ATI RN
Promoting Client Comfort During Labor and Delivery Questions
Question 1 of 5
The nurse detects hypotension in a laboring patient after an epidural. Which actions should the nurse plan to implement? (SeNleUctRaSllIthNatGaTpBpl.y.)C OM
Correct Answer: C
Rationale: The correct answer is C: Administer a normal saline bolus as prescribed. In this scenario, hypotension post-epidural could be due to vasodilation leading to decreased blood pressure. Administering a normal saline bolus can help increase intravascular volume and improve blood pressure. Encouraging the patient to drink fluids (A) may not provide immediate volume resuscitation. Placing the patient in a Trendelenburg position (B) can worsen hypotension by increasing pressure on the vena cava. Administering oxygen (D) may be helpful but addressing the hypotension with a saline bolus is the priority.
Question 2 of 5
A labor patient, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse anticipate would be required in the birth room for administration?
Correct Answer: B
Rationale: The correct answer is B: Naloxone (Narcan). Meperidine is an opioid analgesic that can cross the placenta and potentially cause respiratory depression in the newborn if given close to delivery. Naloxone is a specific opioid antagonist that can reverse the effects of opioids like meperidine quickly and effectively. Administering naloxone in this scenario can help prevent or reverse neonatal respiratory depression. Choice A: Oxytocin (Pitocin) is not required in this scenario as it is used to induce or augment labor, not to counter the effects of meperidine. Choice C: Bromocriptine (Parlodel) is a medication used to suppress lactation and is not indicated in this situation. Choice D: Oxygen may be needed during delivery for maternal or fetal distress, but it is not the specific medication needed to counter the effects of meperidine in the newborn.
Question 3 of 5
The nurse is preparing a patient for a cesarean birth scheduled to be performed under general anesthesia. Which should the nurse plan to administer, if ordered by the health care provider, to prevent aspiration of gastric contents?
Correct Answer: C
Rationale: The correct answer is C: Hydroxyzine (Vistaril). Hydroxyzine is a first-generation antihistamine with antiemetic properties that can help reduce the risk of aspiration of gastric contents during general anesthesia. It works by decreasing nausea and vomiting, which in turn decreases the likelihood of aspiration. Citric acid (Bicitra) can actually increase gastric acidity and promote aspiration. Ranitidine (Zantac) is a histamine-2 receptor antagonist used to reduce gastric acid secretion but does not directly prevent aspiration. Glycopyrrolate (Robinul) is an anticholinergic medication used to reduce secretions but does not specifically target prevention of aspiration. Therefore, hydroxyzine is the most appropriate choice in this scenario.
Question 4 of 5
A nurse is assisting a laboring patient with breathing techniques to reduce labor pain. Which technique involves exhaling slowly while concentrating on relaxing each muscle group?
Correct Answer: B
Rationale: The correct answer is B: Slow-paced breathing. This technique involves exhaling slowly while focusing on relaxing each muscle group, which helps reduce labor pain. Slow-paced breathing promotes relaxation and reduces stress, making it an effective pain management technique during labor. Cleansing breaths (A) focus on deep breathing to clear the mind, not necessarily on muscle relaxation. Modified-paced breathing (C) involves breathing in a controlled pattern but may not specifically target muscle relaxation. Effleurage (D) is a massage technique involving light stroking movements, not breathing techniques for pain management.
Question 5 of 5
The nurse is monitoring a laboring patient who is using patterned breathing techniques. The patient suddenly complains of lightheadedness and tingling in her hands. What should the nurse do?
Correct Answer: B
Rationale: The correct answer is B: Instruct the patient to breathe into her cupped hands. This is because lightheadedness and tingling in hands may indicate hyperventilation from rapid breathing. Breathing into cupped hands helps rebreathe carbon dioxide, restoring balance. Choice A is incorrect as elevating legs increases blood flow to brain, worsening symptoms. Choice C is unnecessary as oxygen is not the issue. Choice D may exacerbate hyperventilation.