ATI RN
labor and delivery nclex questions Questions
Question 1 of 5
A patient asks the nurse how she can tell if labor is real. Which information should the nurse provide to this patient? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A) In true labor, the cervix begins to dilate. This is because cervical dilation is a definitive sign of true labor progression. As labor advances, the cervix effaces (thins out) and dilates (opens up) to allow for the passage of the baby through the birth canal. This physical change in the cervix is a clear indicator that labor is indeed real. Option B) is incorrect because contractions felt in the abdomen and groin can occur in both true and false labor. Option C) is incorrect because although contractions in true labor can sometimes feel like menstrual cramps, this is not a definitive indicator. Option D) is incorrect because contractions in true labor should become more regular, longer, and stronger over time, rather than being inconsistent in frequency, duration, and intensity. Educationally, it is crucial for nurses to educate expectant mothers about the signs of true labor to help them differentiate between true and false labor. Understanding these signs can prevent unnecessary hospital visits and ease anxiety about the onset of labor. By explaining the physiological processes involved in labor, nurses empower patients to make informed decisions about when to seek medical attention.
Question 2 of 5
The onset of labor is multifactorial. These reasons include which of the following? Select all that apply.
Correct Answer: B
Rationale: In the context of labor and delivery, the correct answer is B) Increase in estrogen. Estrogen plays a crucial role in initiating labor by stimulating uterine contractions. As pregnancy progresses, estrogen levels rise, leading to an increase in uterine sensitivity to oxytocin and the development of oxytocin receptors. This hormone also contributes to cervical ripening and the softening of the cervix in preparation for childbirth. Option A) Increase in progesterone is incorrect because progesterone levels actually decrease as labor approaches. Progesterone maintains the uterine quiescence during pregnancy, and its decline allows for the onset of labor. Option C) Increase in human chorionic gonadotropin (hCG) is not directly involved in initiating labor. hCG is primarily responsible for supporting the corpus luteum in early pregnancy and stimulating the production of progesterone. Option D) Aging of placenta is not a factor in the onset of labor. While placental aging can impact fetal well-being, it does not directly trigger the initiation of labor. Understanding the hormonal changes that occur during pregnancy and their impact on the onset of labor is crucial for healthcare providers involved in maternity care. By recognizing the role of estrogen in labor initiation, practitioners can better support and manage the labor process for expectant mothers.
Question 3 of 5
Which female pelvis is most suitable for vaginal delivery?
Correct Answer: A
Rationale: In the context of pharmacology, understanding the anatomical considerations for vaginal delivery is crucial for healthcare professionals. The gynecoid pelvis is the most suitable for vaginal delivery due to its round shape, wide diameter, and adequate space for the passage of the baby's head. This type of pelvis is commonly found in the majority of women and is associated with successful and uncomplicated deliveries. The android pelvis (Option B) is more heart-shaped and narrower, making it less suitable for vaginal delivery as it may lead to obstructed labor. The platypelloid pelvis (Option C) is flat and wide, which can also present challenges during delivery. The anthropoid pelvis (Option D) is elongated with a narrow pubic arch, which may require more effort during labor. Educationally, this question highlights the importance of understanding pelvic anatomy in relation to childbirth outcomes. Healthcare providers need to recognize the variations in pelvic shapes and their impact on the labor process to provide optimal care for mothers and babies. By knowing the characteristics of each type of pelvis, healthcare professionals can anticipate potential challenges and intervene appropriately to ensure safe and successful vaginal deliveries.
Question 4 of 5
The nurse has just performed a sterile vaginal examination on her patient and reports the examination as 4 cm, 50%, –1. What does this represent?
Correct Answer: D
Rationale: The correct answer is D) Dilation, effacement, and station. In labor and delivery, these three components are crucial assessments to monitor the progress of labor and the descent of the fetus through the birth canal. Dilation refers to the opening of the cervix measured in centimeters, effacement is the thinning of the cervix expressed in percentage, and station indicates the position of the presenting part of the fetus in relation to the ischial spines of the pelvis. Option A) Effacement, station, and dilation is incorrect as the order of the components is reversed. Option B) Dilation, station, and fetal lie is incorrect because fetal lie is not typically included in the assessment of vaginal examinations in labor. Option C) Dilation, effacement, and status of membranes is incorrect as it does not include the station, which is an essential aspect of assessing the descent of the fetus. Understanding these components is crucial for nurses and healthcare providers in labor and delivery settings to accurately assess the progress of labor, determine the need for interventions, and provide appropriate care to the mother and baby.
Question 5 of 5
On admission to the labor unit, a primigravid woman at 38 weeks gestation states, “I need to urinate more now but at least I can breathe easier.” The nurse is aware that this is likely due to which physiological process?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Lightening. Lightening refers to the descent of the fetal presenting part into the maternal pelvis as the fetus settles into a lower position. This physiological process relieves pressure on the diaphragm, allowing the woman to breathe more easily. Additionally, as the fetus descends, it shifts away from the bladder, decreasing pressure on it and leading to increased urinary frequency, which explains why the woman feels the need to urinate more. Regarding the incorrect options: A) Onset of labor typically involves contractions, cervical dilation, and effacement, but it does not directly relate to the changes in pressure on the bladder and diaphragm described in the scenario. B) Effacement is the thinning of the cervix in preparation for labor, and it does not influence the woman's ability to breathe easier or her urinary frequency. D) Rupture of membranes occurs when the amniotic sac breaks, leading to the release of amniotic fluid, but this event does not directly affect the woman's breathing or urinary patterns in the manner described in the question. Understanding these physiological changes in late pregnancy is crucial for nurses caring for women in labor and delivery, as it helps them recognize normal processes and provide appropriate support and education to expectant mothers during this critical time.