ATI RN
labor and delivery questions and answers Questions
Question 1 of 5
Which criteria should be verified prior to vacuum or forceps use? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B: The fetus must be at least 34 weeks gestation. This is because using vacuum or forceps delivery before 34 weeks gestation can increase the risk of complications for both the mother and the baby. For the other choices: A: The woman’s bladder being empty is not a specific criteria for vacuum or forceps use. C: A Category I tracing is related to fetal heart monitoring and does not directly impact the decision to use vacuum or forceps. D: While it is ideal for the cervix to be completely dilated before vacuum or forceps use, it is not the primary criteria to be verified.
Question 2 of 5
A gravida 3, para 2 is attempting a vaginal birth without the use of pain medicine or anesthesia. Following spontaneous rupture of membranes, the patient’s cervical exam was 5 cm dilated, 60% effaced, -2 station. Which therapeutic intervention is appropriate for this patient?
Correct Answer: C
Rationale: The correct answer is C: Sitting on birthing ball. This position helps to open up the pelvis, allowing gravity to assist in descent of the baby. It also promotes optimal positioning for the baby, reducing the risk of malpresentation. The other choices (A, B, D) do not provide the same benefits in terms of promoting optimal fetal positioning and utilizing gravity to aid in labor progress. Ambulation with assistance may not provide as much support for the pelvis, squatting with support from the partner may not be as stable or comfortable for the mother, and resting on hands and knees may not encourage as much engagement of the baby's head in the pelvis.
Question 3 of 5
During an oxytocin induction, which assessment finding is most concerning to the labor and delivery nurse?
Correct Answer: B
Rationale: The correct answer is B (A uterine resting tone of 30 mm Hg) because a high uterine resting tone indicates uterine hyperstimulation, which can lead to uterine rupture, fetal distress, and compromised blood flow to the placenta. A higher resting tone of 30 mm Hg is concerning compared to the normal range of 12-18 mm Hg. Choice A (A uterine resting tone of 17 mm Hg) is within the normal range, so it is not as concerning as a higher resting tone. Choices C (Contractions every 3 minutes lasting 60 seconds) and D (Contractions every 5 minutes lasting 60 seconds) describe the frequency and duration of contractions, which are important but are not as immediately concerning as a high uterine resting tone.
Question 4 of 5
Which woman is the best candidate for a trial of labor after cesarean (TOLAC)?
Correct Answer: B
Rationale: Rationale for Choice B (Correct Answer): - A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD is the best candidate for TOLAC. - Low-transverse incisions have the lowest risk of uterine rupture during labor. - CPD is not a contraindication for TOLAC. - Young age and low parity are favorable factors for successful TOLAC. - Therefore, this candidate has the highest likelihood of a successful VBAC. Summary for Other Choices: - Choice A: Classical cesarean section carries a high risk of uterine rupture; prematurity increases this risk. - Choice C: Low-transverse incision is favorable, but the indication for the previous cesarean (late decelerations) may indicate an ongoing fetal concern. - Choice D: T-shaped incision increases the risk of uterine rupture; macrosomia is a risk factor for failed TOL
Question 5 of 5
The nurse is providing discharge instructions to a person who was evaluated for possible labor. How does the nurse explain how losing the mucus plug could be a sign of impending labor?
Correct Answer: A
Rationale: Step-by-step rationale: 1. Increased estrogen levels lead to softening of the cervix, causing the mucus plug to be expelled. 2. Contractions usually start after the mucus plug is expelled, not before. 3. The mucus plug is typically expelled before the membranes rupture. 4. Effacement and dilation of the cervix prepare the body for labor but are not directly related to the expulsion of the mucus plug. In summary, Choice A is correct as increased estrogen leads to the expulsion of the mucus plug, indicating impending labor. Choices B, C, and D are incorrect as they do not accurately explain the relationship between the mucus plug and impending labor.