ATI RN
high risk labor and delivery nclex questions Questions
Question 1 of 5
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
Correct Answer: B
Rationale: The correct answer is B: Engagement. Engagement occurs when the largest diameter of the fetal presenting part passes through the pelvic inlet, indicating the descent of the fetal head into the pelvis. This is a crucial step in labor progress as it signifies the baby's readiness for birth. A: Extension occurs during the second stage of labor when the baby's head passes through the birth canal. C: Internal rotation is the movement of the baby's head within the pelvis to align with the maternal pelvis. D: External rotation happens after the baby's head is delivered to allow for the shoulders to rotate for birth. In summary, engagement is the correct answer as it specifically refers to the largest diameter of the fetal presenting part passing the pelvic inlet, setting the stage for the progression of labor.
Question 2 of 5
A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
Correct Answer: B
Rationale: The correct answer is B: Active phase. In the active phase of labor, the cervix is typically dilated from 6 to 10 cm. This phase marks the transition from early labor to active labor, where contractions become stronger and more frequent, leading to further cervical dilation for the eventual delivery of the baby. The other choices are incorrect because: A: Latent phase is typically from 0 to 6 cm dilation. C: Second stage refers to the stage of labor starting from full dilation (10 cm) until the baby is born. D: Third stage is the stage after the baby is born, focusing on the delivery of the placenta.
Question 3 of 5
A patient in labor presents with a breech presentation. The nurse understands that a breech presentation is associated with
Correct Answer: D
Rationale: The correct answer is D: umbilical cord compression. In a breech presentation, the baby's bottom or feet present first, increasing the risk of umbilical cord prolapse or compression. This can lead to fetal distress due to compromised blood flow and oxygen supply. Other choices are incorrect as breech presentation is not associated with more rapid labor (A), high risk of infection (B), or increased maternal perineal trauma (C). It is crucial to prioritize addressing umbilical cord compression in a breech presentation to prevent potential complications for the baby.
Question 4 of 5
Which assessment finding would cause a concern for a patient who had delivered vaginally?
Correct Answer: B
Rationale: The correct answer is B - White blood cell count of 28,000 mm3 postbirth. This finding indicates a possible infection or inflammation, which can be concerning after vaginal delivery. A high white blood cell count may suggest an ongoing infection that needs immediate attention. A: Estimated blood loss of 500 mL is within normal range for vaginal delivery and is not a cause for concern. C: Fingers tingling may be due to various reasons unrelated to the delivery process and is not a typical concern post vaginal delivery. D: Thirst is a common symptom post-delivery and is not indicative of a serious complication.
Question 5 of 5
If a notation on the patient’s health record states that the fetal position is LSP, this indicates that the
Correct Answer: C
Rationale: The correct answer is C because LSP stands for Left Sacrum Posterior, meaning the baby's back is on the left side of the mother's spine and facing towards her back. This position is common during the early stages of labor. Choice A is incorrect as it describes a different position, choice B is incorrect as it refers to a different quadrant, and choice D is incorrect as it describes a location in the abdomen, not the pelvis.