Maternal Newborn ATI Practice

A nurse is providing dietary teaching to a client who has hyperemesis gravidarum. Which of the following statements by the client indicates an understanding of the teaching? a. "I will eat foods that taste good instead of balancing my meals" b. "I will avoid having a snack before I go to bed each night" c. "I will have a cup of hot tea with each meal" d. "I will eliminate products that contain dairy from my diet"

" I will eat foods that taste good instead of balancing my meals"

Manifestations of a Physical Assessment of a Newborn

- Acrocyanosis - Positive Babinski reflex - Two umbilical arteries

Risk Factors for Preeclampsia

- Pregestational DM - Preexisitin hypertension - Renal disease - Sytemic lupus erythematosus - Rheumatoid arthritis

Leopold Maneuvers

1. Palpate the fundus to identify the fetal part 2. Determine the location of the fetal back 3. Palpate for the fetal part presenting at the inlet 4. Identify the attitude of the head

Which of the following findings contraindicate the initiation of the oxytocin infusion and should be reported to the provider? a. late decelerations b. moderate variability of the FHR c. cessation of uterine dilation d. prolonged active phase of labor

a. late decelerations

A nurse is planning care for a client who is in labor and is to have an amniotomy. Which of the following assessments should the nurse identify as the priority? a. O2 saturation b. Temperature c. Blood pressure d. Urinary output

b. Temperature Amniotomy poses a high risk for infection.

A nurse is caring for a client who is at 36 weeks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound? a. To estimate fetal weight b. To locate a pocket of fluid c. To determine multiparity d. To prescreen for fetal anomalies

b. To locate a pocket of fluid

A nurse is teaching a client who is in preterm labor about terbutaline. Which of the following statements by the client indicates an understanding of the teaching? a. "I will get injections of the medication once daily until my labor stops" b. "My blood sugar may be low while I'm on this medication" c. "I will have blood tests because my potassium might decrease" d. "My blood pressure may increase while I'm on this medication"

c. "I will have blood tests because my potassium might decrease"

A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control. Which of the following actions should the nurse include in the plan of care? a. Place the client in supine position for 30 minutes following the first dose of anesthetic solution b. Administer 1000 mL of dextrose 5% in water prior to the first dose of anesthetic solution c. Monitor the client's blood pressure every 5 minutes following the first dose of anesthetic solution d. Ensure the client has been NPO 4 hour prior to the placement of the epidural and the first dose of anesthetic solution

c. Monitor the client's blood pressure every 5 minutes following the first dose of anesthetic solution

A nurse is assessing a client who is at 38 weeks of gestation during a weekly prenatal visit. Which of the following findings should the nurse report to the provider? a. BP 136/88 mmHg b. Report of insomnia c. Weight gain of 2.2 kg d. Report of Braxton Hicks contractions

c. Weight gain of 2.2 kg

A nurse is assessing a newborn 12 hours after birth. Which of the following manifestations should the nurse report to the provider? a. acrocyanosis b. transient strabismus c. jaundice d. caput succedaneum

c. jaundice

A nurse is assessing a newborn who was delivered vaginally and experienced a tight nuchal cord. Which of the following findings should the nurse expect? a. bruising over the buttocks b. hard nodules on the roof of the mouth c. petechiae over the head d. bilateral periauricular papillomas

c. petechiae over the head

A nurse is planning care for a client who is 2 hours postpartum. Which of the following interventions should the nurse plan to implement during the taking hold phase of postpartum behavioral adjustment? a. Discuss contraceptive options with the client and her partner b. Repeat information to ensure client understanding c. Listen to the client and her partner as they reflect upon the birth experience d. Demonstrate to the client how to perform a newborn bath

d. Demonstrate to the client how to perform a newborn bath

A nurse is providing teaching to a client who is at 40 weeks of gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching? a. "I can administer oxytocin 4 hours after insertion of the medication" b. "You will need a full bladder prior to the insertion of the medication" c. "Remain in a side lying position for 15 minutes after the medication is inserted" d. "An antacid will be given 20 minutes prior to the insertion of the medication"

a. "I can administer oxytocin 4 hours after insertion of the medication"

A nurse is teaching a new parent about newborn safety. Which of the following instructions should the nurse include in the teaching? a. "You can share your room with your baby for the next few weeks" b. "Cover your baby with a light blanket while sleeping" c. "Check the temperature of your baby's bath water with your hand" d. "Your baby can nap in the car seat during the daytime"

a. "You can share your room with your baby for the next few weeks"

A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? a. Cholecystitis b. Hypertension c. HPV d. Migraine headaches e. Anxiety disorder

a. Cholecystitis b. Hypertension d. Migraine headaches

A nurse is reviewing the lab results for a client who is at 10 weeks of gestation. Which of the following lab findings should the nurse report to the provider? a. Hemoglobin 10 g/dL b. WBC count 15,000/mm3 c. RBC count 5.8 million/mm3 d. Hematocrit 34%

a. Hemoglobin 10 g/dL

A nurse is caring for a client who is at 24 weeks of gestation and has a suspected placental abruption. Which of the following lab tests should the nurse expect the provider to prescribe? a. Kleihauer - Betke test b. Progesterone serum level c. Lecithin/sphingomyelin (L/S) ratio d. Maternal alpha fetoprotein (AFP)

a. Kleihauer - Betke test

A nurse on a postpartum unit is caring for a client who is experiencing hypovolemic shock. After notifying the provider, which of the following actions should the nurse take next? a. Massage the client's fundus b. Insert an indwelling urinary catheter c. Administer oxygen at 10 L/min d. Elevate the client's right hip

a. Massage the client's fundus The client is at high risk for hemorrhage.

