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ATI Maternal Newborn-2023

Total Questions : 50

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Question 1:

A nurse in a provider’s office is caring for a client who is pregnant.

The client is at 32 weeks of gestation, has a medical history of penicillin allergy, and has been experiencing headaches, blurred vision, and dizziness for 5 days.

The client reports swelling of their feet and fingers.

The nurse notes 2+ pitting edema of the lower extremities bilaterally and swelling of fingers and hands.

Fetal heart tones (FHT) are 148/min.

Which of the following assessment findings should the nurse report to the provider?

Answer and Explanation

A
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Question 2:

A nurse is caring for a client who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise.
Which of the following medications should the nurse anticipate a prescription from the provider for the client?

Answer and Explanation

A
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Question 3:

The nurse caring for the pregnant patient understands that which hormone is essential for maintaining pregnancy?

Answer and Explanation

A
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Question 4:

A 28-year-old female client is in the second stage of labor in the maternity ward.
Nurses Notes:
1. 08:00 - Client reported feeling pressure in the pelvic area.
2. 10:00 - Observed retraction of the fetal head against the maternal perineum.
3. 12:00 - Client reported increased discomfort; breathing exercises initiated.
4. 14:00 - Client’s contractions have become more frequent and intense.
Diagnostic Results:
1. Ultrasound: Healthy fetus in cephalic presentation.
2. Blood Test: Hemoglobin levels within normal range.
3. Urinalysis: No signs of infection or preeclampsia.
4. Fetal Heart Rate: Consistent with labor progression.
Medical History:
1. First pregnancy, no complications.
2. No history of chronic illnesses.
3. No history of surgeries.
4. No known allergies.
Vital Signs:
1. 08:00 - BP: 120/80, HR: 80 bpm, Temp: 98.6°F
2. 10:00 - BP: 122/82, HR: 82 bpm, Temp: 98.7°F
3. 12:00 - BP: 124/84, HR: 84 bpm, Temp: 98.8°F
4. 14:00 - BP: 126/86, HR: 86 bpm, Temp: 98.9°F Provider’s Prescriptions:
1. Regular monitoring of vital signs.
2. Pain management as needed.
3. Encourage mobility as tolerated.
4. Regular monitoring of fetal heart rate.
Physical Examination Results:
1. Cervix fully dilated.
2. Fetus in cephalic presentation.
3. Membranes ruptured.
4. Contractions regular and progressing.
Question: A nurse is caring for a client who is in the second stage of labor. The nurse observes retraction of the fetal head against the maternal perineum. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.
Condition Choices:
1. Prolonged labor
2. Normal labor progression
3. Fetal distress
4. Premature labor Action Choices:
1. Administer pain medication
2. Encourage the client to push during contractions
3. Prepare for immediate delivery
4. Monitor fetal heart rate
5. Reassure the client Parameter Choices:
1. Client’s blood pressure
2. Frequency of contractions
3. Fetal heart rate
4. Client’s temperature
5. Amount of amniotic fluid

Answer and Explanation
Correct Answer: Encourage the client to push during Monitor fetal heart rate Frequency of contractions Fetal heart rate

Explanation

Answer and explanation
The client is most likely experiencing Normal labor progression. The retraction of the fetal head against the maternal perineum, regular and progressing contractions, and full dilation of the cervix are all signs of normal labor progression.
Actions: The nurse should:
1. Encourage the client to push during contractions. This will help the baby move down the birth canal.
2. Monitor fetal heart rate. This is crucial to ensure the baby is not in distress.
Parameters: The nurse should monitor:
1. Frequency of contractions. This will help assess the progress of labor.
2. Fetal heart rate. Any abnormalities could indicate fetal distress, which would require immediate medical attention.


A
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Question 5:

A nurse is preparing an in-service program about preventing medication errors when transcribing a prescription.
The nurse is using a dosage example of two tenths of a milligram.

Answer and Explanation

A
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Question 6:

A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus.
Which of the following newborn complications should the nurse recognize as the priority focus of care?

