ATI RN
high risk labor and delivery nclex questions Questions
Question 1 of 5
The patient with which vaginal exam is most at risk for an umbilical cord prolapse?
Correct Answer: B
Rationale: The correct answer is B because a patient who is 5 cm dilated, 60% effaced, and at -3 station is most at risk for an umbilical cord prolapse. At this stage, the presenting part of the baby is not well engaged in the pelvis, increasing the likelihood of the cord slipping down in front of the baby. This can lead to compression of the cord during labor, which is a serious obstetric emergency. Choice A is less likely as the baby is only at -1 station and not as far down in the pelvis. Choice C also has the baby at a higher station (-2) and more dilated, which may help secure the baby's position. Choice D is the least likely as the baby is fully engaged at 0 station, reducing the risk of cord prolapse.
Question 2 of 5
When caring for a woman with a complete placenta previa, which finding should the nurse report to the physician?
Correct Answer: D
Rationale: The correct answer is D: O2 saturation less than 95%. In placenta previa, the placenta covers the cervix, increasing the risk of bleeding. Decreased oxygen saturation can indicate poor perfusion due to bleeding, necessitating immediate medical attention. A: BP of 95/60 is relatively normal and not an urgent concern in this scenario. B: Temperature of 100.1°F may indicate an infection but is not directly related to placenta previa. C: Urine output of 40 mL/hour is within the normal range and does not directly impact the management of placenta previa.
Question 3 of 5
What is a direct influence on cervical dilation? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: positioning of the pregnant person. The position of the pregnant person can directly influence cervical dilation by affecting the alignment of the uterus and baby, allowing for optimal pressure on the cervix. Proper positioning can facilitate the descent of the baby's head onto the cervix, promoting dilation. Summary of why other choices are incorrect: B: The strength of uterine contractions indirectly influences cervical dilation by aiding in the effacement and descent of the baby, but it does not directly impact dilation. C: The length of time since ROM (rupture of membranes) can affect the risk of infection but does not directly influence cervical dilation. D: Fetal presentation refers to the position of the baby in the uterus and can affect labor progress, but it does not directly impact cervical dilation.
Question 4 of 5
What makes up the powers of labor and birth?
Correct Answer: A
Rationale: The correct answer is A: contractions and pushing efforts. During labor and birth, contractions help to dilate the cervix and push the baby down the birth canal. Pushing efforts from the mother help to expel the baby out. Pelvis and pelvic floor tissues (choice B) provide the passage for the baby but do not actively contribute to the powers of labor. Fetal position, attitude, lie, and presentation (choice C) refer to the baby's position and orientation in the womb, which can affect the progress of labor but do not constitute the powers of labor. Oxytocin (choice D) is a hormone that stimulates contractions but is not the sole component of the powers of labor and birth.
Question 5 of 5
When does the second stage of labor begin?
Correct Answer: D
Rationale: The correct answer is D: when pushing begins. The second stage of labor begins when the cervix is fully dilated, and the mother starts pushing to deliver the baby. This stage ends with the birth of the baby. Option A is incorrect because the second stage begins after birth. Option B is incorrect as it refers to the transition phase, not the second stage. Option C is incorrect because the cervix being fully dilated and effaced marks the beginning of the second stage, not the end of it.