ATI RN
Intrapartum Complications NCLEX Questions Questions
Question 1 of 5
In a spontaneous abortion, if bleeding from the retained products of conception cannot be stopped, what is the next course of action?
Correct Answer: C
Rationale: The correct answer is C: administration of magnesium sulfate. This is because magnesium sulfate is used to control bleeding in cases of retained products of conception in a spontaneous abortion. It works by causing uterine contractions, which help expel the remaining tissue and stop the bleeding. Surgery for dilation and curettage (choice A) is typically performed if bleeding persists after medical management. Surgery for a hysterectomy (choice B) is not necessary for managing bleeding in this situation. Administration of calcium gluconate (choice D) is not indicated for controlling bleeding in cases of retained products of conception.
Question 2 of 5
A patient who is expecting her first baby tells the nurse, “I am afraid of the whole birth experience and plan to ask the doctor for a cesarean delivery.” Which response by the nurse is most appropriate?
Correct Answer: B
Rationale: The correct answer is B: Most women avoid cesarean births unless it is an emergency. Rationale: 1. Cesarean delivery is a major surgery with potential risks and longer recovery time compared to vaginal birth. 2. Most women opt for vaginal birth unless there are medical reasons necessitating a cesarean section. 3. It is important for the nurse to educate the patient on the benefits of vaginal birth and address her fears about the birth experience. 4. Encouraging the patient to consider vaginal birth unless there is a medical emergency aligns with best practices in obstetric care. Summary: - Choice A is incorrect because focusing solely on pain management may not address the patient's underlying fear of the birth experience. - Choice C is incorrect as seeking another opinion may not be necessary if the patient's concerns can be addressed through education and counseling. - Choice D is incorrect as not all cesarean deliveries lead to complications in subsequent pregnancies.
Question 3 of 5
An emergency cesarean is being implemented. The patient describes tingling in her ears and a metallic taste with the administration of regional anesthesia. The nurse is aware that which incidence has occurred?
Correct Answer: B
Rationale: The correct answer is B: Inadvertent injection of the anesthetic agent into the maternal bloodstream. This is indicated by the patient experiencing tingling in her ears and a metallic taste, which are signs of systemic toxicity from the anesthetic agent. The anesthetic has entered the bloodstream instead of staying localized to the intended area. Other choices are incorrect as A is more related to opioid overdose, C is more related to hypotension, and D implies that these symptoms are normal when they are not.
Question 4 of 5
The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B: Increased number of elective or maternal request cesareans. This is correct because the rise in elective cesarean births, often due to patient preference or convenience, can contribute to the overall high rates of cesarean births. A: Fetuses in breech position unable to deliver vaginally - This is a valid reason for cesarean births, but it does not address the question about high rates of cesarean births. C: Incidences of women of older maternal age getting pregnant - While advanced maternal age can be a factor in cesarean births, it is not directly related to the high rates of cesarean births at the facility. D: Decreasing rate of malpractice litigation with cesarean birth - This is an irrelevant factor in determining the reasons for high rates of cesarean births at the facility.
Question 5 of 5
Following a cesarean birth, intrathecal morphine is administered to the patient for postoperative pain management. Of which fact about intrathecal morphine therapy is the nurse aware? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B: The nurse needs to closely monitor for common side effects. 1. Intrathecal morphine can lead to side effects such as respiratory depression, nausea, vomiting, and pruritus. 2. Monitoring for these side effects is crucial for early detection and intervention. 3. Anesthesiologists or CRNAs typically administer intrathecal morphine, not nurses. 4. Intrathecal morphine primarily acts locally at the spinal cord level, not producing generalized CNS depression. 5. The recommended dose of intrathecal morphine is typically much lower than 10-15 mg to avoid overdose and side effects.