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ATI PN Maternal Newborn ATI Maternity Newborn Assessment 200 Questions and Correct Answers, Exams of Medicine

A comprehensive set of 200 questions and answers related to newborn assessment in the context of maternal newborn nursing. It covers a wide range of topics, including newborn transition, home safety, hyperemesis gravidarum, postpartum care, car seat safety, newborn abduction prevention, labor and delivery complications, and newborn care practices. The questions and answers are designed to help students prepare for exams and gain a deeper understanding of newborn assessment principles and procedures.

Typology: Exams

2023/2024

Available from 12/06/2024

Davieacademia
Davieacademia 🇺🇸

281 documents

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Download ATI PN Maternal Newborn ATI Maternity Newborn Assessment 200 Questions and Correct Answers and more Exams Medicine in PDF only on Docsity!

ATI PN Maternal Newborn ATI Maternity

Newborn Assessment 200 QUESTIONS

AND CORRECT ANSWERS

  1. A nurse is assisting with the data collection of a newborn who is 1 hr old. Which of the following manifestations should indicate to the nurse that the newborn is experiencing difficulty transitioning to extrauterine life?: retractions Grunting, nasal flaring, retractions, and tachypnea are manifestations that indicate the newborn is having difficulty transitioning to extrauterine life. The nurse should report the findings to the provider.
  2. A nurse is reinforcing teaching about home safety with a client who is postpartum. Which of the following statements should the nurse include in the teaching? "You should keep the water temperature at 110 degrees Fahrenheit for your baby's bath." "You should be able to fit at least three fingers between the sides of your baby's crib and the mattress."

"You should place your baby's head on a pillow while she is awake." "You should dress your baby in a one-piece sleeper at bedtime.": You should dress your baby in a one-piece sleeper at bedtime MY ANSWER The nurse should instruct the client to use a sleep sack or one-piece sleeper and refrain from covering the newborn with blankets to reduce the newborn's risk of entrapment or suffocation.

  1. A nurse is caring for a client who is at 16 weeks of gestation and is at risk for developing hyperemesis gravidarum. Which of the following conditions places the client at an increased risk for developing this condition?: diabetes mellitus 4. A nurse is caring for a postpartum client who has an episiotomy. Which of the following actions should the nurse take?: apply an anesthetic spray to the client's perineal area as needed for pain
    1. A nurse is collecting data from a client who has hyperemesis gravidarum. Which of the following findings indicates that the client is at risk for dehydration?: ketonuria
    2. A nurse is reinforcing discharge teaching about car seat safety with the guardian of a newborn. which of the following statement by the guardian demonstrates in understanding of the teaching?

"I will place my baby at a 45-degree angle in the car seat." "I will position the harness retainer clip across my baby's stomach." "I will keep my baby's car seat rear-facing until she weighs 20 pounds and is 1 year old." "I will place padding under my baby's back until she reaches 10 pounds.": I will place my baby at a 45-degree angle in the car seat The newborn should be placed in the car seat at a 45° angle to prevent slumping and airway obstruction. The newborn will be unable to hold their head erect. Therefore, the newborn's head should be supported at all times.

  1. A nurse on a postpartum unit is reinforcing teaching with an assistive personnel (AP) about preventing newborn abduction. Which of the following information should the nurse include?: the AP should have their photo identification badge displayed
  2. A nurse is assisting with the care of a client who is in the active stage of labor. For which of the following findings should the nurse notify the provider?: prolapsed umbilical cord
  3. A nurse in an antepartum clinic is collecting data from a client who is at 28 weeks of gestation. Which of the following findings

should the nurse identify as an indication of a potential complications?: dysuria

