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 umbilical cord prolapse. At this stage, the presenting part of the baby is relatively high in the pelvis, increasing the likelihood of the cord slipping past and becoming compressed against the cervix during contractions. This can lead to decreased blood flow and oxygen supply to the baby, posing a serious risk. Choices A, C, and D are less likely to result in cord prolapse due to the lower station of the baby in the pelvis, reducing the chance of cord compression.
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, there is a risk of maternal hemorrhage, which can lead to decreased oxygen delivery to tissues. Reporting low O2 saturation is crucial as it indicates potential hypoxia, necessitating immediate intervention. Choice A (BP of 95/60) may be within normal limits. Choice B (Temperature of 100.1°F) can indicate infection but is not directly related to placenta previa. Choice C (Urine output of 40 mL/hour) may reflect renal function but is not the priority in this situation.
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 because the positioning of the pregnant person affects the alignment of the baby's head in the pelvis, directly influencing cervical dilation. Proper positioning helps the baby apply pressure to the cervix, promoting dilation. In contrast, the strength of uterine contractions (B) affects labor progress but not cervical dilation specifically. The length of time since ruptured membranes (C) may increase infection risk but does not directly impact dilation. Fetal presentation (D) affects the descent of the baby, not 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) because they are the main physiological components of labor and birth. Contractions help to thin and dilate the cervix, while pushing efforts help the baby descend through the birth canal. Pelvis and pelvic floor tissues (B) play a role in the mechanics of birth but do not make up the powers of labor. Fetal position, attitude, lie, and presentation (C) are important factors influencing labor progress but do not constitute the powers of labor. Oxytocin (D) is a hormone that stimulates contractions but is not a direct component of the powers of labor.
Question 5 of 5
When does the second stage of labor begin?
Correct Answer: D
Rationale: The correct answer is D because the second stage of labor begins when the mother starts pushing to deliver the baby. This stage involves the actual delivery of the baby and ends with the birth. The other choices are incorrect because: A: Labor begins before the second stage. B: The early phase is part of the first stage of labor. C: Full dilation and effacement mark the transition between the first and second stages but pushing is when the second stage actually begins.