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: In this scenario, the correct answer is D) Leg cramping. During the second trimester of pregnancy, leg cramping is a common symptom due to factors such as increased weight and pressure on the legs, changes in circulation, and mineral imbalances. Leg cramping can be especially prevalent in multigravid clients who have been pregnant before, as their body may react differently compared to first-time pregnancies. 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. Option B) Dyspnea (shortness of breath) is often experienced in the later stages of pregnancy as the growing uterus puts pressure on the diaphragm and lungs. While dyspnea can occur, it is not typically a prominent symptom at 22 weeks. Option C) Urinary frequency is common in early pregnancy due to hormonal changes and later in pregnancy due to the growing uterus pressing on the bladder. At 22 weeks, urinary frequency may have improved compared to the first trimester but can vary among individuals. Educationally, understanding the timing and common symptoms of pregnancy is crucial for nurses caring for pregnant clients. By recognizing the expected symptoms at different stages of pregnancy, nurses can provide appropriate education, support, and interventions to promote the well-being of both the mother and the baby.
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). Explanation of why Option B is correct: 1. Lateral-recumbent position: This position is preferred during pregnancy as it helps prevent supine hypotensive syndrome by reducing pressure on the vena cava. This position allows for optimal blood flow to the uterus and placenta, promoting maternal and fetal well-being. Explanation of why the other options are wrong: 1. Orthopneic position (Option A): This position is more commonly used for patients experiencing respiratory distress, not for routine prenatal examinations. 2. Sims' position (Option C): Sims' position is typically used for rectal examinations or procedures, not for prenatal examinations. 3. Semi-Fowler's position (Option D): This position is a semi-upright position with the head of the bed elevated. While it can be used for some examinations, the lateral-recumbent position is more appropriate for prenatal examinations to avoid pressure on the vena cava. Educational context: Understanding the importance of positioning during prenatal examinations is crucial for nurses and healthcare providers caring for pregnant clients. Proper positioning not only ensures the comfort of the client but also promotes optimal maternal and fetal health by facilitating adequate blood flow and reducing the risk of complications. By selecting the appropriate position, nurses can contribute to a positive pregnancy experience and ensure the well-being of both the mother and 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 increase indicates a normal physiological response to stress and potential infection during pregnancy, known as leukocytosis. It signals the body's defense mechanism gearing up to protect both the mother and the fetus during labor. Option A) Rise in hematocrit from 34% to 38% is unlikely during pregnancy as there is a normal physiological hemodilution due to increased plasma volume. Option C) Rise in potassium from 3.9 mEq/L to 5.2 mEq/L is concerning as it could indicate hyperkalemia, which is not a typical finding during pregnancy. Option D) Rise in sodium from 137 mEq/L to 150 mEq/L is also abnormal and could indicate hypernatremia, which is not a typical finding during pregnancy. Understanding these physiological changes is crucial in maternal monitoring to differentiate between normal adaptations and potential complications during pregnancy and labor. It helps healthcare providers make informed decisions to ensure the well-being of both the mother and the baby.
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: In this scenario, the correct answer is A) Stay out of any rooms that are being renovated. This advice is critical because renovation work in an older home may disturb lead-based paint or asbestos, both of which can pose serious health risks to the unborn child. Lead exposure can lead to developmental delays and cognitive impairments, while asbestos exposure is linked to respiratory issues and cancer. Option B) Drink water only from the hot water tap is incorrect because lead contamination is more common in hot water due to lead leaching from pipes. Option C) Refrain from entering the basement is incorrect as the concern lies more with the renovation process and potential exposure to harmful substances rather than the location itself. Option D) Climb the stairs only once per day is unrelated to the risks associated with living in an older home. Educationally, it is important for healthcare providers to understand the potential environmental hazards that pregnant women may be exposed to and to provide appropriate guidance to ensure the health and safety of both the mother and the unborn child. By recognizing the specific risks associated with older homes and renovations, nurses can play a crucial role in promoting a healthy pregnancy environment for their patients.
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 a woman has had, including the current one. Parity (P) refers to the number of pregnancies that have reached viability, regardless of the outcome. This woman has had 5 pregnancies (G5) - including the current one - and has given birth twice (P2), had 2 preterm births (P2), and had 1 first-trimester abortion (P1). This makes her parity 2-2-1-1. Option A (G4 P2121) is incorrect because it does not account for all of the woman's pregnancies. Option B (G4 P1212) is incorrect because it does not reflect the preterm birth history. Option C (G5 P1122) is incorrect because it does not include the first-trimester abortion. Understanding gravidity and parity is crucial in maternity care as it helps healthcare providers assess a woman's obstetric history, anticipate potential risks, and provide appropriate care during pregnancy and labor. It also aids in identifying patterns that may impact future pregnancies and deliveries.