  1. A nurse is assisting with the care of a client who is in active labor and notes late decelerations in the fetal heart rate. Which of the following actions should the nurse take first?: place the client in a side- lying position
  2. A nurse is planning to administer phytonadione IM to a newborn shortly after birth. The nurse should identify that this medication is administered to prevent which of the following complications?: hemorrhage disease
  3. A nurse is contributing to the plan of care for a client who is in labor and tested positive for group B streptococcus B-hemolytic. which of the following interventions should the nurse include in the plan of care?: administer ampicillin via intermittent IV bolus
  4. A nurse is reviewing the laboratory results of a client who is at weeks of gestation. Which of the following results should the nurse report to the provider?: Hct 31%
  5. A nurse is collecting data from a newborn who has Down syndrome. Which of the following should the nurse expect in a term newborn who has Down syndrome?: hypotonic muscle tone
  1. a nurse is collecting data from a client who is pregnant and reports that the first day of their last menstrual period was Jan 27. According to Nagele's rule, the nurse should calculate the client's estimated date of delivery as which of the following?: Nov 3
  2. A nurse is contributing to the plan of care for a full term newborn whose mother has type 1 diabetes mellitus. Which of the following is the priority action for the nurse to include in the plan of care? Obtain the glucose level of the newborn. Administer vitamin K and erythromycin. Give the newborn a sponge bath. Complete the metabolic screening test.: obtain the glucose level of the newborn The newborn is at risk for developing hypoglycemia. If brain cells become completely depleted of glucose, brain damage can occur. Therefore, this is the priority action the nurse should include in the plan of care.
  3. A nurse is reinforcing teaching about daily fetal movement count with a client who is at 34 weeks of gestation. Which of the following statements by the client indicates an understanding of the teaching?

"I should have further testing if my baby moves 10 times in 1 hour." "I should expect my baby's movements to decrease as I get close to my due date." "I will lay flat on my back while counting my baby's movements." "I will notify my provider if I do not feel my baby move for 12 hours.": "I will notify my provider if I do not feel my baby move for 12 hours." The nurse should instruct the client to report absence of fetal movement for 12 hr to the provider. This is known as the fetal alarm signal, which can indicate fetal distress. 18. A nurse is contributing to the plan of care for a client who is in labor and tested positive for group B streptococcus ß-hemolytic. Which of the following interventions should the nurse include in the plan of care? Initiate droplet precautions. Prepare the client for a cesarean birth. Report the client's infection to the local health department. Administer ampicillin via intermittent IV bolus.: Administer ampicillin via intermittent IV bolus.

  1. A nurse is reviewing the laboratory reports of four newborns. Which of the following laboratory results should the nurse report to the provider? Platelet count 200,000/mm Hct 45% Hgb 10 g/dL WBC 15,000/mm3: Hgb 10 g/dL A hemoglobin level of 10 g/dL is below the expected reference range of 14 to 24 g/dL for a newborn. The nurse should report this finding to the provider.
  2. A nurse is contributing to the plan of care for a client who plans to formula feed their newborn. Which of the following interventions should the nurse recommend to include? Discard prepared formula after 72 hr. Dilute concentrated formula with equal parts water. Warm formula in the microwave on a low setting. Add two scoops of powdered formula for each ounce of water: Dilute concentrated formula with equal parts water.

The nurse should instruct the client to dilute concentrated formula with an equal volume of water to provide the correct amount of nutrients to the newborn. Formula prepared with too little water is over concentrated and can provide protein and minerals in quantities that exceed the ability of the newborn's kidneys to excrete them, whereas formula prepared with too much water does not provide an adequate amount of calories for growth

  1. A nurse in a clinic is caring for a client who tests positive for gonorrhea. Which of the following findings should the nurse expect during data collection? Chronic pelvic pain Blood in the urine Painless labial lesion Perineal itching: Chronic pelvic pain
  2. A nurse in a clinic is assisting with the plan of care for a client who is at 36 weeks of gestation. Which of the following actions should the nurse include in the plan of care? Obtain a culture for group B streptococcus ß-hemolytic. Collect a blood sample for maternal serum alpha-fetoprotein.

Administer Rho(D) immune globulin. Perform a 1-hr glucose tolerance test.: Obtain a culture for group B streptococcus ß-hemolytic.

