ATI RN
Maternal Monitoring During Labor Questions
Question 1 of 5
The school nurse is counseling a group of adolescent girls. What does the nurse explain about sperm ejaculated near the cervix?
Correct Answer: B
Rationale: The correct answer is B) They survive up to 5 days and can cause pregnancy. Sperm ejaculated near the cervix can survive in the female reproductive tract for up to 5 days, waiting for an egg to fertilize. This information is crucial for adolescent girls to understand the potential risk of pregnancy even if intercourse occurs a few days before ovulation. Option A) They are destroyed by the acidic pH of the vagina is incorrect because the vagina actually provides a slightly alkaline environment to support the survival of sperm. Option C) They lose their motility in about 12 hours after intercourse is incorrect because sperm can remain motile for several days inside the female reproductive tract. Option D) They are usually pushed out of the vagina by the muscular action of the vaginal wall is incorrect as the cervical mucus and the shape of the cervical canal actually help in transporting sperm towards the uterus. This educational context is important for adolescent girls to make informed decisions about sexual activity and contraception, emphasizing the importance of understanding reproductive physiology to prevent unintended pregnancies.
Question 2 of 5
The clinic nurse is obtaining a health history on a newly pregnant patient. Which is an indication for fetal diagnostic procedures if present in the health history?
Correct Answer: A
Rationale: In pharmacology, understanding maternal monitoring during labor is crucial to ensure the well-being of both the pregnant woman and the fetus. In this scenario, the correct answer is option A) Maternal diabetes, as it is a significant indication for fetal diagnostic procedures due to the potential risks associated with diabetes in pregnancy. Maternal diabetes can lead to complications such as macrosomia (large birth weight), congenital anomalies, and increased risk of stillbirth. Therefore, close monitoring of the fetus through diagnostic procedures like ultrasound, non-stress tests, or biophysical profiles is essential to assess fetal well-being and make timely interventions if needed. Option B) Weight gain of 25 lb is not a direct indication for fetal diagnostic procedures during pregnancy. It is important for overall maternal health monitoring but does not specifically warrant fetal diagnostic procedures. Option C) Maternal age older than 30 years is a common factor in pregnancies today, and while advanced maternal age may increase some risks, it is not a direct indication for fetal diagnostic procedures unless other risk factors are present. Option D) Previous infant weighing more than 3000 g at birth is not a specific indication for fetal diagnostic procedures unless there were complications during the previous birth related to the infant's size. Educationally, pharmacology students and healthcare professionals need to understand the rationale behind fetal monitoring during pregnancy to provide safe and effective care to pregnant women. Recognizing high-risk conditions like maternal diabetes and understanding when fetal diagnostic procedures are warranted are key components of maternal-fetal pharmacology.
Question 3 of 5
What does optimal nursing care after an amniocentesis include?
Correct Answer: B
Rationale: In the context of maternal monitoring during labor, optimal nursing care after an amniocentesis includes monitoring uterine activity. This is the correct answer because after an amniocentesis, it is crucial to monitor uterine contractions to ensure that the procedure has not triggered any unwanted changes in the uterine activity that could potentially lead to preterm labor or other complications. Monitoring uterine activity allows healthcare providers to detect any signs of distress early on and intervene promptly. Pushing fluids by mouth (Option A) is important for hydration but is not directly related to post-amniocentesis care. Placing the patient in a supine position for 2 hours (Option C) is not recommended as it can lead to decreased blood flow to the placenta and fetus. Applying a pressure dressing to the puncture site (Option D) is not typically done after an amniocentesis as it can increase the risk of infection or interfere with the healing process. Educationally, understanding the importance of monitoring uterine activity post-amniocentesis is crucial for nurses and healthcare providers caring for pregnant women. This knowledge helps in providing safe and effective care, ensuring the well-being of both the mother and the fetus during the critical period following the procedure.
Question 4 of 5
For which patient would an L/S ratio of 2:1 potentially be considered abnormal?
Correct Answer: B
Rationale: In pharmacology, the L/S ratio (lecithin/sphingomyelin ratio) is a crucial indicator of fetal lung maturity. An L/S ratio of 2:1 is generally considered normal, indicating mature fetal lungs. Option B, a 24-year-old gravida 1, para 0, with diabetes, would potentially have an abnormal L/S ratio of 2:1 because diabetes can delay fetal lung maturity, leading to a higher ratio than expected. Option A, a 38-year-old gravida 2, para 1, at 38 weeks' gestation, is less likely to have an abnormal L/S ratio as advanced maternal age alone is not a significant factor in fetal lung maturity. Option C, a 44-year-old gravida 6, para 5, at term, is also less likely to have an abnormal ratio as multiparity does not necessarily impact fetal lung maturity. Option D, an 18-year-old gravida 1, para 0, in early labor at term, is less likely to have an abnormal ratio as age and parity are not typically associated with delayed fetal lung maturity. Understanding these factors is essential for healthcare providers involved in maternal monitoring during labor to interpret and respond to variations in the L/S ratio accurately, ensuring the best outcomes for both the mother and the baby.
Question 5 of 5
The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? Select all that apply.
Correct Answer: B
Rationale: In the context of maternal monitoring during labor, it is crucial for nurses to understand the physiological changes that occur in pregnancy and how they impact laboratory values. Fibrinogen is expected to be elevated above prepregnancy levels. This is because fibrinogen is an acute phase reactant that increases during pregnancy to support the body's hemostatic needs during labor and delivery. Glucose levels are not typically expected to be elevated above prepregnancy levels during labor unless the client has gestational diabetes. Hematocrit levels may decrease slightly during pregnancy due to hemodilution, so they would not be expected to be elevated. Bilirubin levels are not typically elevated above prepregnancy levels during labor unless there are specific liver or gallbladder issues present. Understanding the normal physiological changes in pregnancy and their impact on laboratory values is essential for nurses to provide safe and effective care to pregnant clients during labor and delivery. By knowing which values are expected to be elevated or altered, nurses can detect deviations from normal more effectively and intervene promptly if necessary.