ATI RN
Maternal Monitoring During Labor Questions
Question 1 of 5
A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?
Correct Answer: D
Rationale: Rationale: The correct answer is D) Leg cramping. Leg cramping is a common symptom during pregnancy, especially in the second and third trimesters, due to factors like increased weight, pressure on blood vessels, and hormonal changes. This discomfort is often experienced by multigravid clients as their uterine ligaments and muscles have been stretched with previous pregnancies, leading to increased susceptibility to cramping. Option A) Nausea is more commonly associated with early pregnancy (first trimester) due to hormonal changes and is less likely to be a prominent symptom at 22 weeks gestation in a multigravid client. Option B) Dyspnea (shortness of breath) is a common symptom in late pregnancy when the uterus enlarges and presses on the diaphragm, but it is not typically a significant concern at 22 weeks unless there are other underlying health issues. Option C) Urinary frequency is common in early pregnancy due to hormonal changes and pressure on the bladder as the uterus grows, but it tends to improve in the second trimester as the uterus rises into the abdomen. Educational Context: Understanding the common symptoms experienced by pregnant clients at different stages is crucial for nurses providing care during pregnancy. Recognizing normal discomforts and differentiating them from potential complications is essential for effective maternal monitoring. Leg cramping, in this case, is a common discomfort that can be managed through strategies like hydration, gentle stretching, and proper positioning, highlighting the importance of holistic care for pregnant individuals.
Question 2 of 5
The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination.
Correct Answer: B
Rationale: In the context of maternal monitoring during labor, the correct position for a 31-week gestation client to lie on the examining table during a prenatal examination is the lateral-recumbent position (Option B). This position is suitable for pregnant women as it helps to relieve pressure on the vena cava, promoting better blood flow to the placenta and reducing the risk of supine hypotensive syndrome. Option A, Orthopneic position, is not suitable for a pregnant woman during a prenatal examination as it can cause discomfort and may not provide the needed support for the client's body. Option C, Sims' position, is used for rectal examinations and not appropriate for prenatal examinations. Option D, Semi-Fowler’s position, is commonly used for patients experiencing respiratory distress or for postoperative care but is not the ideal position for a prenatal examination in a 31-week gestation client. Educationally, it is essential for nurses and healthcare providers to understand the importance of positioning pregnant clients correctly during prenatal examinations to ensure the safety and well-being of both the mother and the fetus. By selecting the lateral-recumbent position, healthcare providers can optimize maternal comfort and circulation during the examination, ultimately contributing to better outcomes for both the mother and the baby.
Question 3 of 5
The blood of a pregnant client was initially assessed at 10 weeks’ gestation and reassessed at 38 weeks’ gestation.
Correct Answer: B
Rationale: In the context of maternal monitoring during labor, the correct answer is B) Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3. This change indicates an increase in white blood cells, which is a normal physiological response during pregnancy due to the body's preparation for potential postpartum hemorrhage. Option A) Rise in hematocrit from 34% to 38% is not a typical finding during pregnancy, as hematocrit levels tend to decrease slightly due to hemodilution. Option C) Rise in potassium from 3.9 mEq/L to 5.2 mEq/L could indicate a potential issue like renal dysfunction, but it is not a common finding solely related to pregnancy. Option D) Rise in sodium from 137 mEq/L to 150 mEq/L is not a typical change during pregnancy and could indicate dehydration or other underlying conditions. Educationally, understanding the normal physiological changes in laboratory values during pregnancy is crucial for healthcare providers caring for pregnant women. Monitoring these values helps in early detection of any abnormalities and ensures appropriate interventions are implemented promptly to safeguard the health of both the mother and the fetus.
Question 4 of 5
A gravid woman and her husband inform the nurse that they have just moved into a three-story home that was built in the 1930s. Which of the following is critical for the nurse to advise the woman to protect the unborn child?
Correct Answer: A
Rationale: The correct answer is A) Stay out of any rooms that are being renovated. This advice is critical because the woman and her unborn child could be exposed to potentially harmful substances during the renovation process, such as lead paint or asbestos, which were commonly used in homes built in the 1930s. These substances can pose serious health risks to the developing fetus. Option B) Drink water only from the hot water tap is incorrect because it does not address the specific risk associated with renovating an older home. Option C) Refrain from entering the basement is also incorrect as it does not specifically address the potential dangers of exposure to renovation materials. Option D) Climb the stairs only once per day is unrelated to the scenario presented and does not provide any protection from the hazards of renovation. In an educational context, it is essential for healthcare providers to counsel pregnant women on potential environmental hazards that could impact their health and the health of their unborn child. This scenario highlights the importance of being aware of the risks associated with living in older homes and undergoing renovations during pregnancy to ensure the safety and well-being of both the mother and the baby.
Question 5 of 5
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
Correct Answer: D
Rationale: In this case, the correct answer is D) G5 P2211. Gravidity (G) refers to the total number of pregnancies, including the current one, regardless of the outcome. Parity (P) indicates the number of pregnancies that have reached viability (over 20 weeks) regardless of the outcome. In this scenario, the woman had a total of 5 pregnancies (G5) - including the current one. She has had 2 full-term deliveries (P2), 2 preterm births (before 37 weeks), 1 miscarriage (pregnancy loss before 20 weeks), and 1 first-trimester abortion. Option A (G4 P2121) is incorrect because it does not account for all of the woman's pregnancies and their outcomes accurately. Option B (G4 P1212) is incorrect as it misrepresents the number of preterm births and miscarriages. Option C (G5 P1122) is incorrect because it inaccurately reflects the number of preterm deliveries and miscarriages. Understanding gravidity and parity is crucial in maternal monitoring during labor as it provides essential information about a woman's obstetrical history, which can influence current pregnancy management and care decisions. By correctly interpreting these terms, healthcare providers can offer more personalized and effective care to pregnant individuals.