ATI RN
labor and delivery nclex questions Questions
Question 1 of 5
Which maternal factor may inhibit fetal descent during labor?
Correct Answer: A
Rationale: A full bladder can inhibit fetal descent during labor by obstructing the pathway for the baby to descend through the birth canal. A distended bladder can physically block the baby's head from moving down and putting pressure on the cervix, which is necessary for the progress of labor. It is important for pregnant individuals to empty their bladder regularly during labor to optimize the conditions for fetal descent and facilitate a smoother delivery process.
Question 2 of 5
The health care provider for a laboring patient makes the following entry into the patient’s record: 3/50%/+1. What instruction will the nurse implement with the patient?
Correct Answer: A
Rationale: The notation "3/50%/+" in the patient's record indicates that the patient is dilated 3 cm, the effacement is 50%, and the presenting part of the fetus is at +1 station. This information signifies that the patient is in active labor. The nurse should implement the instruction of having the patient remain in bed attached to the electronic fetal monitor to closely monitor the progression of labor and the well-being of the fetus. This will allow for continuous assessment and prompt interventions as needed.
Question 3 of 5
A patient asks the nurse how she can tell if labor is real. Which information should the nurse provide to this patient? (Select all that apply.)
Correct Answer: A
Rationale: Rationale: A) The correct answer is A) In true labor, the cervix begins to dilate. This is because cervical dilation is a key indicator of true labor progression. As labor begins and contractions become more regular and intense, the cervix starts to efface and dilate to allow the baby to move through the birth canal. This physiological change is a definitive sign that labor is indeed real. B) Option B is incorrect because the location of contractions alone cannot definitively determine if labor is real or false. While abdominal and groin contractions can be common in labor, the key factor is the progression of cervical dilation. C) Option C is incorrect as contractions in true labor typically become stronger and more frequent over time, unlike menstrual cramps which may not increase in intensity in a consistent pattern. Menstrual-like cramps can also occur in false labor, known as Braxton Hicks contractions. D) Option D is incorrect as true labor contractions typically become more regular, frequent, and intense as labor progresses. Inconsistent contractions in terms of frequency, duration, and intensity are more characteristic of false labor or prodromal labor. Educational Context: Understanding the signs of true labor is crucial for expectant mothers to differentiate between false labor and the real onset of labor. By recognizing the key indicators such as cervical dilation, women can better gauge when to seek medical attention and head to the hospital for delivery. This knowledge empowers mothers to make informed decisions about their labor experience and ensures timely and appropriate care during childbirth.
Question 4 of 5
Which clinical finding should the nurse expect to assess in the third stage of labor that indicates the placenta has separated from the uterine wall? (Select all that apply.)
Correct Answer: C
Rationale: In the third stage of labor, the correct clinical finding indicating placental separation is the fundus descending below the umbilicus. This is because as the placenta detaches from the uterine wall, the uterus contracts, causing the fundus to rise and then eventually descend as the placenta is expelled. Option A, a gush of blood appearing, is common in the immediate postpartum period but does not specifically indicate placental separation. Option B, the uterus rising upward in the abdomen, is incorrect as the uterus should be firm and well-contracted after the placenta is delivered. Option D, the cord descending further from the vagina, is not a reliable indicator of placental separation as the cord length can vary depending on the position of the baby and the extent of cord traction. Understanding the sequence of events in the stages of labor is crucial for nurses caring for laboring women. Recognizing the signs of placental separation is important to ensure that the placenta is delivered completely and to monitor for any signs of postpartum hemorrhage. Nurses must be competent in assessing these clinical findings to provide safe and effective care during the labor and delivery process.
Question 5 of 5
The onset of labor is multifactorial. These reasons include which of the following? Select all that apply.
Correct Answer: B
Rationale: In the context of labor and delivery, the correct answer is B) Increase in estrogen. Estrogen plays a crucial role in the initiation of labor by promoting uterine contractions and stimulating the production of prostaglandins, which help ripen the cervix. This hormone also aids in the activation of oxytocin receptors on the uterine muscle cells, further enhancing the contraction process. A) Increase in progesterone is not a factor in the onset of labor. In fact, progesterone levels decrease as labor approaches, allowing for the uterus to become more sensitive to the stimulatory effects of estrogen. C) Increase in human chorionic gonadotropin (hCG) is primarily involved in the maintenance of the corpus luteum during early pregnancy and is not directly implicated in the onset of labor. D) Aging of the placenta is associated with post-term pregnancies but is not a direct factor in the initiation of labor. Understanding the hormonal changes and their effects on uterine activity is crucial in the field of pharmacology, especially when considering interventions like oxytocin administration to induce or augment labor. By grasping the multifactorial nature of labor onset, healthcare providers can make informed decisions to support safe and effective childbirth.