  1. A nurse in an antepartum clinic is collecting data from a client who is at 28 weeks of gestation. Which of the following findings should the nurse identify as an indication of a potential complication? Fetal heart rate 120/min Dysuria Leukorrhea Fasting blood glucose 80 mg/dL: Dysuria
  2. A nurse is caring for a client who is at 16 weeks of gestation and is at risk for developing hyperemesis gravidarum. Which of the following conditions places the client at an increased risk for developing this condition? Placenta previa Hypertension Iron deficiency anemia Diabetes mellitus: Diabetes mellitus

The nurse should identify diabetes mellitus as a risk factor for the development of hyperemesis gravidarum. Other risk factors for developing this condition include gastrointestinal disorders, hyperthyroid disorders, molar pregnancy, asthma, and migraines

  1. A nurse is collecting data from a client who is pregnant and reports that the first day of their last menstrual period was January 27. According to Nägele's rule, the nurse should calculate the client's estimated date of delivery as which of the following? October 20 October 27 November 3 November 10: November 3
  2. A nurse is reinforcing discharge teaching with a parent of a newborn following a circumcision using the Plastibell technique. Which of the following statements by the parent indicates an understanding of the teaching? "I will remove the yellow discharge from my baby's penis with a damp cloth."

"I will be sure that my baby's diaper does not put pressure on his penis." "I will clean my baby's penis with soap and water after the first 24 hours." "I will remove the bell from my baby's penis 36 hours after the procedure.": "I will be sure that my baby's diaper does not put pressure on his penis." The nurse should identify that this statement indicates an understanding of the teaching. The diaper should be applied loosely to prevent the application of pressure to the circumcision site.

  1. A nurse is reinforcing teaching with a client who is at 11 weeks of gestation about a transvaginal ultrasound. Which of the following client statements indicates an understanding of the teaching? "I might feel some pressure when the probe is moved during the ultrasound." "I will need to be sure my bladder is full before the ultrasound." "This test will require me to take a laxative the day before the ultrasound." "This test will measure the amount of amniotic fluid around my baby.": "I might feel some pressure when the probe is moved during the ultrasound." MY ANSWER

The nurse should instruct the client that a transvaginal ultrasound is not painful. However, the client might feel pressure when the provider moves the probe 28. A nurse on a postpartum unit is reinforcing teaching with an assistive personnel (AP) about preventing newborn abduction. Which of the following information should the nurse include? The AP should use the identification card on the crib to confirm the newborn's identity. The AP should allow the newborn to remain in the mother's room while she showers. The AP should carry the newborn to the nursery. The AP should have their photo identification badge displayed.: The AP should have their photo identification badge displayed.

  1. A nurse is assisting with the admission assessment of a client whose labor is being induced. The client reports using heroin 6 hr ago. For which of the following manifestations of abstinence should the nurse monitor the client? Constipation Insomnia

Flaccid muscles Euphoria: Insomnia

  1. A nurse is reinforcing teaching with the guardians of a newborn about the care of the umbilical stump. Which of the following instructions should the nurse include in the teaching? "Clean the umbilical stump with soap and water with each diaper change." "Loosely cover the umbilical stump with the diaper." "Sponge bathe your baby until the umbilical stump has fallen off." "Expect the umbilical stump to separate in about 4 weeks.": "Sponge bathe your baby until the umbilical stump has fallen off."
  2. A nurse is collecting data from a newborn who is 6 hr old. Which of the following manifestations should the nurse expect? (Select all that apply.) Rust-stained urine Distended abdomen Overlapping cranial sutures Periodic breathing

Yellow coloration of the sclera: Rust-stained urine is correct. A newborn's first void can contain uric acid crystals, which will give the urine a rust-stained appearance. Overlapping cranial sutures is correct. A newborn's cranial sutures should be palpable without evidence of fusion. Overlapping sutures can occur during a vaginal birth to allow passage of the fetus through the birth canal. Periodic breathing is correct. A newborn's respiratory effort is shallow and irregular and can have periods of 5 to 10 seconds with respiratory effort.

