ATI RN
Maternal Monitoring Questions
Question 1 of 5
A woman in labor who is receiving oxytocin starts to experience uterine hyperstimulation. What should the nurse do first?
Correct Answer: A
Rationale: The correct answer is A: Stop the oxytocin infusion. Uterine hyperstimulation can lead to fetal distress and compromise maternal and fetal well-being. Stopping the oxytocin infusion is the first step to prevent further complications. Administering a tocolytic agent (B) is not the initial action for uterine hyperstimulation. Increasing the oxytocin infusion rate (C) would exacerbate the hyperstimulation. Positioning the patient on her left side (D) can help improve blood flow but is not the priority in this situation.
Question 2 of 5
A 35-week pregnant woman presents with ruptured membranes. What is the priority intervention?
Correct Answer: A
Rationale: The correct answer is A: Check for cord prolapse. This is the priority intervention because with ruptured membranes, there is a risk of umbilical cord prolapse, which can lead to fetal compromise. Checking for cord prolapse allows for quick identification and immediate intervention to prevent potential harm to the baby. Choice B is incorrect as monitoring for fetal distress is important but not the immediate priority when cord prolapse is a concern. Choice C, administering antibiotics, may be necessary but does not address the immediate risk of cord prolapse. Choice D, performing a vaginal exam, can increase the risk of infection and should be avoided until cord prolapse is ruled out.
Question 3 of 5
A woman in labor is experiencing severe perineal pressure and the urge to push. What should the nurse assess next?
Correct Answer: A
Rationale: The correct answer is A: Cervical dilation. Assessing cervical dilation is crucial as it indicates the progress of labor and readiness for pushing. The nurse needs to determine if the woman is fully dilated to guide the timing of pushing. B: Fetal position is important but not the immediate priority when the woman is experiencing the urge to push. C: Fetal heart rate should be continually monitored during labor but is not the next assessment when the woman has the urge to push. D: Maternal blood pressure is important but not the immediate concern when the woman is ready to push.
Question 4 of 5
The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence?
Correct Answer: C
Rationale: The correct answer is C: Alcohol abuse. During adolescence, children of parents who have substance abuse issues, like alcohol, are at an increased risk of developing similar problems. This is due to genetic predisposition, environmental factors, and learned behavior. Children tend to model the behavior of their parents, and if they are exposed to alcohol abuse at a young age, they are more likely to engage in alcohol abuse themselves as they grow older. Incorrect choices: A: Hypertension - This choice is not directly related to the situation described and is not typically a risk factor associated with parental alcohol abuse. B: Diabetes - Similar to choice A, diabetes is not directly linked to parental alcohol abuse and is not a common risk factor during adolescence in this scenario. D: Intraventricular bleeding - This is a medical condition that is not typically influenced by parental alcohol abuse and is not a common risk factor during adolescence.
Question 5 of 5
The nurse is caring for a woman who is pregnant and reports that she has used tobacco throughout her pregnancy. What is the most likely risk to her baby?
Correct Answer: C
Rationale: The correct answer is C: Low birth weight. Tobacco use during pregnancy is associated with several adverse outcomes, including low birth weight. Nicotine in tobacco can constrict blood vessels, reducing the flow of oxygen and nutrients to the baby, leading to poor growth and low birth weight. Neonatal death (A) is a severe outcome but not the most likely risk associated with tobacco use during pregnancy. Fetal alcohol syndrome (B) is caused by alcohol consumption, not tobacco use. Cerebral palsy (D) is a neurological condition not directly linked to tobacco use during pregnancy.