ATI Maternal Newborn Test 3 Exam Study Guide

1) How would the nurse best analyze the results from a client's sonogram that shows the fetal shoulder as the presenting part? A) Breech, transverse B) Breech, longitudinal C) Breech, frank D) Vertex, transverse Explanation: A) A shoulder presentation is one type of breech presentation, and is also called a transverse lie. 2) A clinic nurse is preparing diagrams of pelvic shapes. Which pelvic shapes are considered least adequate for vaginal childbirth? Select all that apply. A) Android B) Anthropoid C) Gynecoid D) Platypelloid E) Lambdoidal suture Explanation: A) In the android and platypelloid types, the pelvic diameters are diminished. Labor is more likely to be difficult (longer) and a cesarean birth is more likely. D) In the android and platypelloid types, the pelvic diameters are diminished. Labor is more likely to be difficult (longer) and a cesarean birth is more likely. 3) The nurse is caring for laboring clients. Which women are experiencing problems related to a critical factor of labor? Select all that apply. A) Woman at 7 cm, fetus in general flexion B) Woman at 3 cm, fetus in longitudinal lie C) Woman at 4 cm, fetus with transverse lie D) Woman at 6 cm, fetus at -2 station, mild contractions E) Woman at 5 cm, fetal presenting part is right shoulder Explanation: C) A transverse lie occurs when the cephalocaudal axis of the fetal spine is at a right angle to the woman's spine and is associated with a shoulder presentation and can lead to complications in the later stages of labor. D) Station refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis. If the presenting part is higher than the ischial spines, a negative number is assigned, noting centimeters above zero station. A -2 station is high in the pelvis. Contractions should be strong to cause fetal descent. Mild contractions will not move the baby down or open the cervix. This client is experiencing a problem between the maternal pelvis and the presenting part. E) When the fetal shoulder is the presenting part, the fetus is in a transverse lie and the acromion process of the scapula is the landmark. This type of presentation occurs less than 1% of the time. This client is experiencing a problem between the maternal pelvis and the presenting part. 4) The charge nurse has received the shift change report. Which client requires immediate intervention? A) Woman at 6 cm undergoing induction of labor, strong contractions every 3 minutes B) Woman at 4 cm whose fetus is in a longitudinal lie with a cephalic presentation C) Woman at 10 cm and fetus at +2 station experiencing a strong expulsion urge D) Woman at 3 cm screaming in fear because her mother died during childbirth Explanation: D) This client is most likely fearful that she will die during labor because her mother died during childbirth. This client requires education and a great deal of support, and is therefore the top priority. 5) Premonitory signs of labor include which of the following? Select all that apply. A) Braxton Hicks contractions B) Cervical softening and effacement C) Weight gain D) Rupture of membranes E) Sudden loss of energy Explanation: A) A premonitory sign of labor includes Braxton Hicks contractions. B) A premonitory sign of labor includes cervical softening and effacement. D) A premonitory sign of labor includes rupture of membranes. 6) A client arrives in the labor and delivery unit and describes her contractions as occurring every 10-12 minutes, lasting 30 seconds. She is smiling and very excited about the possibility of being in labor. On exam, her cervix is dilated 2 cm, 100% effaced, and -2 station. What best describes this labor? A) Second phase B) Latent phase C) Active phase D) Transition phase Explanation: B) In the early or latent phase of the first stage of labor, contractions are usually mild. The woman feels able to cope with the discomfort. The woman is often talkative and smiling and is eager to talk about herself and answer questions.