ATI RN
Intrapartum Complication Questions
Question 1 of 5
When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?
Correct Answer: B
Rationale: The correct answer is B: Variable decelerations. When the mother's membranes rupture during active labor, variable decelerations should be observed in the fetal heart rate. This is because the rupture of membranes can lead to umbilical cord compression, causing variable decelerations in the fetal heart rate pattern. Variable decelerations are characterized by abrupt and visually apparent decreases in heart rate variability. A: Early decelerations are usually associated with head compression during contractions and are benign. C: Nonperiodic accelerations are not a typical pattern seen in response to ruptured membranes during labor. D: An increase in baseline variability is a positive sign and does not specifically indicate the occurrence of variable decelerations related to umbilical cord compression.
Question 2 of 5
Which of the following is the priority intervention for a supine patient whose monitor strip shows decelerations that begin after the peak of the contraction and return to the baseline after the contraction ends?
Correct Answer: C
Rationale: The correct answer is C: Reposition to left side-lying position. This is the priority intervention because decelerations that start after the peak of the contraction and return to baseline after it ends suggest umbilical cord compression. Repositioning the patient to the left side-lying position can alleviate pressure on the cord, potentially improving fetal perfusion. Increasing IV infusion (A) may not directly address the cord compression. Elevating lower extremities (B) may not alleviate the pressure on the cord. Administering oxygen (D) may be beneficial, but repositioning the patient is the primary intervention to address the underlying issue.
Question 3 of 5
When a pattern of variable decelerations occur, the nurse should immediately
Correct Answer: D
Rationale: The correct answer is D because positioning the patient in a knee-chest position helps to relieve pressure on the vena cava, improving blood flow to the placenta and fetus. This can help alleviate variable decelerations. Choice A is incorrect because administering oxygen at 8 to 10 L/min would not directly address the cause of variable decelerations. Choice B is incorrect as placing a wedge under the right hip is typically used for supine hypotension syndrome. Choice C is incorrect because increasing IV fluids may not directly address the issue of variable decelerations.
Question 4 of 5
Which medications could potentially cause hyperstimulation of the uterus during labor? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is a uterotonic agent commonly used to induce or augment labor. It can cause hyperstimulation of the uterus, leading to uterine hypertonicity and potentially compromising fetal oxygenation. Misoprostol, Dinoprostone, and Methylergonovine maleate are not known to cause hyperstimulation of the uterus during labor.
Question 5 of 5
A new client is seen at the prenatal clinic and says she thinks she is pregnant. The first day of her last menstrual period was April 1, 2014. What is her EDB?
Correct Answer: A
Rationale: The correct answer is A: December 30, 2014. To calculate the Estimated Date of Birth (EDB), you add 9 months and 7 days to the first day of the last menstrual period. In this case, April 1, 2014 + 9 months is January 1, 2015, and then adding 7 days gives December 30, 2014 as the EDB. This calculation takes into account the typical 40-week gestational period of a pregnancy. Choices B, C, and D are incorrect because they do not consider the full 40-week gestational period from the last menstrual period.