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: Rationale: A) The correct answer is A) In true labor, the cervix begins to dilate. This is because cervical dilation is a key indicator of true labor progression. As labor begins and contractions become more regular and intense, the cervix starts to efface and dilate to allow the baby to move through the birth canal. This physiological change is a definitive sign that labor is indeed real. B) Option B is incorrect because the location of contractions alone cannot definitively determine if labor is real or false. While abdominal and groin contractions can be common in labor, the key factor is the progression of cervical dilation. C) Option C is incorrect as contractions in true labor typically become stronger and more frequent over time, unlike menstrual cramps which may not increase in intensity in a consistent pattern. Menstrual-like cramps can also occur in false labor, known as Braxton Hicks contractions. D) Option D is incorrect as true labor contractions typically become more regular, frequent, and intense as labor progresses. Inconsistent contractions in terms of frequency, duration, and intensity are more characteristic of false labor or prodromal labor. Educational Context: Understanding the signs of true labor is crucial for expectant mothers to differentiate between false labor and the real onset of labor. By recognizing the key indicators such as cervical dilation, women can better gauge when to seek medical attention and head to the hospital for delivery. This knowledge empowers mothers to make informed decisions about their labor experience and ensures timely and appropriate care during childbirth.
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 the initiation of labor by promoting uterine contractions and stimulating the production of prostaglandins, which help ripen the cervix. This hormone also aids in the activation of oxytocin receptors on the uterine muscle cells, further enhancing the contraction process. A) Increase in progesterone is not a factor in the onset of labor. In fact, progesterone levels decrease as labor approaches, allowing for the uterus to become more sensitive to the stimulatory effects of estrogen. C) Increase in human chorionic gonadotropin (hCG) is primarily involved in the maintenance of the corpus luteum during early pregnancy and is not directly implicated in the onset of labor. D) Aging of the placenta is associated with post-term pregnancies but is not a direct factor in the initiation of labor. Understanding the hormonal changes and their effects on uterine activity is crucial in the field of pharmacology, especially when considering interventions like oxytocin administration to induce or augment labor. By grasping the multifactorial nature of labor onset, healthcare providers can make informed decisions to support safe and effective childbirth.
Question 3 of 5
Which female pelvis is most suitable for vaginal delivery?
Correct Answer: A
Rationale: In the context of pharmacology and labor and delivery, understanding the female pelvis types and their implications for childbirth is crucial. The correct answer is A) Gynecoid. The gynecoid pelvis is most suitable for vaginal delivery as it is characterized by a round inlet, ample capacity, and a wide subpubic angle, allowing for easier passage of the infant's head during birth. This type of pelvis is considered ideal for childbirth due to its favorable dimensions and shape. Choice B) Android pelvis is not ideal for vaginal delivery as it is heart-shaped with a narrow pubic arch, which can lead to complications during childbirth, such as obstructed labor. Choice C) Platypelloid pelvis is flat and wide, making it less suitable for vaginal delivery as it may impede the descent of the fetus. Choice D) Anthropoid pelvis is elongated with an oval shape, which can also present challenges during childbirth, especially with the engagement of the fetal head. Educationally, understanding the different pelvic types and their impact on labor and delivery is essential for healthcare professionals, especially pharmacologists working in obstetric settings. This knowledge helps in anticipating potential complications, making informed clinical decisions, and providing optimal care for pregnant women during childbirth. By recognizing the most suitable pelvic type for vaginal delivery, healthcare providers can contribute to safe and successful birthing experiences for both the mother and the baby.
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: In labor and delivery, understanding the components of a sterile vaginal examination is crucial for assessing the progress of labor and the well-being of both the mother and the fetus. In this scenario, the nurse's report of "4 cm, 50%, -1" indicates dilation, effacement, and station, which are key parameters used to monitor labor progress. Option A, effacement, station, and dilation, is incorrect because the order in which the parameters are listed is incorrect. Additionally, fetal lie is not relevant to this specific assessment. Option B, dilation, station, and fetal lie, is incorrect as it includes fetal lie, which is not part of the assessment provided. Option C, dilation, effacement, and status of membranes, is incorrect as it includes membranes, which are not mentioned in the nurse's report. Understanding these components is essential for nurses and healthcare providers caring for laboring women as it helps in determining the stage of labor, making informed decisions regarding interventions, and providing appropriate support and care to the mother. Mastering this skill is vital for safe and effective labor management.
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 fetus into the maternal pelvis as the baby prepares for delivery. This process relieves pressure on the diaphragm, allowing the woman to breathe easier. The increased pressure on the bladder from the descending fetus also leads to the feeling of needing to urinate more frequently. Option A) Onset of labor is incorrect because the woman's statement does not indicate active labor contractions. Option B) Effacement refers to the thinning of the cervix, not the descent of the fetus. Option D) Rupture of membranes would present with a gush of amniotic fluid, not the symptoms described by the woman. Educationally, understanding these physiological processes is crucial for nurses caring for pregnant women. Recognizing the signs of labor and understanding the changes a woman's body undergoes can help nurses provide appropriate care and support during the labor and delivery process. It also allows for timely interventions if needed, ensuring the well-being of both the mother and the baby.