ATI RN
Maternal and Newborn Nursing Questions
Question 1 of 5
What is the first action for a mother experiencing excessive bleeding two hours postpartum?
Correct Answer: A
Rationale: In the scenario of a mother experiencing excessive bleeding two hours postpartum, the first action should be to monitor her blood pressure and heart rate, which are vital signs that can provide immediate information about her condition. By monitoring these parameters, healthcare providers can quickly assess the severity of the bleeding and the mother's hemodynamic status. This information is critical for determining the appropriate course of action. Performing uterine massage to stimulate contractions (option B) is an important intervention to help control postpartum bleeding caused by uterine atony. However, before initiating this intervention, it is essential to assess the mother's vital signs to ensure that she is stable enough to undergo the procedure. Preparing for a possible blood transfusion (option C) is premature without first evaluating the mother's current status through vital sign monitoring. Blood transfusion may be necessary in cases of severe postpartum hemorrhage, but it should be based on a comprehensive assessment of the mother's condition. Notifying the healthcare provider immediately (option D) is important, but it should not precede the initial assessment of vital signs. Prompt notification should follow the assessment to ensure timely involvement of the healthcare team in managing the situation effectively. In an educational context, understanding the prioritization of interventions in postpartum hemorrhage is crucial for maternal and newborn nurses. By prioritizing actions based on assessment findings, nurses can provide timely and appropriate care to prevent further complications and ensure the well-being of the mother and newborn. Monitoring vital signs as the first action aligns with the principles of assessing and managing postpartum hemorrhage effectively.
Question 2 of 5
Which factor should alert the nurse for the potential of a prolapsed umbilical cord?
Correct Answer: A
Rationale: A presenting part at station minus 3 indicates that there is too much empty space between the presenting part (usually the fetus's head) and the pelvic inlet. This increased space raises the potential for the umbilical cord to prolapse through the cervix and into the birth canal ahead of the baby, especially when the membranes rupture. A prolapsed umbilical cord is a severe obstetric emergency that can cause fetal compromise due to umbilical cord compression and compromise of blood flow. It requires immediate intervention to relieve the pressure on the cord and increase the likelihood of a safe delivery. Therefore, a presenting part at station minus 3 should alert the nurse to the potential of a prolapsed umbilical cord.
Question 3 of 5
How would the nurse best analyze the results from a patient sonogram that shows the fetal shoulder is the presenting part? What position?
Correct Answer: A
Rationale: When the sonogram shows the fetal shoulder as the presenting part, it indicates a bridge transverse position. This position means that the baby is lying sideways in the uterus, with one shoulder presenting first. It is essential for the nurse to recognize this position as it may impact the mode of delivery and require additional monitoring to ensure the safe delivery of the baby. Through proper analysis and understanding of the sonogram results, healthcare providers can make informed decisions and provide appropriate care for both the mother and the baby.
Question 4 of 5
The primiparous patient that's 40 weeks' gestation reports to the nurse that she has increased pelvic pressure and increased urinary frequency. Which response by the nurse is best?
Correct Answer: A
Rationale: The best response by the nurse is to reassure the primiparous patient that her increased pelvic pressure and urinary frequency could mean that the baby's head has descended further into the pelvis. This can indicate that labor is approaching, as the baby is getting into position for birth. It is important for the nurse to provide this information to ease the patient's concerns and help her understand the potential significance of these symptoms at 40 weeks' gestation.
Question 5 of 5
The nurse should anticipate the labor pattern for a fetal occiput posterior position to be
Correct Answer: A
Rationale: The nurse should anticipate the labor pattern for a fetal occiput posterior position to be prolonged and more painful. This is because in occiput posterior position, the baby's head is facing the mother's abdomen instead of her back, which can lead to slower descent and dilation of the cervix. The baby's head may have difficulty rotating to the optimal position for birth, causing longer labor and increased back pain for the mother. Nurses should be prepared to provide additional support and pain management strategies for women experiencing labor with a fetal occiput posterior position.