C: Perform a vaginal exam to assess for fetal position. This is important because the position of the fetus can affect the safety and efficacy of administering an epidural in a patient with a history of back surgery. If the fetus is in a breech position or in any other position that could complicate the epidural placement, alternative pain management options may need to be considered. A: History of spinal surgery or deformity is important but assessing the fetal position takes precedence in this scenario. B: Fetal heart rate monitoring is essential during labor but not the most important assessment before proceeding with the epidural in this case. D: Administering Pitocin is unrelated to the assessment needed before proceeding with the epidural.
Question 3 of 5
The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different?
Correct Answer: D
Rationale: 1. The correct answer is D: Hospital support for breastfeeding. This is the most different trend compared to the early 1980s. 2. In the past, breastfeeding support in hospitals was minimal, but now it is a standard practice to provide education and assistance. 3. Fetal monitoring throughout labor (A) has been a common practice for many years and is not a recent trend. 4. Postpartum stay of 10 days (B) is excessive; postpartum stays have actually become shorter over time. 5. Having expectant partners and family in the operating room for cesarean birth (C) is a more recent practice but has become increasingly common in recent years.
Question 4 of 5
The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following?
Correct Answer: A
Rationale: The correct answer is A: "My child may be at increased risk for birth injury." This is correct because a pregnant patient with a BMI of 33 is considered obese, which can increase the risk of birth injury to the baby due to complications such as macrosomia (large birth weight). Explanation: 1. Obesity in pregnancy can lead to complications such as macrosomia, shoulder dystocia, and birth trauma. 2. Higher BMI can also increase the risk of cesarean delivery, which may be necessary to prevent birth injuries. 3. Childhood diabetes risk is not decreased with maternal obesity. 4. Mode of delivery (vaginal or cesarean) is not solely determined by BMI. 5. Gestational hypertension risk is actually higher in women with obesity. In summary, choice A is correct because it directly relates to the increased risk of birth injury associated with maternal obesity, while the other choices are not directly linked to the patient's BMI and pregnancy complications.
Question 5 of 5
The nurse is counseling a pregnant patient who is concerned about gestational diabetes. The patient has a family history of diabetes and is overweight. Which statement by the nurse would be most appropriate?
Correct Answer: B
Rationale: The correct answer is B because gestational diabetes can indeed cause excessive birth weight, leading to delivery complications such as shoulder dystocia and cesarean section. This is important for the patient to be aware of to ensure the health and safety of both herself and her baby. Choice A is incorrect because gestational diabetes can persist after delivery and may increase the risk of developing type 2 diabetes later in life for both the mother and the baby. Choice C is incorrect because pregnant women with gestational diabetes still need carbohydrates for proper nutrition; however, they should monitor their carbohydrate intake and choose complex carbohydrates to manage blood sugar levels. Choice D is incorrect because having gestational diabetes does increase the risk of developing type 2 diabetes later in life. It is important for the patient to understand this potential risk and take steps to manage their health accordingly.