ATI RN
Maternal Monitoring During Labor Questions
Question 1 of 5
The clinic nurse is obtaining a health history on a newly pregnant patient. Which is an indication for fetal diagnostic procedures if present in the health history?
Correct Answer: A
Rationale: In the context of maternal monitoring during labor, identifying high-risk factors that may impact the health of the fetus is crucial for ensuring a safe delivery. Maternal diabetes is a significant risk factor that can lead to complications during pregnancy, such as macrosomia (large birth weight) in the fetus. Therefore, it is essential to conduct fetal diagnostic procedures to monitor the well-being of the baby in utero. Option A (Maternal diabetes) is the correct answer because it directly correlates with potential fetal complications that warrant fetal diagnostic procedures. Maternal diabetes can lead to issues such as fetal macrosomia, birth defects, and other complications that require close monitoring. Option B (Weight gain of 25 lb) is not a direct indication for fetal diagnostic procedures. While excessive weight gain during pregnancy can have implications for maternal health, it does not necessarily indicate a need for fetal monitoring procedures. Option C (Maternal age older than 30 years) is a common risk factor for certain pregnancy complications, but it alone is not a direct indication for fetal diagnostic procedures. Advanced maternal age may increase the risk of chromosomal abnormalities but does not mandate immediate fetal monitoring. Option D (Previous infant weighing more than 3000 g at birth) is not a clear indication for fetal diagnostic procedures either. While a history of delivering a large baby may suggest a potential risk for macrosomia in subsequent pregnancies, it is not a definitive reason to perform fetal diagnostic procedures without other concerning factors present. Educationally, understanding the rationale behind the need for fetal diagnostic procedures based on specific maternal risk factors is essential for nurses and healthcare providers involved in maternal care. By recognizing which factors necessitate closer monitoring, healthcare professionals can provide targeted care and interventions to ensure the best outcomes for both the mother and the baby.
Question 2 of 5
For which patient would an L/S ratio of 2:1 potentially be considered abnormal?
Correct Answer: B
Rationale: The correct answer is B) A 24-year-old gravida 1, para 0, who has diabetes. In the context of maternal monitoring during labor, the L/S (lecithin/sphingomyelin) ratio is used to assess fetal lung maturity. A ratio of 2:1 is considered abnormal because it indicates insufficient lung maturity, which can increase the risk of respiratory distress syndrome in the newborn. Option A is less likely to be abnormal as the patient is at term, which increases the likelihood of fetal lung maturity. Option C is also less likely to be abnormal as the patient is at term and has a history of multiple pregnancies, which may indicate fetal lung maturity. Option D is less likely as the patient is in early labor at term, which allows time for fetal lung maturity to progress. Understanding the implications of abnormal L/S ratios is crucial in obstetric pharmacology to guide clinical decision-making regarding the timing and management of labor to optimize neonatal outcomes. It is essential for healthcare providers to interpret these results accurately to provide appropriate care for both the mother and the newborn.
Question 3 of 5
The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B) Fibrinogen. During pregnancy, fibrinogen levels increase as part of the body's preparation for potential blood loss during labor and delivery. This elevation is a normal physiological response to support hemostasis and prevent excessive bleeding postpartum. A) Glucose levels may fluctuate during pregnancy due to changes in insulin sensitivity, but they are not typically elevated above prepregnancy levels unless gestational diabetes is present. C) Hematocrit levels may decrease during pregnancy due to hemodilution, which is a normal adaptation to support increased blood volume needed for maternal and fetal circulation. Therefore, hematocrit levels are not expected to be elevated above prepregnancy levels. D) Bilirubin levels are not typically expected to be elevated above prepregnancy levels during pregnancy unless there is a specific underlying medical condition affecting liver function or red blood cell breakdown. Educationally, understanding the normal physiological changes in laboratory values during pregnancy is crucial for nurses providing care to pregnant clients. This knowledge helps in early identification of deviations from normal and prompt intervention if needed to ensure optimal maternal and fetal outcomes.
Question 4 of 5
A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant?
Correct Answer: A
Rationale: In the context of pharmacology and maternal monitoring during labor, understanding the role of hormones in pregnancy is crucial. The correct answer is A) Chorionic gonadotropin, as its elevation is a hallmark sign of pregnancy. This hormone is produced by the placenta shortly after implantation and is responsible for maintaining the corpus luteum, which in turn produces progesterone to sustain the early pregnancy. Option B) Oxytocin is a hormone involved in uterine contractions during labor and milk ejection during breastfeeding, but its elevation alone does not confirm pregnancy. Option C) Prolactin is primarily associated with milk production and breastfeeding, not the early detection of pregnancy. Option D) Luteinizing hormone plays a role in the menstrual cycle by triggering ovulation, but its elevation alone does not indicate pregnancy. Educationally, this question highlights the importance of understanding the specific hormonal changes that occur in pregnancy for accurate maternal monitoring. By recognizing the significance of chorionic gonadotropin in early pregnancy detection, healthcare providers can offer timely prenatal care and support to pregnant individuals.
Question 5 of 5
The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor?
Correct Answer: D
Rationale: The correct answer is D) My first child has cystic fibrosis. This statement indicates a potential genetic component that may increase the risk of cystic fibrosis in subsequent children. Referring the client to a genetic counselor is important to assess the risk, provide genetic counseling, and discuss possible screening options. Option A) My first child has cerebral palsy, option B) My first child has hypertension, and option C) My first child has asthma do not directly indicate a need for genetic counseling. Cerebral palsy, hypertension, and asthma are not typically genetic conditions that would necessitate a referral to a genetic counselor. In an educational context, understanding when to refer a client to a genetic counselor is crucial for nurses providing prenatal care. Genetic counselors play a key role in assessing genetic risks, offering support, and facilitating informed decision-making for families. Identifying red flags in a family history, such as a child with cystic fibrosis, highlights the importance of genetic counseling to support the health and well-being of the mother and her potential future children.