ATI RN
high risk labor and delivery nclex questions Questions
Question 1 of 5
How should the nurse respect the rapid psychologic changes occurring in the fourth stage of labor?
Correct Answer: B
Rationale: The correct answer is B because in the fourth stage of labor, immediate postpartum bonding between parents and newborn is crucial. The nurse should respect the rapid psychologic changes by taking cues from the parents on how they want this bonding experience to unfold. This approach ensures that the parents are supported in establishing a strong emotional bond with their newborn, promoting a positive postpartum experience. Choice A is incorrect because inviting the family in may not align with the parents' wishes for privacy during this intimate moment. Choice C is incorrect as asking multiple questions about taking pictures may be intrusive and disrupt the bonding process. Choice D is incorrect as separating the newborn from the parents can hinder bonding and may not align with current best practices in postpartum care.
Question 2 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 3 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 4 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.
Question 5 of 5
A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
Correct Answer: B
Rationale: The correct answer is B: Active phase. At 6 cm dilation, the active phase of labor begins, where cervical dilation accelerates. In this phase, contractions become stronger and closer together, promoting effacement and descent of the baby. The latent phase (choice A) occurs at 0-6 cm dilation, characterized by slower progress. The second stage (choice C) is when the baby is born, not based on cervical dilation. The third stage (choice D) is the delivery of the placenta, not determined by cervical dilation. Therefore, at 6 cm dilation, the patient is in the active phase of labor.