ATI RN
high risk labor and delivery nclex questions Questions
Question 1 of 5
During the third stage of labor, what may the birthing person experience?
Correct Answer: B
Rationale: During the third stage of labor, the birthing person may experience cramping, a gush of fresh vaginal bleeding, and lengthening of the umbilical cord. This is due to the delivery of the placenta. Cramping helps expel the placenta, fresh vaginal bleeding is normal after delivery, and the lengthening of the umbilical cord indicates that the placenta is detaching. Choices A, C, and D are incorrect as they do not accurately describe the typical experiences during the third stage of labor.
Question 2 of 5
The nurse is caring for a laboring patient with multiple family members in the room. How can the nurse address this situation?
Correct Answer: B
Rationale: The correct answer is B, asking all family members to leave the room. This is important to provide privacy, reduce distractions, and maintain the laboring person's comfort and focus. Educating the family on pain normalcy (A) is secondary to the laboring person's immediate needs. Suggesting an epidural (C) without the laboring person's consent is inappropriate. Assuming the laboring person wants the family in the room (D) disregards the individual's preferences and comfort.
Question 3 of 5
The nurse is explaining the physiology of uterine contractions to a group of nursing students. Which statement best explains the maternal-fetal exchange of oxygen and waste products during a contraction?
Correct Answer: D
Rationale: Rationale for Correct Answer (D): - During uterine contractions, placental blood flow may be temporarily reduced but not completely halted. - Fetal-maternal exchange of oxygen and waste products continues to occur even during contractions. - This is because the placenta acts as a continuous filter, allowing exchange to happen unless placental functions are severely compromised. Summary of Other Choices: A: Incorrect. There is an effect on maternal-fetal exchange during contractions. B: Incorrect. Increased blood pressure does not necessarily correlate with increased exchange. C: Incorrect. Compression of spiral arteries may impact blood flow but does not completely stop exchange.
Question 4 of 5
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
Correct Answer: B
Rationale: The correct answer is B: Engagement. Engagement occurs when the largest diameter of the fetal presenting part (usually the biparietal diameter of the fetal head) passes through the pelvic inlet. This marks the beginning of the descent of the fetal head into the pelvis in preparation for birth. Extension (A) refers to the movement of the fetal head as it passes through the birth canal. Internal rotation (C) is the movement of the fetal head to align with the maternal pelvis. External rotation (D) occurs as the fetal head exits the birth canal.
Question 5 of 5
Which physiologic event is the key indicator of the commencement of true labor?
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation and effacement. This is because true labor is defined by progressive cervical changes, including dilation (opening of the cervix) and effacement (thinning of the cervix). These changes indicate that the body is preparing for childbirth. A: Bloody show may occur during early labor but is not a definitive indicator. C: Fetal descent into the pelvic inlet is a later event in labor. D: Uterine contractions every 7 minutes are not necessarily indicative of true labor as they need to be regular, increasing in frequency, intensity, and duration.