ATI RN
Monitoring Baby During Labour Questions
Question 1 of 5
A pregnant patient is 28 weeks gestation and reports feeling nauseated. What is the nurse's priority intervention?
Correct Answer: C
Rationale: The correct answer is C: Encourage the patient to eat smaller, more frequent meals. This is the priority intervention because nausea during pregnancy, especially in the second trimester, is common and can be alleviated by eating smaller, more frequent meals to prevent fluctuations in blood sugar levels. Ginger tea (A) may help with nausea, but ensuring proper nutrition through small, frequent meals is the priority. Recommending larger meals (B) can worsen nausea due to increased stomach distention. Instructing the patient to avoid all foods and drinks (D) is not appropriate as it can lead to dehydration and nutrient deficiencies.
Question 2 of 5
The nurse is caring for a pregnant patient who is 38 weeks gestation and reports feeling pelvic pressure and mild cramping. What should the nurse do first?
Correct Answer: A
Rationale: The correct answer is A because monitoring the fetal heart rate and checking for signs of labor are essential in assessing the well-being of the fetus and determining if the patient is in active labor. This step helps the nurse identify any potential complications and take appropriate actions promptly. Choice B is incorrect because simply instructing the patient to rest may not address the underlying cause of pelvic pressure and cramping. Choice C is incorrect as assessing blood pressure and urine for protein is not the priority in this situation. Choice D is incorrect because performing a pelvic exam should be done after monitoring fetal well-being and ruling out active labor.
Question 3 of 5
The nurse is assessing a pregnant patient at 28 weeks gestation who reports increased vaginal discharge. What is the nurse's priority action?
Correct Answer: A
Rationale: The correct answer is A: Assess the characteristics of the discharge, including color and odor. This is the priority action because it allows the nurse to gather important information to determine if the increased vaginal discharge is normal or if it may indicate an infection or other issue. By assessing the characteristics, such as color and odor, the nurse can make an informed decision on the next steps for the patient's care. Choice B is incorrect because simply monitoring for changes without assessing the characteristics of the discharge may delay necessary interventions. Choice C is incorrect because performing a pelvic exam should not be the first action without first assessing the characteristics of the discharge. Choice D is incorrect because calling the healthcare provider immediately may not be necessary if the discharge is normal.
Question 4 of 5
A pregnant patient is at 30 weeks gestation and is experiencing difficulty breathing, especially when lying flat. What is the nurse's priority action?
Correct Answer: A
Rationale: The correct answer is A - Encourage the patient to rest in an upright position. This is the priority action because the patient is likely experiencing supine hypotensive syndrome due to pressure on the vena cava when lying flat. This can compromise blood flow to the fetus. By having the patient rest in an upright position, the pressure on the vena cava is reduced, improving blood flow and oxygenation for both the patient and the fetus. Administering oxygen and preparing for delivery (option B) is not the immediate priority. Monitoring fetal heart rate (option C) is important but not the initial action. Instructing the patient to take deep breaths and stay in bed (option D) does not address the underlying issue of supine hypotensive syndrome.
Question 5 of 5
A nurse is caring for a pregnant patient who is 28 weeks gestation and has been diagnosed with gestational diabetes. What is the nurse's priority teaching for this patient?
Correct Answer: B
Rationale: The correct answer is B: Monitor blood glucose levels regularly and follow a balanced diet. This is the priority teaching for a pregnant patient with gestational diabetes because it focuses on managing blood sugar levels effectively. Regular monitoring helps the patient understand how their body responds to different foods and activities. Following a balanced diet helps maintain stable blood sugar levels and provides essential nutrients for the baby's development. A: Encouraging vigorous exercise may not be safe during pregnancy, especially for a patient with gestational diabetes. C: Limiting fluid intake is not a priority teaching for gestational diabetes and may lead to dehydration, which can be harmful during pregnancy. D: Recommending insulin therapy immediately is not the first-line treatment for gestational diabetes. Lifestyle modifications like diet and exercise are usually tried first.