ATI-MN ATI Maternal Newborn Exam - Set 3 - Part 3

Correct Answer: The membranes must be ruptured

Internal monitoring requires ruptured membranes and adequate cervical dilation so the spiral electrode can attach to the fetal presenting part. Option a is incorrect because internal monitoring is used during active labor, not before labor begins. Option c is incorrect because the cervix must be dilated, not closed, for the electrode to reach the fetus. Option d is incorrect because the client is positioned for a vaginal procedure, not standing.

Correct Answer: Support position changes for comfort and progress

Frequent position changes increase comfort, relieve fatigue, and use gravity to promote fetal descent, so the nurse supports the client's movement during labor. Option a is incorrect because staying in bed is not required and can slow comfort and labor progress. Option b is incorrect because lying flat can lower blood pressure and is avoided when other positions are available. Option c is incorrect because movement aids labor, so limiting it offers no benefit when the client is able.

Correct Answer: A full bladder can impede fetal descent

A distended bladder can block the descent of the fetus and slow labor, so the nurse encourages frequent voiding to keep the bladder empty. Option a is incorrect because a full bladder does affect labor by impeding fetal descent. Option b is incorrect because bladder fullness is unrelated to the appearance of bloody show. Option d is incorrect because a full bladder slows rather than speeds labor progress.

Correct Answer: Give oxygen by face mask

When late decelerations persist after repositioning and stopping oxytocin, the nurse gives oxygen by face mask to improve the oxygen available to the fetus. Option a is incorrect because the supine position can lower blood pressure and reduce placental flow further. Option c is incorrect because pushing does not address the reduced placental oxygen causing late decelerations. Option d is incorrect because restarting oxytocin would intensify contractions and worsen the decelerations.

Correct Answer: The port closest to the client

Oxytocin is connected to the port closest to the client and given by pump, so the infusion can be stopped quickly with little remaining medication if a problem occurs. Option a is incorrect because the farthest port leaves more medication in the line, delaying how fast it can be stopped. Option b is incorrect because the specific closest port is chosen for safety, not any port at random. Option c is incorrect because oxytocin is given as a secondary infusion into the main line, not a separate independent line.

Correct Answer: An incision to enlarge the vaginal opening

An episiotomy is a surgical incision into the perineum that enlarges the vaginal opening to ease delivery and limit uncontrolled tearing of the tissue. Option b is incorrect because an incision into the uterine wall describes a cesarean, not an episiotomy. Option c is incorrect because an episiotomy widens the opening for birth rather than serving as a method to stop bleeding. Option d is incorrect because a stitch in the cervix describes a cerclage, not an episiotomy.

Correct Answer: Cervical readiness for induction

The Bishop score rates cervical factors to estimate how favorable the cervix is, which helps determine the likelihood that an induction will succeed. Option a is incorrect because placental position is determined by ultrasound rather than by the Bishop score. Option b is incorrect because the Bishop score evaluates the cervix, not the client's level of pain. Option c is incorrect because fetal lung maturity is assessed through amniotic fluid studies, not the Bishop score.

Correct Answer: To turn the fetus to a head-down position

An external cephalic version uses external manipulation to turn a breech fetus to a head-down position so a vaginal birth becomes possible. Option a is incorrect because the procedure repositions the fetus rather than aiming to start labor right away. Option c is incorrect because numbing the perineum describes a pudendal block, not an external version. Option d is incorrect because the placenta is delivered after birth and is unrelated to turning the fetus.

Correct Answer: Light circular stroking of the abdomen

Effleurage is light, gentle circular stroking of the abdomen with the fingertips in rhythm with breathing, which provides distraction and comfort during contractions. Option a is incorrect because soaking in a warm tub is hydrotherapy, which is separate from effleurage. Option b is incorrect because firm pressure on the lower back describes sacral counterpressure, a different comfort measure. Option d is incorrect because breathing into cupped hands treats hyperventilation, not the technique called effleurage.

Correct Answer: It is level with the ischial spines

Station zero means the presenting part has descended to the level of the ischial spines, which marks engagement of the fetus in the pelvis. Option b is incorrect because crowning occurs at a positive station near birth, not at station zero. Option c is incorrect because station zero indicates the fetus has engaged, not that it has yet to enter the pelvis. Option d is incorrect because a presenting part above the inlet would be a negative station, not station zero.