ATI Capstone Week 11 Exam | Nurselytic

Questions 64

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ATI Capstone Week 11 Exam Questions

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Question 1 of 5

A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 min and a frequency of 3 min. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?

Correct Answer: D

Rationale: The correct answer is D: Place the client in a lateral position. This is the priority action because the client's low blood pressure (92/54 mm Hg) indicates hypotension, which could be causing decreased perfusion to the fetus. Placing the client in a lateral position can help improve blood flow to the placenta and fetus. This position can also help alleviate pressure on the vena cava, improving maternal cardiac output.


Choice A (Have the client void) is not the priority action in this case as the client's vital signs indicate a more urgent concern related to hypotension and fetal well-being.
Choice B (Ask the client if she needs pain medication) is not the priority as addressing pain relief is important but not as urgent as addressing potential hypotension.
Choice C (Notify the provider of the findings) may be necessary but is not the immediate priority.

In summary, placing the client in a lateral position is the priority action to address hypotension

Question 2 of 5

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Question 5 of 5

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