ATI RN
Maternal Fetal Monitoring Questions
Question 1 of 9
A client makes the following statement after finding out that her pregnancy test is positive, 'This is not a good time. I am in college and the baby will be due during final exams!' Which of the following responses by the nurse would be most appropriate at this time?
Correct Answer: C
Rationale: Acknowledging the client's feelings of being overwhelmed is the most supportive response. Offering solutions or reassurance without first addressing the client's emotions may not be as effective.
Question 2 of 9
Which factors should be considered a contraindication for transcervical chorionic villus sampling?
Correct Answer: D
Rationale: Maternal infection, such as group B Streptococcus, is a contraindication for the procedure due to the risk of infection.
Question 3 of 9
A nurse is assisting with a vaginal birth. What is the most appropriate nursing action when the head crowns during delivery?
Correct Answer: A
Rationale: The correct answer is A: apply gentle pressure to the fetal head. This action helps prevent rapid delivery, reducing the risk of perineal tearing and promoting controlled delivery of the baby. Applying pressure also helps prevent the baby from being born too quickly, reducing the risk of umbilical cord compression and potential birth injuries. Choices B, C, and D are incorrect because at the moment the head crowns, the priority is to assist with the controlled delivery of the baby's head. Delivering the placenta (B) and assisting with shoulder delivery (C) are steps that come after the baby's head is delivered. Applying pressure to the perineum (D) is not recommended as it may increase the risk of perineal tearing.
Question 4 of 9
The nurse is teaching a pregnant patient about the importance of folic acid. Which statement by the patient indicates that the teaching has been effective?
Correct Answer: A
Rationale: Step 1: Folic acid is crucial for neural tube development in the fetus. Step 2: Spinal cord defects are a type of neural tube defect. Step 3: Statement A directly links folic acid to preventing spinal cord defects. Therefore, choice A is correct as it demonstrates an understanding of the specific benefit of folic acid during pregnancy. Choices B, C, and D are incorrect as they do not accurately reflect the primary role of folic acid in pregnancy.
Question 5 of 9
A woman who has had multiple cesarean sections is in labor. What is the most important complication to monitor for?
Correct Answer: A
Rationale: Correct Answer: A: Uterine rupture Rationale: 1. History of multiple cesarean sections increases the risk of uterine rupture. 2. Uterine rupture is a life-threatening complication for both mother and baby. 3. Signs include sudden severe abdominal pain, fetal distress, and hemodynamic instability. 4. Immediate intervention is crucial to prevent adverse outcomes. Summary: B: Precipitous labor - Quick labor is not specifically associated with multiple cesarean sections. C: Maternal hypotension - Important but not the most critical complication in this scenario. D: Fetal malpresentation - While important, it is not the most immediate concern compared to uterine rupture.
Question 6 of 9
What is the primary purpose of performing an episiotomy during delivery?
Correct Answer: A
Rationale: The primary purpose of performing an episiotomy during delivery is to reduce the risk of perineal trauma. Episiotomy is a surgical incision made in the perineum to widen the vaginal opening during childbirth, which can help prevent severe tearing of the perineal tissue. This procedure is performed to provide controlled and precise incision, reducing the likelihood of extensive tears that may lead to complications such as infection or prolonged healing time. It is not done to promote faster delivery, facilitate fetal descent, or provide immediate fetal oxygenation. These choices do not accurately reflect the main goal of episiotomy, which is to minimize perineal trauma.
Question 7 of 9
A pregnant patient is 32 weeks gestation and reports having trouble sleeping. Which of the following interventions should the nurse recommend?
Correct Answer: C
Rationale: The correct answer is C: Sleep with several pillows to elevate the upper body. Elevating the upper body with pillows can help relieve discomfort from heartburn, shortness of breath, and back pain commonly experienced during pregnancy. This position promotes better circulation and reduces pressure on the uterus. Incorrect choices: A: Taking a warm bath may help relax but does not address the underlying sleep issues. B: Sleeping on the back can compress major blood vessels, leading to decreased blood flow to the fetus. D: Taking sedatives is not recommended during pregnancy due to potential risks to the fetus.
Question 8 of 9
A nurse is caring for a postpartum person during the fourth stage of labor. The nurse is assessing uterine involution to ensure that the uterus is returning to its prepregnancy size and position. Which finding is indicative of normal uterine involution during this stage?
Correct Answer: B
Rationale: The correct answer is B because during the fourth stage of labor, the uterine fundus should be firm and at the level of the umbilicus. This indicates proper involution as the uterus is contracting and reducing in size. Choice A is incorrect as the uterus should not be palpable at the level of the umbilicus during normal involution. Choice C is incorrect as the uterus should not be displaced to the right side of the abdomen. Choice D is incorrect as the uterus should not be above the level of the umbilicus, as this would suggest inadequate involution.
Question 9 of 9
A nurse is assessing a pregnant patient at 18 weeks gestation who complains of feeling lightheaded when standing. What should the nurse advise the patient to do?
Correct Answer: D
Rationale: The correct answer is D because changing positions slowly helps prevent a sudden drop in blood pressure, which can cause lightheadedness. Sitting down immediately if feeling faint promotes safety and prevents falls. Taking deep breaths and lying flat on the back (choice A) can exacerbate lightheadedness by reducing blood flow to the brain. Increasing fluid intake and avoiding prolonged standing (choice B) may help with other issues but may not directly address the lightheadedness. Taking frequent rests while sitting upright (choice C) does not address the issue of changing positions slowly to prevent lightheadedness.