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: In the context of maternal monitoring during labor, it is crucial for nurses to understand the physiological changes that occur in pregnancy and how they impact laboratory values. Fibrinogen is expected to be elevated above prepregnancy levels. This is because fibrinogen is an acute phase reactant that increases during pregnancy to support the body's hemostatic needs during labor and delivery. Glucose levels are not typically expected to be elevated above prepregnancy levels during labor unless the client has gestational diabetes. Hematocrit levels may decrease slightly during pregnancy due to hemodilution, so they would not be expected to be elevated. Bilirubin levels are not typically elevated above prepregnancy levels during labor unless there are specific liver or gallbladder issues present. Understanding the normal physiological changes in pregnancy and their impact on laboratory values is essential for nurses to provide safe and effective care to pregnant clients during labor and delivery. By knowing which values are expected to be elevated or altered, nurses can detect deviations from normal more effectively and intervene promptly if necessary.
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 need for referral to a genetic counselor because cystic fibrosis is a genetic disorder that can be inherited. Genetic counseling would be essential for the client to understand the genetic implications, risks, and options for future pregnancies. Option A) My first child has cerebral palsy does not necessarily indicate a need for genetic counseling as cerebral palsy is not typically a genetic condition but rather a result of brain injury or abnormal brain development. Option B) My first child has hypertension is a common medical condition that is not typically genetic and would not warrant genetic counseling. Option C) My first child has asthma is also not typically a genetic condition and does not require genetic counseling. In an educational context, understanding when to refer a client to a genetic counselor is crucial for nurses providing prenatal care. Genetic counselors can provide valuable information and support to clients with genetic concerns, helping them make informed decisions about family planning and genetic testing. By recognizing red flags like a child with a known genetic disorder, nurses can ensure their clients receive comprehensive care and appropriate referrals.
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: In this scenario, the correct answer is D) Leg cramping. During the second trimester of pregnancy, leg cramping is a common symptom due to factors such as increased weight and pressure on the legs, changes in circulation, and mineral imbalances. Leg cramping can be especially prevalent in multigravid clients who have been pregnant before, as their body may react differently compared to first-time pregnancies. 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. Option B) Dyspnea (shortness of breath) is often experienced in the later stages of pregnancy as the growing uterus puts pressure on the diaphragm and lungs. While dyspnea can occur, it is not typically a prominent symptom at 22 weeks. Option C) Urinary frequency is common in early pregnancy due to hormonal changes and later in pregnancy due to the growing uterus pressing on the bladder. At 22 weeks, urinary frequency may have improved compared to the first trimester but can vary among individuals. Educationally, understanding the timing and common symptoms of pregnancy is crucial for nurses caring for pregnant clients. By recognizing the expected symptoms at different stages of pregnancy, nurses can provide appropriate education, support, and interventions to promote the well-being of both the mother and the baby.
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 that indicate potential complications. Option A is the correct answer as it reflects a significant increase in blood pressure from the prepregnancy baseline to the third trimester, indicating gestational hypertension or preeclampsia, which are critical conditions requiring medical intervention. Option B is incorrect as a slight increase in respiratory rate can be a normal physiological adaptation to pregnancy due to increased oxygen demand, and it may not necessarily indicate a problem. Option C is incorrect because a modest increase in heart rate can also be normal during pregnancy as the body adapts to the increased demands of the growing fetus and placenta. Option D is incorrect as a slight elevation in temperature is not uncommon in pregnant women and may not be a cause for immediate concern unless it is accompanied by other symptoms of infection. Educationally, understanding the normal physiological changes during pregnancy and being able to identify abnormal vital sign trends are crucial for nurses caring for pregnant women. Highlighting the correct vital sign changes can help in early identification and management of complications, ensuring the well-being of both the mother and the baby.
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). Explanation of why Option B is correct: 1. Lateral-recumbent position: This position is preferred during pregnancy as it helps prevent supine hypotensive syndrome by reducing pressure on the vena cava. This position allows for optimal blood flow to the uterus and placenta, promoting maternal and fetal well-being. Explanation of why the other options are wrong: 1. Orthopneic position (Option A): This position is more commonly used for patients experiencing respiratory distress, not for routine prenatal examinations. 2. Sims' position (Option C): Sims' position is typically used for rectal examinations or procedures, not for prenatal examinations. 3. Semi-Fowler's position (Option D): This position is a semi-upright position with the head of the bed elevated. While it can be used for some examinations, the lateral-recumbent position is more appropriate for prenatal examinations to avoid pressure on the vena cava. Educational context: Understanding the importance of positioning during prenatal examinations is crucial for nurses and healthcare providers caring for pregnant clients. Proper positioning not only ensures the comfort of the client but also promotes optimal maternal and fetal health by facilitating adequate blood flow and reducing the risk of complications. By selecting the appropriate position, nurses can contribute to a positive pregnancy experience and ensure the well-being of both the mother and baby.