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ATI Intrapartum Care Practice Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+ Brand New Version!!
Question 1
A primigravida at 39 weeks gestation is admitted to the labor and
delivery unit with regular uterine contractions every 3 to 4 minutes,
lasting 60 seconds, and moderate to strong intensity. Her cervix is 5 cm
dilated, 90% effaced, and the fetal vertex is at -1 station. Which of the
following nursing actions is the priority?
A. Administer prescribed oxytocin to augment labor.
B. Encourage the patient to use the bathroom.
C. Assess the fetal heart rate tracing and maternal vital signs.
D. Prepare for immediate cesarean delivery.
Answer: C
Explanation: The priority nursing action is to assess fetal well-being and
maternal status upon admission. A baseline fetal heart rate tracing and
maternal vital signs provide critical data to guide subsequent
interventions. Oxytocin is not indicated for a patient in active labor with
adequate contractions. Encouraging bathroom use is appropriate but
not the priority, and cesarean delivery is not indicated based on the
data provided.
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Question 2
A patient in active labor has an epidural catheter in place for pain
management. Her blood pressure drops from 120/80 mm Hg to 90/60
mm Hg. Which of the following is the nurse's initial intervention?
A. Increase the rate of the intravenous fluids.
B. Administer intravenous ephedrine as prescribed.
C. Position the patient in a left lateral position.
D. Notify the anesthesia provider immediately.
Answer: C
Explanation: The initial intervention for hypotension following epidural
analgesia is to place the patient in a left lateral position or elevate the
legs to improve venous return and cardiac output. Increasing IV fluids
and administering vasopressors are subsequent steps, but repositioning
is the first-line, non-invasive action. Notifying the anesthesia provider is
important but not the immediate first step.
Question 3
A patient's cervical examination is 6 cm dilated, 100% effaced, and the
fetal head is at +1 station. The fetal heart rate is 140 beats per minute
with moderate variability and no decelerations. The patient reports
intense back pain with each contraction. The nurse suspects which of
the following fetal positions?
A. Left occiput anterior (LOA)
B. Right occiput anterior (ROA)
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C. Occiput posterior (OP)
D. Breech
Answer: C
Explanation: Intense back pain during labor is a hallmark of occiput
posterior position, where the fetal occiput is directed toward the
maternal sacrum, causing pressure on the maternal spine and sacral
nerves. LOA and ROA positions typically present with less back
discomfort. Breech presentation involves the fetal buttocks or feet as
the presenting part, which may also cause back pain but is less common
and not the primary association with this symptom.
Question 4
A nurse is monitoring a patient who is receiving oxytocin for labor
augmentation. The patient's contractions are now occurring every 1.5
to 2 minutes and lasting 90 seconds, with a resting uterine tone of 30
mm Hg. The fetal heart rate shows late decelerations. Which of the
following actions should the nurse take first?
A. Turn off the oxytocin infusion.
B. Decrease the oxytocin infusion rate.
C. Administer oxygen via face mask at 10 L/min.
D. Position the patient in a Trendelenburg position.
Answer: A
Explanation: The priority action is to immediately discontinue the
oxytocin infusion to reduce uterine hyperstimulation, which is causing
fetal compromise evidenced by late decelerations. While administering
oxygen and repositioning are also critical interventions, removing the
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cause of hyperstimulation is the initial and most definitive step.
Decreasing the rate is insufficient in the presence of tachysystole and
fetal distress.
Question 5
A patient is in the second stage of labor. The nurse observes an
acceleration of the fetal heart rate of 15 beats per minute above the
baseline lasting 20 seconds in response to a fetal scalp stimulation. This
finding is indicative of:
A. Fetal acidemia.
B. An intact central nervous system and absence of hypoxia.
C. Umbilical cord compression.
D. Head compression.
Answer: B
Explanation: A fetal heart rate acceleration of at least 15 beats per
minute for 15 seconds in response to fetal scalp stimulation is a
reassuring sign indicating a well-oxygenated fetus with an intact central
nervous system. This response rules out significant acidemia. Umbilical
cord compression is associated with variable decelerations, and head
compression is associated with early decelerations.
Question 6
A patient at 41 weeks gestation is undergoing a biophysical profile
(BPP). The BPP score is 6 out of 10. Which of the following components
is most likely the reason for this score?
