ATI Maternal Newborn Proctored Exam

A nurse is caring for a 2-day-old newborn who was born t 35 weeks gestation. Which of the following actions should the nurse take?

D. Insert an orogastric decompression tube with low wall suction

A nurse is planning care for a newborn who had neonatal abstinence syndrome. Which of the following interventions should the nurse include in the plan of care?

D. Swaddle the newborn in a flexed position

A nurse is caring for a client who is int he second stage of labor. Which of the following manifestations should the nurse expect?

D. The client delivers the newborn

A nurse is receiving laboratory results for a term newborn who is 24 hr old. Which of the following results requires intervention by the nurse?

Glucose 20 mg/dL

A nurse is assessing a newborn immediately following a gavial birth. For which of the following findings should the nurse intervene?

A. Sternal retractions

A nurse is planning to teach a group of clients who are pregnant about breastfeeding after returning to work. Which of the following information should the nurse include in the teaching?

"Breast milk can be store in a deep freezer for 12 months"

A nurse is proving discharge teaching to a client following a tube ligation. Which of the following statements by the client indicates an understanding of the teaching?

B. "Ovulation will remain the same"

A nurse is caring for a client who is experiencing preterm labor and has a prescription for 4 doses of dexamethasone 6 mg IM every 12-hr. Available is dexamethasone 10 mg/mL. How many mL of dexamethasone should the nurse administer per dose? (round answer to the nearest tenth)

0.6 mL

A nurse is caring for a newborn immediately following birth and notes a large amount of mucus in the newborns mouth and nose. Identify the sequence the nurse should follow when performing suction with a bulb syringe.

1. Compress the bulb syringe 2. Place the bulb syringe in the newborn's mouth 3. Use the bulb syringe to suction the newborn's nose 4. Assess the newborn for reflex bradycardia

A nurse in a providers office is assessing a client at her first antepartum visit. The client states that the first day of her last menstrual cycle was March 8th. Use the Nagele's rule to calculate the estimated date of delivery.

1215

A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching?

A. "Transmission can occur via the saliva and urine of the newborn"

A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statements should the nurse make?

A. "You can bathe and dress your baby if you'd like"

A nurse is reviewing signs of effective breastfeeding with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching?

A. "You should feel a tugging sensation when the baby is sucking"

A nurse is providing teaching to a client who is 38 weeks of gestation and has a prescription to receive misoprostol intravaginally. Which of the following statements should the make?

A. "You will need to stay in a side-lying position for 30 minutes after each dose"

A nurse is assessing a client following an aminocentesis. Which of the following findings should the nurse recognize as complications? (SATA)

A. Amnionitis // D. Leakage of amniotic fluid // E. Preterm Labor

A nurse is caring for a client following an amniocentesis. The nurse should observe the client for which of the following complications?

A. Hemorrhage

A nurse is caring for a client who has bacterial vaginosis. Which of the following medications should the nurse expect to administer?

A. Metronidazole

A nurse is caring for a client who is 14 weeks of gestation. AT which of the following locations should the nurse place the doppler device when assessing the fetal heart rate?

A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis

A nurse is caring for four newborns. Which of the following newborns should the nurse assess first?

A. Newborn who has nasal flaring

A nurse is assisting the provider administer a dinoprostone insert labor for a client. Which of the following actions should the nurse take?

A. Place the client in semi-fowler position for 1 hr after administration

A nurse is caring for a client who is at 20 weeks gestation and has trichomoniasis. Which of the following findings should the nurse expect?

A. Thick, White vaginal discharge

A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect?

A. Uterine Tenderness

A nurse is caring for a newborn who is 24 hr old. Which of the following laboratory findings should the nurse report to the provider?

ABC count 32.000/mm^3

A nurse is proving teaching to a client who has mild preeclampsia and will be caring for herself at home during the last 2 months of pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

B. "I will alternate the arm used to check my blood pressure"

A nurse is teaching a client who is at 41 weeks gestation about a non stress test. Which of the following information should the nurse include in the teaching?

B. "This test will determine the adequacy of placental perfusion"

A nurse in a provider's office is caring for a 20-year old client who is at 12 weeks gestation and requests an amniocentesis to determine the sex of her fetus. Which of the following responses should the nurse make?

B. "We can schedule the procedure for later today if you'd like"

A nurse is caring for a client who is receiving prenatal care and is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

B. 1 h4 glucose tolerance test

A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for induction of labor with misoprostol?

B. A client who has gestational diabetes mellitus

A nurse is caring for a client who is in the transition phase of labor and reports a pain level of 7 on a scale of 0 to 10. Which of the following actions should the nurse take?

B. Apply counter pressure to the client's sacral

A nurse is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the nurse include in the plan of care?

B. Avoid using lotion or ointment on the newborn's skin

A nurse in a women's health client is obtaining a health history from a client. Which of the following findings should the nurse identify as increasing the client's risk for developing pelvic inflammatory disease (PID)?

B. Chlamydial infection

A nurse is caring for a client who is experiencing sore nipples from breastfeeding. Which of the following actions should the nurse take?

