ATI RN
Advanced Maternal Age Monitoring Questions
Question 1 of 5
A nurse is preparing to administer a postpartum tetanus shot. What is the most important action before administering the shot?
Correct Answer: C
Rationale: Rationale: C is correct because assessing for uterine atony is crucial before administering a postpartum tetanus shot to ensure no postpartum hemorrhage risk. Uterine atony can lead to excessive bleeding, which can be exacerbated by the tetanus shot. Summary: A - Verifying immunization status is important but not the most immediate action. B - Assessing blood pressure is important but not directly related to the risk of postpartum hemorrhage. D - Preparing for a cesarean section is not necessary for administering a postpartum tetanus shot.
Question 2 of 5
A nurse is preparing a laboring person for an epidural. What is the most important nursing action prior to the procedure?
Correct Answer: C
Rationale: The correct answer is C: ensure informed consent is obtained. Prior to any medical procedure, including epidural administration, it is crucial to obtain informed consent from the patient. This involves explaining the procedure, risks, benefits, and alternatives to the patient, ensuring they understand and voluntarily agree to the procedure. Without informed consent, the procedure cannot proceed ethically. Choice A (ensure the birthing person is in a sitting position) is not the most important action as the position can be adjusted during the procedure. Choice B (check for allergies to anesthesia) is important but obtaining informed consent takes precedence. Choice D (administer IV fluids) is not a priority before obtaining informed consent.
Question 3 of 5
A nurse is assisting with a vaginal delivery. What is the most important action to take when the fetal head crowns?
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of perineal tearing and ensuring a controlled birth. Applying too much pressure can cause trauma to the mother and baby. Incorrect choices: B is premature, as shoulder delivery should only be done after the head and shoulders are delivered. C is not the most important action at crowning. D is not necessary at this specific stage of delivery.
Question 4 of 5
A nurse is assisting a laboring person with an epidural. What is the most important nursing intervention prior to the procedure?
Correct Answer: B
Rationale: The correct answer is B: Ensure informed consent. This is crucial before any medical procedure, including epidural administration. It ensures the laboring person understands the risks, benefits, and alternatives of the epidural. Proper positioning (choice A) is important during the procedure but not the most critical pre-procedure intervention. Monitoring contractions (choice C) and assisting with breathing (choice D) are important aspects of labor support but not directly related to obtaining informed consent for the epidural.
Question 5 of 5
A nurse is caring for a laboring person who is experiencing fetal tachycardia. What is the priority intervention?
Correct Answer: A
Rationale: The correct answer is A: administer oxygen. Fetal tachycardia indicates decreased oxygen supply to the fetus. Administering oxygen helps improve oxygenation to the fetus, addressing the root cause. Monitoring fetal heart rate (B) is important but not the priority over addressing the oxygen supply. Increasing fluid intake (C) does not directly address the fetal tachycardia. Increasing oxygen flow (D) is not necessary if the person is already receiving sufficient oxygen.