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 important because before using vacuum or forceps, the fetus should be mature enough to withstand the extraction process. Premature infants may not have fully developed skull bones to withstand the pressure, increasing the risk of injury. Explanation for other choices: A: The woman’s bladder is empty - While it's ideal for the bladder to be empty to prevent injury during the procedure, it's not a criteria that must be verified prior to vacuum or forceps use. C: There is a Category I tracing - Fetal heart rate monitoring is important during labor, but the tracing being Category I does not specifically correlate with the need for vacuum or forceps. D: The cervix must be completely dilated - While full cervical dilation is necessary for vaginal delivery, it is not a specific criteria to verify before vacuum or forceps use.
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 for optimal fetal positioning and descent. It also helps relieve pressure on the cervix, promoting dilation. Ambulation (A) may slow down labor progress, squatting (B) can increase pressure on the cervix and hinder descent, and resting on hands and knees (D) may not be as conducive to gravity-assisted descent.
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 because a uterine resting tone of 30 mm Hg indicates excessive uterine activity, which can lead to uterine hyperstimulation and fetal distress during an oxytocin induction. A higher resting tone suggests the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choices A, C, and D are incorrect because a uterine resting tone of 17 mm Hg is within the normal range, contractions every 3 minutes lasting 60 seconds and every 5 minutes lasting 60 seconds are typical patterns during labor induction, and they do not necessarily indicate complications.
Question 4 of 5
Which woman is the best candidate for a trial of labor after cesarean (TOLAC)?
Correct Answer: B
Rationale: The correct answer is B: A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD. This candidate is the best choice for a trial of labor after cesarean (TOLAC) because a low-transverse incision has the lowest risk of uterine rupture during labor compared to classical, T-shaped, or vertical incisions. Additionally, the indication for the previous cesarean section being cephalopelvic disproportion (CPD) suggests that the pelvis may have been the limiting factor in the previous delivery, making a TOLAC a reasonable option. The other choices have higher risks of uterine rupture (classical incision, T-shaped incision) or indications that may increase the likelihood of complications during TOLAC (prematurity, late decelerations).
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: The correct answer is A because the mucus plug is expelled due to increased estrogen levels before contractions start. Estrogen stimulates the production of mucus that forms the plug, which is then released as a result of hormonal changes signaling the body to prepare for labor. This process occurs before labor contractions begin. Choice B is incorrect because the mucus plug is typically expelled before the membranes rupture during labor. Choice C is incorrect because effacement and dilation of the cervix do not directly cause the expulsion of the mucus plug. Choice D is incorrect because labor can begin even if the mucus plug has not been expelled, and the plug itself does not create a space for the fetus.