Review ATI Maternity Exam 4 Moitiso

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ATI Maternity Exam 4 Moitiso

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Total Questions : 33

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Question 1:

A nurse is caring for a client who has been diagnosed with hyperemesis gravidarum.
Which of the following conditions are risk factors for hyperemesis gravidarum?

A. Oligohydramnios. B. Twin gestations. C. Anemia. D. Molar pregnancy. E. History of hyperemesis.

Answer and Explanation

Choice A:

Oligohydramnios refers to a condition characterized by a deficiency in amniotic fluid. It is not a common risk factor for hyperemesis gravidarum, which is more related to hormonal changes and genetic predisposition.

Choice B:

Twin gestations significantly increase the levels of human chorionic gonadotropin (hCG), leading to a higher incidence of hyperemesis gravidarum. Elevated hCG levels correlate directly with the severity of nausea and vomiting in pregnancy.

Choice C:

Anemia does not have a direct causal relationship with hyperemesis gravidarum. Hyperemesis may contribute to the development of anemia due to nutritional deficiencies, but it is not a predisposing risk factor.

Choice D:

Molar pregnancy, a gestational trophoblastic disease, causes significantly elevated levels of hCG, leading to an increased likelihood of hyperemesis gravidarum. This condition triggers extreme nausea and vomiting due to excessively high hormone levels.

Choice E:

A history of hyperemesis in previous pregnancies strongly predicts recurrence in subsequent pregnancies. This suggests a genetic or environmental predisposition to severe nausea and vomiting.

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Question 2:

A laboring client with preeclampsia is prescribed magnesium sulfate 2g/h IVPB.

The pharmacy sent the IV to the unit labeled magnesium sulfate 20g/500mL normal saline.

To administer the correct dose, the nurse should set the pump to deliver how many milliliters per hour?

Answer and Explanation

Correct Answer: "50" mL/hr

Explanation

Step 1: Calculate the concentration of magnesium sulfate. 20g ÷ 500mL = 0.04g/mL.

Step 2: Determine the required dose in grams per hour. 2g ÷ 1h = 2g/h

Step 3: Calculate the volume to be infused per hour. 2g ÷ 0.04g/mL = 50mL/h

Answer: 50mL/h

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Question 3:

You are receiving report from the night shift nurse on a laboring client.
She is 39 weeks gestation, cervical exam is 9cm/100%/0, she has an epidural in place for pain management.
ROM occurred 25 hours ago with a moderate amount of clear fluid.
EFM assessment includes baseline 175bpm, minimal variability, no accelerations, no decelerations.
Vital signs: Blood pressure: 118/84 mmHg.
Respiratory Rate: 16/min.
O2 saturation: 99% on R

A. Intraamniotic infection. B. Pyelonephritis. C. Cholestasis of pregnancy. D. Placental abruption.

Answer and Explanation

Choice A:

Intraamniotic infection (chorioamnionitis) is suspected due to the combination of prolonged rupture of membranes (25 hours), maternal fever (39.2°C), and fetal tachycardia (baseline of 175 bpm). These are key indicators of infection within the amniotic sac.

Choice B:

Pyelonephritis, an infection of the kidneys, is unlikely without the presence of symptoms such as flank pain, dysuria, and significant changes in urinalysis. The primary signs point towards intraamniotic infection.

Choice C:

Cholestasis of pregnancy primarily presents with intense itching, especially on the hands and feet, and does not typically involve fever or abnormal fetal heart rates. Thus, it is less likely in this scenario.

Choice D:

Placental abruption involves the separation of the placenta from the uterine wall before delivery, often presenting with abdominal pain, vaginal bleeding, and uterine contractions. The absence of these symptoms makes this diagnosis less likely.

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Question 4:

A nurse is admitting a client at 33 weeks gestation who experienced PPROM 4 hours ago.
The client is asking when her next vaginal exam will be since her first exam revealed she is 2 cm dilated.
Which of the following reasons does the nurse explain for not performing another vaginal exam?

A. Increases labor progress. B. Increases pain. C. Increases bleeding. D. Increases risk for infection.

Answer and Explanation

Choice A:

Performing another vaginal exam does not directly influence labor progress. Labor can progress naturally without repeated exams, which can introduce unnecessary risk.

Choice B:

oid multiple exams, especially when managing potential complications.

Choice C:

Vaginal exams might lead to minor bleeding due to irritation, but the risk of bleeding is not a primary concern in this context.

Choice D:

oid frequent vaginal exams after PPROM is the increased risk of infection. Each exam provides a potential pathway for bacteria to ascend, leading to complications like chorioamnionitis.

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Question 5:

A nurse is educating a client at the end of her second trimester about car safety.
Which statement by the client indicates a correct understanding of the nurse's education?

A. I will wear the seatbelt under my arm instead of over my shoulder to reduce pressure on my abdomen. B. I will position the lap belt under my abdomen and the shoulder belt between my breasts and above my abdomen to minimize the risk of abdominal trauma. C. I will avoid wearing a seatbelt during my pregnancy to protect the baby. D. I will remove the seatbelt when driving at a slow speed to reduce the risk of abdominal trauma.

Answer and Explanation

Choice A:

Wearing the seatbelt under the arm is not recommended as it may not distribute the force of a collision evenly and could increase the risk of injury to both the mother and the baby. Proper positioning is crucial for safety.

Choice B:

Positioning the lap belt under the abdomen and the shoulder belt between the breasts and above the abdomen minimizes the risk of abdominal trauma and ensures both mother and baby are protected in the event of a collision. This is the recommended positioning for pregnant women.

Choice C:

Avoiding a seatbelt during pregnancy is not advised as it significantly increases the risk of injury or death for both the mother and the baby in the event of an accident. Seatbelts are crucial for safety.

