ATI LPN
ATI LPN Maternity OB Cohort 65 Exam Questions
Extract:
Client in first stage of labor, umbilical cord protruding from vagina.
Question 1 of 5
A nurse is assisting with the care of a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: Placing the client in a knee-chest or Trendelenburg position immediately relieves pressure on the prolapsed cord, preventing fetal hypoxia, which is the priority in this emergency.
Extract:
Client is a 26-year-old gravida 3 para 2 at 39 weeks gestation being induced for oligohydramnios. No significant social or medical history. Only complication is oligohydramnios. Previously delivered a 7-pound, 5-ounce infant vaginally without complications. Upon admission: 1 cm, 40% effaced, -2 station. No bloody show. Induced via Foley bulb induction. At 1200: 6 cm, 70% effaced, 0 station, membranes intact. Contractions every 2-3 min, strong. Fetal heart rate 140-145/min with average variability, drops to 100/min with contractions, lasts 20 sec, returns to baseline within 30 sec. Vital Signs at 1000: BP 122/74 mm Hg, HR 98/min, RR 20/min, Temp 36.7°C (98.1°F), O2 sat 99% on room air.
Question 2 of 5
Complete the diagram by dragging from the choices below to specify what complication the client is most likely experiencing, 2 actions the nurse should take to address that complication, and 2 parameters the nurse should monitor to assess the client's progress. Actions to take:
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale: Variable decelerations, indicated by a drop to 100/min with contractions, suggest cord compression due to oligohydramnios. Turning the client to the left side relieves cord pressure, and amnioinfusion adds fluid to cushion the cord. Monitoring fetal heart rate baseline and uterine contraction strength assesses intervention effectiveness.
Extract:
Question 3 of 5
Leopold's maneuvers are performed to:
Correct Answer: B
Rationale: Leopold's maneuvers assess fetal position and presentation, aiding in labor and delivery planning.
Question 4 of 5
What is the most common cause of early decelerations in fetal heart rate?
Correct Answer: A
Rationale: Early decelerations are caused by fetal head compression during contractions, a benign finding reflecting normal labor progression.
Extract:
Client in first stage of labor, umbilical cord protruding from vagina.
Question 5 of 5
A nurse is assisting with the care of a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: Placing the client in a knee-chest or Trendelenburg position immediately relieves pressure on the prolapsed cord, preventing fetal hypoxia, which is the priority in this emergency.