ATI RN
Maternal Monitoring During Labor Questions
Question 1 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 2 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.
Question 3 of 5
A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?
Correct Answer: D
Rationale: Rationale: The correct answer is D) Leg cramping. Leg cramping is a common symptom during pregnancy, especially in the second and third trimesters, due to factors like increased weight, pressure on blood vessels, and hormonal changes. This discomfort is often experienced by multigravid clients as their uterine ligaments and muscles have been stretched with previous pregnancies, leading to increased susceptibility to cramping. Option A) Nausea is more commonly associated with early pregnancy (first trimester) due to hormonal changes and is less likely to be a prominent symptom at 22 weeks gestation in a multigravid client. Option B) Dyspnea (shortness of breath) is a common symptom in late pregnancy when the uterus enlarges and presses on the diaphragm, but it is not typically a significant concern at 22 weeks unless there are other underlying health issues. Option C) Urinary frequency is common in early pregnancy due to hormonal changes and pressure on the bladder as the uterus grows, but it tends to improve in the second trimester as the uterus rises into the abdomen. Educational Context: Understanding the common symptoms experienced by pregnant clients at different stages is crucial for nurses providing care during pregnancy. Recognizing normal discomforts and differentiating them from potential complications is essential for effective maternal monitoring. Leg cramping, in this case, is a common discomfort that can be managed through strategies like hydration, gentle stretching, and proper positioning, highlighting the importance of holistic care for pregnant individuals.
Question 4 of 5
Which of the following vital sign changes should the nurse highlight for a pregnant woman’s obstetrician?
Correct Answer: A
Rationale: In the context of maternal monitoring during labor, the nurse should highlight the vital sign changes of the pregnant woman to the obstetrician to ensure the well-being of both the mother and the fetus. Option A is the correct choice as it indicates a significant increase in blood pressure from the prepregnancy state to the third trimester, which could be indicative of gestational hypertension or preeclampsia, conditions that require immediate medical attention. Option B, respiratory rate changes, are not typically a primary concern in maternal monitoring unless there are specific respiratory issues present. Option C, heart rate changes, can be expected to increase slightly during pregnancy due to the physiological changes but are not as critical as blood pressure changes. Option D, temperature changes, are not typically a key indicator of complications during labor unless there are signs of infection. Educationally, understanding the significance of vital sign changes during pregnancy is crucial for nurses to detect and address potential complications promptly. By emphasizing the importance of continuous monitoring and timely reporting of vital sign changes, nurses can contribute to ensuring the safety and well-being of both the mother and the baby during labor and delivery.
Question 5 of 5
The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination.
Correct Answer: B
Rationale: In the context of maternal monitoring during labor, the correct position for a 31-week gestation client to lie on the examining table during a prenatal examination is the lateral-recumbent position (Option B). This position is suitable for pregnant women as it helps to relieve pressure on the vena cava, promoting better blood flow to the placenta and reducing the risk of supine hypotensive syndrome. Option A, Orthopneic position, is not suitable for a pregnant woman during a prenatal examination as it can cause discomfort and may not provide the needed support for the client's body. Option C, Sims' position, is used for rectal examinations and not appropriate for prenatal examinations. Option D, Semi-Fowler’s position, is commonly used for patients experiencing respiratory distress or for postoperative care but is not the ideal position for a prenatal examination in a 31-week gestation client. Educationally, it is essential for nurses and healthcare providers to understand the importance of positioning pregnant clients correctly during prenatal examinations to ensure the safety and well-being of both the mother and the fetus. By selecting the lateral-recumbent position, healthcare providers can optimize maternal comfort and circulation during the examination, ultimately contributing to better outcomes for both the mother and the baby.