A nurse is assessing a newborn who was born at 26 weeks of gestation using the New Ballard Score. Which of the following findings should the nurse expect? a. Minimal arm recoil b. Popliteal angle of 90 degrees c. Creases over the entire foot sole d. Raised areolas with 3-4 mm buds

a. Minimal arm recoil

A nurse is calculating a client's expected date of birth using Nagele's rule. The client tells the nurse that her last menstrual cycle started on November 27th. Which of the following dates is the client's expected date of birth? a. September 3rd b. September 20th c. August 3rd d. August 20th

a. September 3rd Subtract 3 months from the first day of last menstrual cycle and then add 7 days.

A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse see first? a. a client who is at 11 weeks of gestation and reports abdominal cramping b. a client who is at 15 weeks of gestation and reports tingling and numbness in right hand c. a client who is at 20 weeks of gestation and reports constipation for the past 4 days d. a client who is at 8 weeks of gestation and reports having three bloody noses in the past week

a. a client who is at 11 weeks of gestation and reports abdominal cramping Could indicate an ectopic pregnancy and/or manifestations of spontaneous abortion

A nurse is assessing a client who received carboprost for PPH. Which of the following findings is an adverse effect of this medication? a. hypertension b. hypothermia c. constipation d. muscle weakness

a. hypertension Carboprost is a vasoconstrictor

A nurse is assessing a newborn for manifestations of hypoglycemia. Which of the following findings should the nurse expect? a. jitteriness b. hypertonia c. abdominal distension d. mottling

a. jitteriness

A nurse is on an antepartum unit and is caring for four clients. Which of the following clients should the nurse identify as the priority? a. A client who has GDM and a fasting blood glucose of 120 mg/dL b. A client who is at 34 weeks of gestation and reports epigastric pain c. A client who is at 28 week gestation and has an Hgb of 10.4 g/dL d. A client who is at 39 weeks of gestation and reports urinary frequency and dysuria

b. A client who is at 34 weeks of gestation and reports epigastric pain

A nurse is caring for a client who is pregnant and is at the end of her first trimester. The nurse should place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones? a. Just above the umbilicus b. Just above the symphysis pubis c. The right lower quadrant d. The left lower quadrant

b. Just above the symphysis pubis

A nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actions should the nurse take? a. administer antiviral medications b. schedule an ultrasound exam c. administer H. influenzae type b vaccine d. schedule an indirect Coombs test

b. schedule an ultrasound exam This to detect the possible development of fetal hydrops.

A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching? a. "Obtain an informed consent prior to obtaining the specimen" b. "Collect at least 1 mL of urine for the test" c. " Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen" d. "Premature newborns may have false negative tests due to immature development of liver enzymes"

c. " Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen"

A nurse is caring for a client who is at 30 weeks of gestation and has a prescription for magnesium sulfate IV to treat preterm labor. The nurse should notify the provider of which of the following adverse effects? a. client reports nausea b. UO of 40 mL/hr c. RR of 10/min d. Client reports feeling flushed

c. RR of 10/min

A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the following outcomes should the nurse expect? a. decreased uterine contractions b. an increase in the client's hemoglobin levels c. a reduction in respiratory distress in the newborn d. increased production of antibodies in the newborn

c. a reduction in respiratory distress in the newborn

A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn? a. Apply a cool ice pack for 10 min to the heel prior to the procedure b. Request a prescription for IM analgesic c. Use a manual lance blade to pierce the skin d. Place the newborn skin to skin on the mother's chest

d. Place the newborn skin to skin on the mother's chest This decreases the newborn's pain level and anxiety

A nurse is assessing four newborns. Which of the following findings should the nurse report to the provider? a. a newborn who is 26 hours old and has erythema toxicum on his face b. a newborn who is 32 hours old and has not passed a meconium stool c. a newborn who is at 12 hours old and has pink tinged urine d. a newborn who is 18 hours old and has an axillary temp of 99.9

d. a newborn who is 18 hours old and has an axillary temp of 99.9

A nurse is admitting a client to the labor and delivery unit when the client states "My water just broke." Which of the following interventions is the nurse's priority? a. perform nitrazine testing b. assess the fluid c. check cervical dilation d. begin FHR monitoring

d. begin FHR monitoring

Which of the following manifestations is an indication of hypoglycemia? a. hypertonia b. increased feeding c. hyperthermia d. respiratory distress

d. respiratory distress

A nurse is assessing the newborn of a client who took an SSRI during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI? a. large for gestational age b. hyperglycemia c. bradypnea d. vomiting

d. vomiting

A nurse is admitting a client who is in labor. The client admits to recent cocaine use. For which of the following complications should the nurse assess? a. abruptio placenta b. placenta previa c. preeclampsia d. maternal bradycardia

a. abruptio placenta Cocaine use increases the risk of vasoconstriction and possible abruptio placenta

A nurse is caring for a client who is at 36 weeks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests? a. biophysical profile b. amniocentesis c. cordocentesis d. Kleihauer-Betke test

a. biophysical profile

A nurse is providing teaching for a client who has a new prescription for COC. Which of the following findings should the nurse include as an ADR of this medication? a. depression b. polyuria c. hypotension d. urticaria

a. depression

A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? SATA a. flaccid uterus b. cervical laceration c. excess vaginal bleeding d. increased afterbirth cramping e. increased maternal temperature

a. flaccid uterus c. excess vaginal bleeding

A nurse is teaching a client who has pre gestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? a. "I should have a goal of maintaining my fasting blood glucose between 100 and 120" b. "I should engage in moderate exercise for 30 minutes if my blood glucose is 250 of greater" c. "I will continue taking my insulin if I experience nausea and vomiting" d. "I will ensure that my bedtime snack is high in refined sugar"

c. "I will continue taking my insulin if I experience nausea and vomiting"