ATI RN
Intrapartum Complication Questions
Question 1 of 5
The nurse is monitoring a patient who has been in prolonged labor. Which assessment finding will result in the nurse notifying the health care provider about the development of an emergent situation requiring a cesarean delivery?
Correct Answer: C
Rationale: The correct answer is C: Recognition of a Category II fetal heart rate pattern. This indicates fetal distress and potential compromise to the baby's well-being, necessitating immediate intervention like a cesarean delivery to prevent adverse outcomes. A: Maternal hypotension may require intervention but is not an emergent indication for a cesarean section. B: Maternal exhaustion can be managed with support and rest, not an immediate indication for cesarean delivery. D: Maternal fever may indicate infection but does not necessarily require cesarean delivery unless it poses a significant risk to the baby.
Question 2 of 5
A nurse has recently transferred to a labor and delivery unit. During a scheduled cesarean, the nurse notices a prescription for the administration of 1,000 mL of prewarmed IV fluid. For which reason does the health care provider prescribe the fluid in this manner? Select all that apply.
Correct Answer: A
Rationale: Step 1: IV fluid is prewarmed to prevent hypothermia in the mother during cesarean delivery, which can occur due to exposure to cold operating room environment. Step 2: Hypothermia in the mother can lead to adverse outcomes such as increased blood loss, delayed wound healing, and increased risk of infection. Step 3: Maintaining maternal normothermia through prewarmed IV fluids is crucial for optimal maternal outcomes during cesarean delivery. Summary: - B: Improved neonatal umbilical arterial pH is not directly related to prewarmed IV fluid administration. - C: Apgar scores are primarily influenced by factors like neonatal resuscitation and immediate care, not IV fluid temperature. - D: Prewarmed IV fluid administration is more about preventing hypothermia in the mother rather than decreasing the risk for maternal shock.
Question 3 of 5
Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
Correct Answer: A
Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby. Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients. Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication. Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.
Question 4 of 5
Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
Correct Answer: D
Rationale: The correct answer is D because oxytocin can cause increased uterine contractions, potentially impacting uteroplacental exchange and reducing oxygen delivery to the fetus. This can lead to fetal distress, making continuous electronic fetal monitoring crucial to detect any signs of distress promptly. A: Fetal chemoreceptors being stimulated is not directly related to the need for continuous monitoring with oxytocin administration. B: Maternal hypotension is a potential side effect of oxytocin but does not directly necessitate continuous fetal monitoring. C: Maternal fluid volume deficit is a concern with oxytocin, but it does not directly link to the need for continuous fetal monitoring.
Question 5 of 5
When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?
Correct Answer: B
Rationale: The correct answer is B: Variable decelerations. When the mother's membranes rupture during active labor, variable decelerations should be observed in the fetal heart rate. This is because the rupture of membranes can lead to umbilical cord compression, causing variable decelerations in the fetal heart rate pattern. Variable decelerations are characterized by abrupt and visually apparent decreases in heart rate variability. A: Early decelerations are usually associated with head compression during contractions and are benign. C: Nonperiodic accelerations are not a typical pattern seen in response to ruptured membranes during labor. D: An increase in baseline variability is a positive sign and does not specifically indicate the occurrence of variable decelerations related to umbilical cord compression.