ATI Intrapartum Care Practice Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+ Brand New Version!!
Question 1
A primigravida at 39 weeks gestation is admitted to the labor and
delivery unit with regular uterine contractions every 3 to 4 minutes,
lasting 60 seconds, and moderate to strong intensity. Her cervix is 5 cm
dilated, 90% effaced, and the fetal vertex is at -1 station. Which of the
following nursing actions is the priority?
A. Administer prescribed oxytocin to augment labor.
B. Encourage the patient to use the bathroom.
C. Assess the fetal heart rate tracing and maternal vital signs.
D. Prepare for immediate cesarean delivery.
Answer: C
Explanation: The priority nursing action is to assess fetal well-being and
maternal status upon admission. A baseline fetal heart rate tracing and
maternal vital signs provide critical data to guide subsequent
interventions. Oxytocin is not indicated for a patient in active labor with
adequate contractions. Encouraging bathroom use is appropriate but
not the priority, and cesarean delivery is not indicated based on the
data provided.
,2|Page
Question 2
A patient in active labor has an epidural catheter in place for pain
management. Her blood pressure drops from 120/80 mm Hg to 90/60
mm Hg. Which of the following is the nurse's initial intervention?
A. Increase the rate of the intravenous fluids.
B. Administer intravenous ephedrine as prescribed.
C. Position the patient in a left lateral position.
D. Notify the anesthesia provider immediately.
Answer: C
Explanation: The initial intervention for hypotension following epidural
analgesia is to place the patient in a left lateral position or elevate the
legs to improve venous return and cardiac output. Increasing IV fluids
and administering vasopressors are subsequent steps, but repositioning
is the first-line, non-invasive action. Notifying the anesthesia provider is
important but not the immediate first step.
Question 3
A patient's cervical examination is 6 cm dilated, 100% effaced, and the
fetal head is at +1 station. The fetal heart rate is 140 beats per minute
with moderate variability and no decelerations. The patient reports
intense back pain with each contraction. The nurse suspects which of
the following fetal positions?
A. Left occiput anterior (LOA)
B. Right occiput anterior (ROA)
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C. Occiput posterior (OP)
D. Breech
Answer: C
Explanation: Intense back pain during labor is a hallmark of occiput
posterior position, where the fetal occiput is directed toward the
maternal sacrum, causing pressure on the maternal spine and sacral
nerves. LOA and ROA positions typically present with less back
discomfort. Breech presentation involves the fetal buttocks or feet as
the presenting part, which may also cause back pain but is less common
and not the primary association with this symptom.
Question 4
A nurse is monitoring a patient who is receiving oxytocin for labor
augmentation. The patient's contractions are now occurring every 1.5
to 2 minutes and lasting 90 seconds, with a resting uterine tone of 30
mm Hg. The fetal heart rate shows late decelerations. Which of the
following actions should the nurse take first?
A. Turn off the oxytocin infusion.
B. Decrease the oxytocin infusion rate.
C. Administer oxygen via face mask at 10 L/min.
D. Position the patient in a Trendelenburg position.
Answer: A
Explanation: The priority action is to immediately discontinue the
oxytocin infusion to reduce uterine hyperstimulation, which is causing
fetal compromise evidenced by late decelerations. While administering
oxygen and repositioning are also critical interventions, removing the
, 4|Page
cause of hyperstimulation is the initial and most definitive step.
Decreasing the rate is insufficient in the presence of tachysystole and
fetal distress.
Question 5
A patient is in the second stage of labor. The nurse observes an
acceleration of the fetal heart rate of 15 beats per minute above the
baseline lasting 20 seconds in response to a fetal scalp stimulation. This
finding is indicative of:
A. Fetal acidemia.
B. An intact central nervous system and absence of hypoxia.
C. Umbilical cord compression.
D. Head compression.
Answer: B
Explanation: A fetal heart rate acceleration of at least 15 beats per
minute for 15 seconds in response to fetal scalp stimulation is a
reassuring sign indicating a well-oxygenated fetus with an intact central
nervous system. This response rules out significant acidemia. Umbilical
cord compression is associated with variable decelerations, and head
compression is associated with early decelerations.
Question 6
A patient at 41 weeks gestation is undergoing a biophysical profile
(BPP). The BPP score is 6 out of 10. Which of the following components
is most likely the reason for this score?