Answer and Explanation

A
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Question 7:

A nurse is assessing a client who is pregnant for preeclampsia.
Which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder?

Answer and Explanation

A
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Question 8:

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation.
Which of the following explanations about this test should the nurse provide to the client?

Answer and Explanation

A
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Question 9:

A nurse is caring for a client who is at 34 weeks of gestation.

The client reports headache, dizziness, and blurred vision for 1 week.

The nurse notes 3+ edema in lower extremities and deep tendon reflexes (DTRs) 3+ with positive clonus.

The fetal heart rate (FHR) is 140 with minimal variability.

The nurse is reviewing the client’s electronic medical record to develop a plan of care.

Which condition is the client most likely experiencing, what are two actions the nurse should take to

Answer and Explanation

A
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Question 10:

A nurse is attending to a first-time pregnant woman who is at term.

She is experiencing contractions but is unsure if she is in labor.

Which of the following should the nurse identify as a labor sign?

Answer and Explanation

A
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Question 11:

A nurse is caring for a client who is 39 weeks pregnant and in active labor.

The nurse detects the fetal heart tones above the client’s umbilicus at the midline.

Which of the following positions should the nurse suspect the fetus is in?

Answer and Explanation

A
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Question 12:

A nurse is caring for a client who is 34 weeks pregnant.

The nurse is reviewing the client’s electronic medical record to develop a care plan.

The nurse should take which of the following actions to address the condition the client is most likely experiencing, and monitor which parameters to assess the client’s progress.

Answer and Explanation

A
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Question 13:

A nurse is caring for a term macrosomic newborn whose mother has poorly controlled type 2 diabetes.

The newborn has respiratory distress syndrome.

The nurse should be aware that the most likely cause of the respiratory distress is which of the following?

Answer and Explanation

A
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Question 14:

A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation.
At which location should the nurse expect to palpate the fundus?

Answer and Explanation

A
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Question 15:

A nurse is leading a discussion about contraception with a group of 14-year-old clients. After the presentation, a client asks the nurse which method would be best for her to use.
Which of the following responses should the nurse make?

Answer and Explanation

A
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Question 16:

A nurse is caring for a client who is in labor and has an external fetal monitor.
The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following? A. Fetal head compression.

Answer and Explanation

A
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Question 17:

A nurse is caring for a client who is in the second stage of labor. The nurse observes retraction of the fetal head against the maternal perineum as the head is birthed.
Which condition is the client most likely experiencing?

Answer and Explanation

A
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Question 18:

A nurse is caring for a client who is in active labor and notes late decelerations in the FHR.
Which of the following actions should the nurse take first?

Answer and Explanation

A
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Question 19:

A nurse has received an order to administer Morphine 5mg IV once immediately.
The available concentration is 2.5 mg/mL. How many mL of morphine should the nurse prepare for administration?

Answer and Explanation

A
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Question 20:

A nurse is monitoring a patient who is receiving magnesium sulfate to manage pre-eclampsia.
Which of the following observations should the nurse report to the healthcare provider?

Answer and Explanation

A
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Question 21:

A nurse is caring for a patient who is about to undergo a biophysical profile. The patient asks the nurse what aspects are evaluated during this test.
Which of the following should the nurse include? (Select all that apply)

Answer and Explanation

A
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Question 22:

A nurse is admitting a patient with severe pre-eclampsia at 35 weeks of gestation and is reviewing the provider’s orders.
Which of the following orders requires clarification?

Answer and Explanation

A
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Question 23:

Which blood pressure (BP) finding during the second trimester indicates a risk for pregnancy-induced hypertension?

Answer and Explanation

A
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Question 24:

A nurse on the labor and delivery unit is caring for a patient following a vaginal examination by the provider which is documented as: -1. Which of the following interpretations of this finding should the nurse make?

Answer and Explanation

A
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Question 25:

In the context of diabetes incidence and classification, which statement should maternity nurses be aware of?

Answer and Explanation

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