Choice D:

Removing the seatbelt when driving at a slow speed still poses a significant risk. Even at low speeds, sudden stops or collisions can cause harm to both mother and baby. Consistent seatbelt use is essential.

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Question 6:

A client arrives to OB triage at 37 weeks gestation with a known complete placenta previa this pregnancy.
She reports feeling some inconsistent contractions over the last 4 hours and wants to know if she is in labor.
The client asks the nurse why the provider did not perform a vaginal exam.
What is the most appropriate answer by the nurse?

A. A vaginal exam will increase the risk of rupturing your membranes. B. A vaginal exam could cause vaginal bleeding. C. A vaginal exam would cause infection if you are not in labor. D. A vaginal exam could initiate preterm labor.

Answer and Explanation

Choice A:

While rupturing membranes can be a concern, the primary issue with a vaginal exam in the presence of placenta previa is the risk of severe bleeding. This choice is partially correct but not the most accurate answer.

Choice B:

oid a vaginal exam.

Choice C:

oid a vaginal exam in the case of placenta previa. The main concern is the risk of bleeding.

Choice D:

Initiating preterm labor is a possible risk with any vaginal exam late in pregnancy, but it is not the primary concern in cases of placenta previa. The main issue is the potential for causing severe bleeding.

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Question 7:

A nurse is providing education about TORCH infections to a pregnant client and her partner.
The nurse identifies that the client is at risk for which infection?

A. Cytomegalovirus. B. Herpes Simplex Virus. C. Hepatitis B. D. Rubella. E. Toxoplasmosis.

Answer and Explanation

Choice A:

Cytomegalovirus (CMV) is a common infection that can be transmitted to the fetus, leading to serious complications such as hearing loss, vision impairment, and developmental delays. It is one of the TORCH infections.

Choice B:

Herpes Simplex Virus (HSV) can be transmitted to the baby during delivery, especially if there is an active outbreak. It can cause severe neonatal infections, making it a significant concern during pregnancy.

Choice C:

Hepatitis B is not classified under the TORCH infections. While it is a serious concern in pregnancy, it is typically managed through vaccination and other precautions to prevent vertical transmission to the baby.

Choice D:

Rubella is part of the TORCH complex and can lead to congenital rubella syndrome, causing serious birth defects such as heart problems, developmental delays, and hearing loss if the mother contracts it during pregnancy.

Choice E:

Toxoplasmosis is included in the TORCH infections and can cause severe fetal complications such as brain damage, vision problems, and developmental delays if the mother is infected during pregnancy.

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Question 8:

A client is at risk for a spontaneous abortion at 14 weeks gestation.
The client's two previous pregnancies were miscarriages in the same gestational time frame.
The client states, "They want to sew my cervix shut.”. The nurse shares the terminology for surgical treatment of an incompetent cervix.
Which of the following would the nurse explain?

A. Aminoinfusion. B. Hysterectomy. C. Cerclage. D. Beta-adrenergic agonist therapy.

Answer and Explanation

Choice A:

Aminoinfusion is a procedure where fluid is infused into the amniotic sac. It is used to treat certain complications during labor but is not related to treating an incompetent cervix.

Choice B:

Hysterectomy is a surgical procedure to remove the uterus and is not a treatment for an incompetent cervix. It is typically performed for conditions such as cancer, severe bleeding, or other significant uterine issues.

Choice C:

Cerclage is the correct term for the surgical procedure used to treat an incompetent cervix. It involves stitching the cervix closed to prevent premature dilation, which can lead to miscarriage or preterm birth.

Choice D:

Beta-adrenergic agonist therapy is used to delay preterm labor by relaxing the uterus but does not address the structural issue of an incompetent cervix. It is a medication-based approach rather than a surgical one. .

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Question 9:

A nurse is caring for a client who was recently diagnosed with Hyperemesis Gravidarum.
Which of the following medications should the nurse anticipate administering?

A. 400 mg Motrin (ibuprofen) PO. B. 500 mL of 0.9% Sodium Chloride IV bolus. C. 4 g Magnesium Sulfate IV over 30 minutes. D. 50 mg Pyridoxine (vitamin B6) PO.

Answer and Explanation

Choice A:

Ibuprofen is not recommended during pregnancy, especially in the later stages, as it can cause harm to the fetus and affect amniotic fluid levels.

Choice B:

While hydration is crucial for managing Hyperemesis Gravidarum, 0.9% Sodium Chloride alone won't address the underlying symptoms like nausea and vomiting effectively.

Choice C:

Magnesium Sulfate is typically used to prevent seizures in preeclampsia, not for Hyperemesis Gravidarum.

Choice D:

Pyridoxine (vitamin B6) is often recommended for Hyperemesis Gravidarum as it can help reduce nausea and vomiting.

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Question 10:

A nurse is caring for a client receiving Magnesium Sulfate therapy IV for preterm labor.
Which of the following medications should the nurse anticipate administering if the client exhibits hypotension, decreased urine output, and a respiratory rate of 10/min?

A. Methotrexate. B. Labetalol. C. Nifedipine. D. Calcium gluconate.

Answer and Explanation

Choice A:

Methotrexate is used for treating ectopic pregnancies and certain cancers, but it is not an antidote for Magnesium Sulfate toxicity.

Choice B:

Labetalol is a beta-blocker used for hypertension management in pregnancy, not for reversing Magnesium Sulfate toxicity.

Choice C:

Nifedipine is a calcium channel blocker used to manage high blood pressure and preterm labor, not for counteracting Magnesium Sulfate toxicity.

Choice D:

Calcium gluconate is the specific antidote for Magnesium Sulfate toxicity, effectively reversing its effects.

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Total Questions : 33

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ATI Maternity Exam 4 Moitiso

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