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ATI RN maternal newborn 2019 with NGN - Exam 2

Total Questions : 62

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Question 1:

A nurse is assessing a client who is at 12 weeks of gestation. The nurse should report which of the following findings to the provider as an indication of an imminent spontaneous abortion?

Answer and Explanation

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Question 2:

A nurse is caring for a client who is in active labor. The nurse administers butorphanol IV bolus for pain. Which of the following findings should the nurse report to the provider following this medication?

Answer and Explanation

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Question 3:

A nurse is assessing the reflexes of a term newborn. After placing the newborn in the supine position, which of the following methods should the nurse use to elicit the Moro reflex?

Answer and Explanation

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Question 4:

A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B2. Which of the following foods should the nurse recommend?

Answer and Explanation

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Question 5:

A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)

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Question 6:

A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?

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Question 7:

A nurse is preparing to administer gentamicin 2 mg/kg IM to a client who has pelvic inflammatory disease and weighs 132 lb. Available is gentamicin injection 40 mg/mL. How many mL should the nurse administer?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation
Correct Answer: 3 mL

Explanation

Use the following formula to calculate the amount of gentamicin to administer:

Volume (mL) = Dose (mg) / Concentration (mg/mL)

First, I need to convert the client's weight from pounds to kilograms. One pound is equal to 0.4536 kilograms. Therefore, 132 lb is equal to 132 x 0.4536 = 59.8752 kg.

Next, I need to multiply the client's weight by the prescribed dose of gentamicin per kilogram. The prescribed dose is 2 mg/kg, so the total dose is 2 x 59.8752 = 119.7504 mg.

Finally, I need to divide the total dose by the concentration of gentamicin in the injection. The concentration is 40 mg/mL, so the volume is 119.7504 / 40 = 2.99376 mL.

To round the answer to the nearest whole number, I need to look at the first decimal place. If it is 5 or more, I round up; if it is less than 5, I round down. In this case, the first decimal place is 9, which is more than 5, so I round up. Therefore, the final answer is 3 mL.

The nurse should administer 3 mL of gentamicin injection to the client.


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Question 8:

A nurse is caring for a client who is in active labor and is receiving oxytocin via IV infusion. The nurse has applied an internal fetal heart monitor and recognizes an early deceleration of the fetal heart rate tracing. Which of the following actions should the nurse take?

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Question 9:

A nurse is providing teaching to a postpartum client who has type 1 diabetes mellitus and is breastfeeding her newborn. Which of the following instructions should the nurse give the client?

Answer and Explanation

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Question 10:

A nurse is caring for a client who has maternal hypotension following the placement of an epidural. Which of the following actions should the nurse take?

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Question 11:

A nurse on the labor and delivery unit is planning care for a client who has human immunodeficiency virus (HIV). Which of the following is an appropriate action for the nurse to take following the birth of the newborn?

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Question 12:

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

Answer and Explanation

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Question 13:

A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr. ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?

Answer and Explanation

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Question 14:

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

Answer and Explanation

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Question 15:

A nurse is caring for a client who is in labor. Which of the following findings should prompt the nurse to reassess the client?

Answer and Explanation

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Question 16:

A nurse is caring for a client who has bladder distention following a vaginal birth. Which of the following actions should the nurse take first?

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Question 17:

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?

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Question 18:

A nurse is caring for a client who is 1 day postpartum and breastfeeding her newborn. The client reports sore nipples. Which of the following actions should the nurse take?

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Question 19:

A nurse is caring for a client who is at 8 weeks of gestation and has an ectopic pregnancy. Which of the following manifestations should the nurse expect?

Answer and Explanation

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Question 20:

A nurse is teaching a prenatal client about listeriosis and dietary modifications during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

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Question 21:

A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Nägele's Rule, which of the following is the client's estimated date of delivery?

Answer and Explanation

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Question 22:

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?

Answer and Explanation

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Question 23:

A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?

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Question 24:

A nurse in a clinic is caring for a client who is in her second trimester of pregnancy. The client expresses concern about preparing her 2-year-old child for a new sibling. Which of the following is an appropriate response by the nurse?

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Question 25:

A nurse is assessing a newborn whose mother had a primary cytomegalovirus (CMV) infection during pregnancy. The newborn acquired CMV transplacentally. Which of the following findings should the nurse expect the newborn to exhibit?

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