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 is a serious complication where the placenta separates from the uterine wall before delivery, leading to severe abdominal pain, dark red bleeding, fetal distress (as indicated by low fetal heart tones), and a rigid, tender abdomen due to internal bleeding and uterine contractions. These signs indicate an emergent situation requiring immediate medical intervention to prevent harm to both the mother and the baby. The other options are incorrect in this context: - B) Placental accreta is when the placenta attaches too deeply into the uterine wall, which presents with painless bleeding in the third trimester, not the acute symptoms described. - C) Placenta previa is when the placenta partially or fully covers the cervix, causing painless bleeding, not the acute abdominal pain and tenderness seen here. - D) Placenta succenturiata is a rare variation where accessory lobes of the placenta are present, usually asymptomatic and not associated with the described symptoms. Understanding these distinctions is crucial for nurses and healthcare providers working in labor and delivery to make quick and accurate assessments, prioritize care, and respond effectively to obstetric emergencies like placental abruption. Early recognition and intervention can significantly impact outcomes for both the mother and the baby.
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. This patient has a history of cesarean section, which is a known risk factor for placenta previa. Placenta previa occurs when the placenta partially or completely covers the cervix, leading to vaginal bleeding. A history of cesarean section increases the risk of placenta previa due to scarring of the uterine wall, which can affect placental implantation in subsequent pregnancies. The other options are not directly related to the risk factors for placenta previa in this case. Maternal age of 24, twin gestation, and gestational age of 29 weeks are not specific risk factors for placenta previa. It is important to understand the unique risk factors associated with placenta previa to provide appropriate care and management for pregnant patients. Educationally, this question highlights the significance of understanding how a history of cesarean section can impact future pregnancies and the potential complications, such as placenta previa. It emphasizes the importance of recognizing risk factors in pregnant patients to provide timely interventions and ensure positive maternal and fetal outcomes.