ATI RN
labor and delivery nclex questions Questions
Question 1 of 5
Which is the best explanation for the use of hydration and relaxation in the treatment of hypertonic labor?
Correct Answer: A
Rationale: Hydration helps to dilute endogenous oxytocin, which can reduce uterine contractions and relax the uterus. Hypertonic labor involves excessive uterine contractions, and hydration can counteract this by regulating contractions and improving perfusion, which ultimately aids in a more coordinated and effective labor progression.
Question 2 of 5
Cephalohematoma occurring from an operative vaginal delivery increased a newborn’s risk of developing which of the following complications?
Correct Answer: C
Rationale: Cephalohematomas are a common complication from operative vaginal deliveries. The accumulation of blood between the infant's skull and periosteum increases the risk of jaundice because of the breakdown of red blood cells, which can overwhelm the infant's immature liver and lead to hyperbilirubinemia.
Question 3 of 5
While attending the delivery of a patient with GODM, the nurse notices the retraction of the fetal head onto the perineum. What is the nurse’s next best action?
Correct Answer: D
Rationale: The retraction of the fetal head onto the perineum during labor can be indicative of shoulder dystocia or other obstructive complications, requiring immediate action. The best response is to assist the mother into hands-and-knees position, which can relieve pressure on the perineum and help with fetal descent.
Question 4 of 5
A woman presents to labor and delivery at 37 weeks plus 6 days gestation with complaints of constant abdominal pain and dark red bleeding that started 30 minutes ago. Upon examination, the woman’s abdomen is consistently rigid and tender. Fetal heart tones are noted to be in the 70s. Which are these findings are associated with?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Placental abruption. Placental abruption involves the premature separation of the placenta from the uterine wall before delivery, leading to significant complications for both the mother and the fetus. The clinical presentation of constant abdominal pain, dark red bleeding, rigid/tender abdomen, and fetal bradycardia (heart rate in the 70s) is indicative of a severe placental abruption. Option B) Placental accreta refers to abnormal adherence of the placenta to the uterine wall, which typically presents with painless bleeding in the third trimester, not the acute and severe symptoms described in the case. Option C) Placenta previa involves the implantation of the placenta over or near the cervix, leading to painless bleeding in the third trimester, not the characteristic symptoms of abdominal pain, rigidity, and fetal distress seen in placental abruption. Option D) Placenta succenturiata is a rare variation where accessory placental lobes are connected to the main placenta by blood vessels. This condition is not typically associated with the acute clinical presentation described in the case. Understanding these distinctions is crucial for healthcare providers managing pregnant patients to make timely and accurate diagnoses, initiate appropriate interventions, and prevent adverse outcomes for both the mother and the fetus. Early recognition and management of placental abruption are essential to optimize maternal and fetal outcomes in such critical situations.
Question 5 of 5
A 24-year-old G4 T1 A2 L1 presents to obstetric triage with complaints of contractions every 3 minutes, accompanied by bright red vaginal bleeding. The woman is 29 weeks gestation with a twin pregnancy. She has had three urinary tract infections during this pregnancy and is currently taking Microbid daily as prophylaxis. Her last baby was born via cesarean section for breech malpresentation. She denies any other significant medical history. What risk factors for placenta previa does this patient have? Select all that apply.
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Previous delivery by cesarean section. A history of cesarean section is a known risk factor for placenta previa due to the potential for abnormal placentation over the scarred area of the uterus. This can lead to placenta previa, where the placenta partially or completely covers the cervix, causing bleeding. Maternal age of 24, twin gestation, and gestational age of 29 weeks are not direct risk factors for placenta previa. While advanced maternal age and twin gestation can pose their own set of risks during pregnancy, they are not specifically associated with an increased risk of placenta previa. Additionally, gestational age alone does not contribute to the development of placenta previa. Educationally, understanding the risk factors for placenta previa is crucial for healthcare providers working in labor and delivery settings. Recognizing these risk factors can aid in early identification, appropriate management, and timely intervention to prevent complications such as hemorrhage and preterm birth in pregnant individuals. It highlights the importance of thorough obstetric history-taking and risk assessment in the care of pregnant women.