  1. A nurse is reinforcing teaching with a client who is pregnant and has iron deficiency anemia. Which of the following food sources should the nurse instruct the client to include in their diet to increase absorption of an iron supplement? Oranges Bran Milk Eggs: Oranges
  1. A nurse is assisting with the care of a newborn who has hyperbilirubinemia and is receiving phototherapy. Which of the following findings should the nurse identify as a potential complication of phototherapy? Loose stools Decreased urinary output Axillary temperature of 37° C (98.6° F) Skin rash: Decreased urinary output The nurse should closely monitor urinary output while the newborn is receiving phototherapy. Phototherapy can increase the rate of insensible water loss, which can lead to dehydration. The nurse should ensure the newborn is eating every 2 to 3 hr to promote adequate hydration
  2. A nurse is assisting with the care of a postpartum client and their newborn. The nurse observes that the newborn appears to be choking on formula. Which of the following actions should the nurse take? (Select all that apply.) Reposition the newborn. Suction the newborn's mouth with a bulb syringe.

Apply oxygen via nasal cannula. Perform chest percussion. Auscultate breath sounds.: Reposition the newborn is correct. The nurse should reposition the newborn to help facilitate removal of oral secretions. Suction the newborn's mouth with a bulb syringe is correct. The nurse should suction the newborn's mouth with a bulb syringe to facilitate removal of oral secretions, which could be obstructing the airway. Auscultate breath sounds is correct. The nurse should auscultate the newborn's breath sounds to collect further data to evaluate the respiratory status of the newborn.

  1. A nurse is reinforcing teaching with a client who is at 8 weeks of gestation and has chlamydia. Which of the following statements should the nurse include? "Chlamydia can be treated, but not cured." "Chlamydia cannot be treated during pregnancy." "Your provider will prescribe intravenous antibiotics during labor."

"After treatment, you will need another test in 3 weeks and again between 35 and 37 weeks.": "After treatment, you will need another test in 3 weeks and again between 35 and 37 weeks."

  1. A nurse is reinforcing teaching about an amniocentesis with a client who is at 36 weeks of gestation. Which of the following statements by the client indicates an understanding of the teaching? "My provider will determine the position of my baby with an x-ray 2 hours before the procedure." "I will be sitting in a semi-reclining position during the procedure." "I will need to have a full bladder for this procedure." "The procedure will determine if my baby's lungs are mature.": "The procedure will determine if my baby's lungs are mature."
  2. A nurse is collecting data from an antepartum client who reports taking ferrous sulfate twice per day for the past month. The nurse should notify the provider of which of the following findings? Diarrhea Dark green stools Gingivitis Ptyalism: Diarrhea
  1. A nurse is collecting data from a client who is 24 hr postpartum. Which of the following findings is the priority for the nurse to report to the provider? Saturated perineal pad within 15 min Voided 3,000 mL/day Fundus palpated to the right of the umbilicus Temperature of 37.8° C (100° F): Saturated perineal pad within 15 min
  2. A nurse in a prenatal clinic is reinforcing nutritional teaching with a client who is at 10 weeks of gestation. Which of the following statements by the client indicates an understanding of the instructions? "I eat a 6-ounce can of white tuna every other day." "I make sure that I get 1,000 milligrams of calcium per day." "I am consuming 300 micrograms of folate each day." "I limit my caffeine intake to three cups of coffee each day.": "I make sure that I get 1,000 milligrams of calcium per day."
  3. A nurse is assisting with discharge teaching about pain management to a client who had a cesarean birth and is experiencing

gas pains. Which of the following instructions should the nurse include in the teaching? Drink fluids through a straw. Rock in a rocking chair. Lie supine when in bed. Consume whole milk with meals.: Rock in a rocking chair.

  1. A nurse is collecting data from a client who has hyperemesis gravidarum. Which of the following findings indicates that the client is at risk for dehydration? Hematuria Sodium 140 mEq/L Potassium 3.5 mEq/L Ketonuria: Ketonuria
  2. A nurse is reviewing the laboratory results of a client who is at 12 weeks of gestation. Which of the following results should the nurse report to the provider? Hgb 12 g/dL WBC 6,000/mm

