ATI RN
Intrapartum Complication Questions
Question 1 of 5
Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
Correct Answer: D
Rationale: The correct answer is D because oxytocin can cause increased uterine contractions, potentially impacting uteroplacental exchange and reducing oxygen delivery to the fetus. This can lead to fetal distress, making continuous electronic fetal monitoring crucial to detect any signs of distress promptly. A: Fetal chemoreceptors being stimulated is not directly related to the need for continuous monitoring with oxytocin administration. B: Maternal hypotension is a potential side effect of oxytocin but does not directly necessitate continuous fetal monitoring. C: Maternal fluid volume deficit is a concern with oxytocin, but it does not directly link to the need for continuous fetal monitoring.
Question 2 of 5
Observation of a fetal heart rate pattern indicates an increase in heart rate from the prior baseline rate of 152 bpm. Which physiologic mechanisms would account for this situation?
Correct Answer: D
Rationale: The correct answer is D: Sympathetic stimulation. Sympathetic stimulation increases heart rate by releasing norepinephrine, which acts on beta-adrenergic receptors in the heart. This leads to an increase in heart rate. Choices A and B are incorrect because inhibition of epinephrine or norepinephrine would not cause an increase in heart rate. Choice C is incorrect because stimulation of the vagus nerve would actually decrease heart rate by releasing acetylcholine, which acts on muscarinic receptors in the heart.
Question 3 of 5
Which of the following is the priority intervention for a supine patient whose monitor strip shows decelerations that begin after the peak of the contraction and return to the baseline after the contraction ends?
Correct Answer: C
Rationale: The correct answer is C: Reposition to left side-lying position. This is the priority intervention because decelerations that start after the peak of the contraction and return to baseline after it ends suggest umbilical cord compression. Repositioning the patient to the left side-lying position can alleviate pressure on the cord, potentially improving fetal perfusion. Increasing IV infusion (A) may not directly address the cord compression. Elevating lower extremities (B) may not alleviate the pressure on the cord. Administering oxygen (D) may be beneficial, but repositioning the patient is the primary intervention to address the underlying issue.
Question 4 of 5
When a pattern of variable decelerations occur, the nurse should immediately
Correct Answer: D
Rationale: The correct answer is D because positioning the patient in a knee-chest position helps to relieve pressure on the vena cava, improving blood flow to the placenta and fetus. This can help alleviate variable decelerations. Choice A is incorrect because administering oxygen at 8 to 10 L/min would not directly address the cause of variable decelerations. Choice B is incorrect as placing a wedge under the right hip is typically used for supine hypotension syndrome. Choice C is incorrect because increasing IV fluids may not directly address the issue of variable decelerations.
Question 5 of 5
Which medications could potentially cause hyperstimulation of the uterus during labor? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is a uterotonic agent commonly used to induce or augment labor. It can cause hyperstimulation of the uterus, leading to uterine hypertonicity and potentially compromising fetal oxygenation. Misoprostol, Dinoprostone, and Methylergonovine maleate are not known to cause hyperstimulation of the uterus during labor.