ATI RN
Intrapartum Complications NCLEX Questions Questions
Question 1 of 5
What is the nursing intervention for prolapsed cord?
Correct Answer: C
Rationale: The correct nursing intervention for prolapsed cord is to lift the presenting part off the cord to relieve pressure and improve blood flow to the fetus. This step prevents further compression of the blood vessels in the cord. Turning the person to the side (A) is not specific to addressing a prolapsed cord. Giving oxygen (B) may be necessary, but it does not directly address the issue of cord prolapse. Increasing oxytocin (D) can worsen the situation by causing stronger contractions, potentially further compressing the cord. Therefore, the most appropriate action is to lift the presenting part off the cord (C) to protect the blood flow to the fetus.
Question 2 of 5
Decreased capillary refill, delay in milk production, and diminished peripheral pulses are signs of what complication?
Correct Answer: C
Rationale: The correct answer is C, alteration in kidney function. Decreased capillary refill indicates poor perfusion due to impaired kidney function leading to reduced blood flow. Delay in milk production is not directly related to kidney or liver function. Diminished peripheral pulses can be a sign of decreased blood flow due to kidney dysfunction affecting circulation. Alteration in liver or uterine function would not typically present with these specific signs. Therefore, the signs listed are most indicative of a complication related to kidney function.
Question 3 of 5
A patient who is expecting her first baby tells the nurse, “I am afraid of the whole birth experience and plan to ask the doctor for a cesarean delivery.” Which response by the nurse is most appropriate?
Correct Answer: B
Rationale: The correct answer is B: Most women avoid cesarean births unless it is an emergency. Rationale: 1. Cesarean delivery is a major surgery with potential risks and longer recovery time compared to vaginal birth. 2. Most women opt for vaginal birth unless there are medical reasons necessitating a cesarean section. 3. It is important for the nurse to educate the patient on the benefits of vaginal birth and address her fears about the birth experience. 4. Encouraging the patient to consider vaginal birth unless there is a medical emergency aligns with best practices in obstetric care. Summary: - Choice A is incorrect because focusing solely on pain management may not address the patient's underlying fear of the birth experience. - Choice C is incorrect as seeking another opinion may not be necessary if the patient's concerns can be addressed through education and counseling. - Choice D is incorrect as not all cesarean deliveries lead to complications in subsequent pregnancies.
Question 4 of 5
An emergency cesarean is being implemented. The patient describes tingling in her ears and a metallic taste with the administration of regional anesthesia. The nurse is aware that which incidence has occurred?
Correct Answer: B
Rationale: The correct answer is B: Inadvertent injection of the anesthetic agent into the maternal bloodstream. This is indicated by the patient experiencing tingling in her ears and a metallic taste, which are signs of systemic toxicity from the anesthetic agent. The anesthetic has entered the bloodstream instead of staying localized to the intended area. Other choices are incorrect as A is more related to opioid overdose, C is more related to hypotension, and D implies that these symptoms are normal when they are not.
Question 5 of 5
The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B: Increased number of elective or maternal request cesareans. This is correct because the rise in elective cesarean births, often due to patient preference or convenience, can contribute to the overall high rates of cesarean births. A: Fetuses in breech position unable to deliver vaginally - This is a valid reason for cesarean births, but it does not address the question about high rates of cesarean births. C: Incidences of women of older maternal age getting pregnant - While advanced maternal age can be a factor in cesarean births, it is not directly related to the high rates of cesarean births at the facility. D: Decreasing rate of malpractice litigation with cesarean birth - This is an irrelevant factor in determining the reasons for high rates of cesarean births at the facility.