ATI RN
Advanced Maternal Age Monitoring Questions
Question 1 of 5
The nurse is educating a pregnant patient at 30 weeks gestation on the signs and symptoms of preterm labor. Which of the following should the nurse instruct the patient to report immediately?
Correct Answer: C
Rationale: The correct answer is C. Regular contractions every 10 minutes or less should be reported immediately as they could indicate preterm labor. The frequency and regularity of contractions are key indicators of labor starting. Other choices, A, B, and D, are common discomforts during pregnancy and not necessarily indicative of preterm labor. Mild cramping and back pain (A), increased vaginal discharge (B), and feeling of pelvic pressure after physical activity (D) are normal symptoms in pregnancy and not urgent signs of preterm labor.
Question 2 of 5
During the postpartum period, a nurse is caring for a birthing person who is receiving uterotonic medications. The nurse's assessment reveals a boggy and enlarged uterus. What is the nurse's immediate action?
Correct Answer: C
Rationale: The correct immediate action is C: Perform fundal massage to promote uterine firmness. Fundal massage helps prevent postpartum hemorrhage by promoting uterine contraction and firmness. A: Documenting the findings as normal is incorrect as a boggy and enlarged uterus is not a normal finding postpartum. B: Continuing to administer uterotonic medication without addressing the boggy uterus can lead to ineffective contraction. D: Administering an analgesic for pain does not address the underlying issue of uterine atony.
Question 3 of 5
A nurse is preparing a laboring person for an epidural block. What is the nurse's priority action before the procedure?
Correct Answer: A
Rationale: The correct answer is A: ensure the birthing person is positioned correctly. This is the priority action because proper positioning is crucial for the safe and effective administration of an epidural block. Incorrect positioning can lead to complications such as inadequate pain relief, nerve damage, or difficulty in performing the procedure. Checking for allergies to anesthesia (B) is important but not the priority before positioning. Administering a test dose of anesthesia (C) should only be done after ensuring correct positioning. Administering IV fluids (D) is important but not the priority action before positioning.
Question 4 of 5
A nurse is caring for a postpartum person with a diagnosis of uterine atony. What is the most appropriate first action to take?
Correct Answer: A
Rationale: The correct first action is to perform fundal massage. This helps stimulate uterine contractions, which can help control bleeding due to uterine atony. The massage should be done gently but firmly to prevent further complications. Administering uterotonic medication (choice B) can be done after fundal massage. Performing a vaginal exam (choice C) can increase the risk of infection and should be avoided initially. Monitoring vital signs (choice D) is important but addressing the uterine atony should be the priority to prevent further complications.
Question 5 of 5
What is the priority intervention for a laboring person with a suspected uterine rupture?
Correct Answer: B
Rationale: The correct answer is B: perform uterine massage. This intervention aims to prevent excessive bleeding and stabilize the uterus. Uterine massage helps to maintain uterine tone, which is crucial in managing uterine rupture. This intervention can help reduce the risk of maternal hemorrhage and improve fetal oxygenation. Incorrect choices: A: Emergency cesarean section may be necessary but is not the priority as immediate measures to control bleeding and maintain uterine tone are crucial. C: Applying pressure to the abdomen is not recommended as it can further exacerbate uterine rupture and increase the risk of complications. D: Continuous monitoring of the fetal heart rate is important but not the priority in managing uterine rupture, which requires immediate intervention to prevent maternal and fetal complications.