ATI RN
labor and delivery questions and answers Questions
Question 1 of 5
Why is precipitous labor most often seen in multiparous women?
Correct Answer: C
Rationale: The correct answer is C because the multigravida uterus has undergone labor before, making muscle coordination more efficient. This allows for faster and more coordinated contractions, leading to precipitous labor. Choice A is incorrect because the cervix does not weaken after each delivery. Choice B is incorrect as simultaneous dilation and effacement are not specific to multiparous women. Choice D is incorrect because the ability to recognize labor onset is not a determining factor in the occurrence of precipitous labor.
Question 2 of 5
During an oxytocin induction, which assessment finding is most concerning to the labor and delivery nurse?
Correct Answer: B
Rationale: The correct answer is B (A uterine resting tone of 30 mm Hg) because a high uterine resting tone indicates uterine hyperstimulation, which can lead to uterine rupture, fetal distress, and compromised blood flow to the placenta. A higher resting tone of 30 mm Hg is concerning compared to the normal range of 12-18 mm Hg. Choice A (A uterine resting tone of 17 mm Hg) is within the normal range, so it is not as concerning as a higher resting tone. Choices C (Contractions every 3 minutes lasting 60 seconds) and D (Contractions every 5 minutes lasting 60 seconds) describe the frequency and duration of contractions, which are important but are not as immediately concerning as a high uterine resting tone.
Question 3 of 5
Which woman is the best candidate for a trial of labor after cesarean (TOLAC)?
Correct Answer: B
Rationale: Rationale for Choice B (Correct Answer): - A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD is the best candidate for TOLAC. - Low-transverse incisions have the lowest risk of uterine rupture during labor. - CPD is not a contraindication for TOLAC. - Young age and low parity are favorable factors for successful TOLAC. - Therefore, this candidate has the highest likelihood of a successful VBAC. Summary for Other Choices: - Choice A: Classical cesarean section carries a high risk of uterine rupture; prematurity increases this risk. - Choice C: Low-transverse incision is favorable, but the indication for the previous cesarean (late decelerations) may indicate an ongoing fetal concern. - Choice D: T-shaped incision increases the risk of uterine rupture; macrosomia is a risk factor for failed TOL
Question 4 of 5
The nurse is providing discharge instructions to a person who was evaluated for possible labor. How does the nurse explain how losing the mucus plug could be a sign of impending labor?
Correct Answer: A
Rationale: Step-by-step rationale: 1. Increased estrogen levels lead to softening of the cervix, causing the mucus plug to be expelled. 2. Contractions usually start after the mucus plug is expelled, not before. 3. The mucus plug is typically expelled before the membranes rupture. 4. Effacement and dilation of the cervix prepare the body for labor but are not directly related to the expulsion of the mucus plug. In summary, Choice A is correct as increased estrogen leads to the expulsion of the mucus plug, indicating impending labor. Choices B, C, and D are incorrect as they do not accurately explain the relationship between the mucus plug and impending labor.
Question 5 of 5
When does the active phase of labor begin according to ACOG?
Correct Answer: A
Rationale: The active phase of labor according to ACOG begins at 6 cm dilation. At this point, contractions become stronger and more frequent, leading to faster cervical dilation. This stage signifies significant progress towards delivery. Choice B (3 cm) is incorrect as it falls within the early phase of labor. Choice C (5 cm) is also incorrect as it is near the beginning of the active phase but not the specific transition point. Choice D (10 cm) is incorrect as it marks full dilation and the transition to the second stage of labor.