ATI RN
high risk labor and delivery nclex questions Questions
Question 1 of 5
The nurse is explaining the physiology of uterine contractions to a group of nursing students. Which statement best explains the maternal-fetal exchange of oxygen and waste products during a contraction?
Correct Answer: D
Rationale: The correct answer is D because maternal-fetal exchange of oxygen and waste products continues during uterine contractions unless placental functions are reduced. Contractions do not directly affect this exchange, so option A is incorrect. Option B is incorrect because blood pressure changes do not necessarily impact the exchange. Option C is incorrect because spiral arteries play a role in supplying blood to the placenta, but compression during contractions does not halt the exchange process.
Question 2 of 5
Which physiologic event is the key indicator of the commencement of true labor?
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation and effacement. This is the key indicator of true labor as it signifies the physiological changes needed for the cervix to open and thin out, allowing the baby to pass through the birth canal. Bloody show (A) can be present in early labor but is not a definitive sign. Fetal descent (C) and regular uterine contractions (D) are important, but cervical changes are the most reliable indicator of true labor initiation.
Question 3 of 5
A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
Correct Answer: B
Rationale: The correct answer is B: Active phase. In the active phase of labor, the cervix is typically dilated from 6 to 10 cm. This phase marks the transition from early labor to active labor, where contractions become stronger and more frequent, leading to further cervical dilation for the eventual delivery of the baby. The other choices are incorrect because: A: Latent phase is typically from 0 to 6 cm dilation. C: Second stage refers to the stage of labor starting from full dilation (10 cm) until the baby is born. D: Third stage is the stage after the baby is born, focusing on the delivery of the placenta.
Question 4 of 5
A patient in labor presents with a breech presentation. The nurse understands that a breech presentation is associated with
Correct Answer: D
Rationale: The correct answer is D: umbilical cord compression. In a breech presentation, the baby's bottom or feet present first, increasing the risk of umbilical cord prolapse or compression. This can lead to fetal distress due to compromised blood flow and oxygen supply. Other choices are incorrect as breech presentation is not associated with more rapid labor (A), high risk of infection (B), or increased maternal perineal trauma (C). It is crucial to prioritize addressing umbilical cord compression in a breech presentation to prevent potential complications for the baby.
Question 5 of 5
Which assessment finding would cause a concern for a patient who had delivered vaginally?
Correct Answer: B
Rationale: The correct answer is B - White blood cell count of 28,000 mm3 postbirth. This finding indicates a possible infection or inflammation, which can be concerning after vaginal delivery. A high white blood cell count may suggest an ongoing infection that needs immediate attention. A: Estimated blood loss of 500 mL is within normal range for vaginal delivery and is not a cause for concern. C: Fingers tingling may be due to various reasons unrelated to the delivery process and is not a typical concern post vaginal delivery. D: Thirst is a common symptom post-delivery and is not indicative of a serious complication.