Platelet count 200,000/mm Hct 31%: Hct 31%

  1. A nurse is reinforcing dietary teaching with a client who is at 10 weeks of gestation. Which of the following foods should the nurse identify as containing the highest amount of folate? ½ cup corn 1 poached egg 3 ½ oz beef liver ½ cup asparagus: 3 ½ oz beef liver
  2. A nurse is reinforcing teaching with a client who is at 30 weeks of gestation and has a prescription for nifedipine to treat preterm labor. Which of the following adverse effects should the nurse include in the teaching? Flushing Oliguria Hypertension Weight loss: Flushing
  1. A nurse is assisting with the care of a client who is in active labor and notes late decelerations in the fetal heart rate. Which of the following actions should the nurse take first? Palpate the client's uterus to check for tachysystole. Place the client in a side-lying position. Administer oxygen at 10 L/min via nonrebreather face mask. Increase the rate of the client's IV fluids: Place the client in a side-lying position.
  2. A nurse is caring for a postpartum client who has an episiotomy. Which of the following actions should the nurse take? Apply an anesthetic spray to the client's perineal area as needed for pain. Place a donut pillow under the client when sitting in a chair. Apply a moist heat pack to the client's perineal area for 20 min every hour for the first 24 hr after delivery. Assist the client with changing the perineal pad every 8 hr to expedite healing: Apply an anesthetic spray to the client's perineal area as needed for pain.
  1. A nurse in an antepartum clinic is collecting data from a client who is at 12 weeks of gestation. Which of the following findings should the nurse report to the provider? Hematocrit of 35% Weight increase of 3 kg (6.6 lb) in one month Urine dipstick negative for ketones Fetal heart auscultated just above the symphysis pubis: Weight increase of 3 kg (6.6 lb) in one month
  2. A clinic nurse is reviewing dietary instructions with a client who is at 20 weeks of gestation and taking iron supplements. Which of the following statements by the client indicates an understanding of the instructions? "I should take my iron with a cup of coffee." "I should double my iron dose if I forget and miss a day." "I should increase my fluid intake while I am taking iron." "I should limit the fiber in my diet because I am taking iron.": "I should increase my fluid intake while I am taking iron."
  1. A nurse is reviewing the laboratory results for a client who has a BP of 156/102 mm Hg and is at 36 weeks of gestation. Which of the following laboratory values should the nurse report to the provider? WBC 11,000/mm3 Hct 35% Platelet count 100,000/mm3 Fasting blood glucose 105 mg/dL: Platelet count 100,000/mm3
  2. A nurse is reinforcing teaching with the parents of a newborn who is having a newborn screening test. Which of the following statements should the nurse include in the teaching? "The test will check your baby's arterial blood gas levels." "The test will check your baby for jaundice." "The test will check your baby's blood glucose level." "The test will check your baby for phenylketonuria.": "The test will check your baby for phenylketonuria."
  3. A nurse is assisting with the care of a client who is in the active stage of labor. For which of the following findings should the nurse notify the provider?

Spontaneous rupture of membranes Prolapsed umbilical cord Pink to bloody mucus discharge Contraction duration of 60 seconds: Prolapsed umbilical cord

  1. A nurse is reinforcing teaching with a guardian about how to care for the umbilical cord of their newborn infant. Which of the following statements by the guardian indicates a need for further teaching? "I know I shouldn't put lotions or creams near the umbilical cord." "I will notify my provider if the cord becomes moist and red." "I will give my newborn a bath once daily." "I will fold the diaper below the umbilical cord.": "I will give my newborn a bath once daily."
  2. A nurse in a clinic is caring for a client who tests positive for gonorrhea. Which of the following findings should the nurse expect during data collection?: chronic pelvic pain
  3. A nurse is reinforcing dietary teaching with a client who is at 10 weeks of gestation. which of the following foods should the nurse identify as containing the highest amount of folate?: 3 1/2 oz of beef liver
  1. A nurse is collecting data from a client who is at 36 weeks of gestation. Which of the following manifestations should the nurse report to the provider as potentially indicating a complication of pregnancy? Insomnia Breast tenderness Frequent headaches Leg cramps: frequent headaches
  2. A nurse is assisting with collecting data from a newborn who is 4 hr old. which of the following findings is the priority for the nurse to report to the provider? Generalized petechiae Cephalhematoma Heart rate 170/min Temperature 36.4° C (97.6° F): generalized petechiae
  3. A clinic nurse is reviewing dietary instruction with a client who is at 20 weeks of gestation and taking Iron supplements. which of the following statements by the client indicates an understanding of the instructions?: I should increase my fluid intake while I am taking iron