ATI RN
labor and delivery nclex questions Questions
Question 1 of 5
A fetus is in the occiput anterior position. During the cardinal movement of extension, which events are occurring? Select all that apply.
Correct Answer: A
Rationale: In the cardinal movement of extension during labor and delivery, the correct answer is option A: The fetal head lines up with the pelvic outlet. This is because during this stage, the fetal head descends and rotates to align with the mother's pelvic anatomy, specifically with the pelvic outlet, to facilitate delivery. This alignment is crucial for the safe passage of the baby through the birth canal. Option B, "The occiput passes under the symphysis pubis," is incorrect because this event typically occurs during the descent phase when the head is crowning and about to be delivered, not during the cardinal movement of extension. Option C, "The fetal head is engaged," is also incorrect as engagement refers to the stage when the largest transverse diameter of the presenting part reaches the level of the maternal ischial spines. This typically occurs before labor begins. Option D, "The head is delivered," is incorrect as the cardinal movement of extension occurs before the actual delivery of the baby's head. Understanding the sequence of events during labor and delivery is essential for healthcare providers, especially those involved in obstetric care, to monitor the progress of labor, assess fetal well-being, and intervene appropriately if complications arise.
Question 2 of 5
Which is the best explanation for the use of hydration and relaxation in the treatment of hypertonic labor?
Correct Answer: A
Rationale: Hydration helps to dilute endogenous oxytocin, which can reduce uterine contractions and relax the uterus. Hypertonic labor involves excessive uterine contractions, and hydration can counteract this by regulating contractions and improving perfusion, which ultimately aids in a more coordinated and effective labor progression.
Question 3 of 5
The nurse is caring for a patient during induction of labor. The oxytocin is currently infusing at 6 mU/min. The fetal heart tracing displays a 130 baseline, moderate variability, and no accelerations or decelerations. Uterine contractions have been every 2 minutes for the last 30 minutes. What is the nurse’s next best action?
Correct Answer: C
Rationale: The correct answer is C) Maintain infusion at 6 mU/min. In this scenario, the fetal heart tracing shows a baseline of 130, moderate variability, and no accelerations or decelerations, indicating reassuring fetal status. Additionally, uterine contractions every 2 minutes for the last 30 minutes suggest effective labor progress. Maintaining the oxytocin infusion at 6 mU/min is the best action because there are currently no signs of fetal distress or hyperstimulation. Increasing the dose (option A) could lead to uterine hyperstimulation, compromising fetal oxygenation. Delaying the next increase (option B) may not be necessary since the current status is reassuring. Discontinuing the oxytocin infusion (option D) could halt labor progress, which is not indicated in this situation. Educationally, this scenario highlights the importance of assessing fetal well-being through continuous monitoring, understanding appropriate oxytocin dosing, and recognizing signs of uterine hyperstimulation. It emphasizes the nurse's critical role in optimizing maternal and fetal outcomes during labor induction.
Question 4 of 5
Cephalohematoma occurring from an operative vaginal delivery increased a newborn’s risk of developing which of the following complications?
Correct Answer: C
Rationale: Cephalohematomas are a common complication from operative vaginal deliveries. The accumulation of blood between the infant's skull and periosteum increases the risk of jaundice because of the breakdown of red blood cells, which can overwhelm the infant's immature liver and lead to hyperbilirubinemia.
Question 5 of 5
While attending the delivery of a patient with GODM, the nurse notices the retraction of the fetal head onto the perineum. What is the nurse’s next best action?
Correct Answer: D
Rationale: The retraction of the fetal head onto the perineum during labor can be indicative of shoulder dystocia or other obstructive complications, requiring immediate action. The best response is to assist the mother into hands-and-knees position, which can relieve pressure on the perineum and help with fetal descent.