B. Ensure the newborn's mouth is wide open before latching to the breast

A nurse is reviewing laboratory results for a client who is pregnant. The nurse should expect with of the following laboratory values to increase?

B. Fasting blood glucose

A nurse is assessing a newborn who was born post-term. Which of the following findings should the nurse expect>

B. Nails extending over the tips of fingers

A nurse is caring for a newborn who is 6 hr old and has type 2 diabetes mellitus. Which of the following actions should the nurse take?

B. Reassess the blood glucose level prior to the next feeding

A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?

Bathe the newborn before initiating skin-to-skin contact

A nurse is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hr postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication?

Blood pressure 142/92 mm Hg

A nurse is caring for a client who is receiving prenatal care and is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

Blood type and Rh

A nurse on a labor and delivery unit is providing teaching to a client who plans to use hypnosis to control labor pain. Which of the following information should the nurse include?

C. "Hypnosis can be beneficial if you practiced it during the prenatal period"

A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct staff to report to the provider?

C. Absent early deceleration of fetal heart rate

A nurse is caring for a client who is in labor and request non pharmacological pain management. Which of the following nursing actions promotes client comfort?

C. Assisting the client into a squatting position

A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?

C. Bilateral crackles

A nurse is assessing a newborn upon admission to the nursery. Which o fit following findings should the nurse expect?

C. Chest circumference 2 cm (0.8in) smaller than the head circumference

A nurse is assessing a newborn following a forceps assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of this birth method?

C. Facial Palsy

A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication for this birth method?

C. Facial Palsy

A nurse is assessing a client who is at 37 weeks gestation. Which of the following statements by the client requires immediate intervention by the nurse?

D. "It burns when I urinate"

A nurse is proving teaching about terbutaline to a client who is experiencing preterm labor. Which of the following statements by the client indicated an understanding of the teaching?

D. "This medication could cause me to experience heart palpitations"

A nurse is proving teaching about expected changes during pregnancy to a client who is at 24 weeks gestation. Which of the following information should the nurse include?

D. "You should expect yours uterus to double in size"

A nurse is teaching a prenatal class regarding false labor. Which of the following information should the nurse include?

D. "Your contractions will become temporarily regular"

A nurse is providing nutritional guidance to a client who is pregnant and follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client that which of the following foods has the highest amount of calcium?

D. 1 cup cooked broccoli

A nurse is caring for four clients. For which of the following clients should the nurse auscultate the fetal heart rate during the prenatal visit?

D. A client who has felt quickening for the first time

A nurse is caring for a client who is 4 hr postpartum and is experiencing hypovolemic shock. Which of the following actions should the nurse take?

D. Administer oxygen at 4L/min via nasal canula

A community health nurse is providing education on gestational diabetes mellitus to a group of clients who are pregnant when discussion risk factors, which of the following ethnicities should the nurse identify as having the lowest incidence of GMD?

D. African American

A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include?

D. Breast Tenderness

A nurse is reviewing the electronic medical record for a postpartum client, The nurse should identify that which of the following factors places the client at risk for infection?

D. Meconium-stained fluid

A nurse is caring for a newborn who is 1 hr old and has a respiratory rate of 50/min, a HR of 130/min, and an auxiliary temperature of 36.1 C (97 F). Which of the following actions should the nurse take?

D. Obtain an oxygen saturation level

A nurse on the labor and delivery unit reviewing infection control standard with a newly licensed nurse. The nurse should instruct the newly licensed nurse to don gloves for which of the following procedures?

D. Performing umbilical cord care

A nurse is caring for a newborn who is 6 hr old and has a beside glucometer reading of 65 mg/dL. The newborn's mother has type 2 diabetes mellitus. Which of the following actions should the nurse take?

D. Reassess the blood glucose level prior to the next feeding

A nurse is assessing a preterm newborn who is at 32 weeks gestation. Which of the following findings should the nurse expect?

D. Sprase lanugo

A nurse is monitoring a client who has preeclampsia and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings should the nurse report to the provider?

D. Urine output less than 20

A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan?

Ensure the newborn's eyes are closed beneath the shield

A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?

Facial Petechiae

A nurse is planning care for a client who is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan of care?

Increase the infusion rate every 30 to 60 minutes

A nurse is caring for a 2-day-old newborn who was at 35 weeks gestation. Which of the following actions should the nurse take?

Measure the abdominal circumference at the level of the newborns umbilicus every 2 hr

A nurse is caring for a client who is receiving oxytocin for induction of labor and notes late deceleration of the fetal heart rate on the monitor tracing. Which of the following actions should the nurse take?

Place the client in the lateral position

A nurse is assessing a client who is 27 weeks gestation and has preeclampsia. Which of the following findings should the nurse report to the provider?

Platelet count 60.00/mm^3

A nurse is caring for a client who has hypermedia gravidarum. Which of the following laboratory tests should the nurse anticipate?

Urine Ketones

A nurse is providing teaching about expected changes during pregnancy to a client who is 24 weeks gestation. Which of the following manifestations should the nurse include?

You should anticipate nasal stiffness