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MATERNAL NEWBORN ATI, MATERNAL NEWBORN PROCTOR ATI 2023 LATEST ASSESSMENT WITH UPDATED AND STRUCTURED QUESTIONS AND CORRECT VERIFIED ANSWERSMATERNAL NEWBORN ATI, MATERNAL NEWBORN PROCTOR ATI 2023 LATEST ASSESSMENT WITH UPDATED AND STRUCTURED QUESTIONS AND CORRECT VERIFIED ANSWERSMATERNAL NEWBORN ATI, MATERNAL NEWBORN PROCTOR ATI 2023 LATEST ASSESSMENT WITH UPDATED AND STRUCTURED QUESTIONS AND CORRECT VERIFIED ANSWERS
Typology: Exams
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FHR can be heard by Doppler at: - CORRECT ANSWER>>> 10 - 12 weeks GA Between 18 and 30 weeks the fundal height should measure what? - CORRECT ANSWER>>> It should equal the week of gestation MSAFP screening is done: - CORRECT ANSWER>>> 15 - 22 weeks of gestation maternal serum alpha-fetoprotein (MSAFP) screen. It's usually as part of a set of tests, which screen for genetic problems, called the quad screen. AFP is a substance made in the liver of an unborn baby (fetus). Smoking tobacco during pregnancy is associated with : - CORRECT ANSWER>>> Low Birth Weight Pregnant mothers should consume how much water each day? - CORRECT ANSWER>>> 2 to 3 Liters of water from food and beverage sources. Regarding kick counts, what are signs that a woman needs further evaluation? - CORRECT ANSWER>>> Fetal movements of less than 3 in one hour No fetal movement for 12 hours The recommended weight gain during pregnancy is usually: - CORRECT ANSWER>>> 25 - 35lbs 3 - 4 lb in first trimester 1 lb per week in the last two trimesters
Foods high in folic acid are: - CORRECT ANSWER>>> Leafy vegetables Dried peas Dried beans Seeds Orange juice It is recommended that _____ mcg of folic acid be taken during pregnancy. - CORRECT ANSWER>>> 600 It is recommended that clients who are lactating consume ____ mcg of folic acid. - CORRECT ANSWER>>> 500 What vitamin aids in the absorption of Iron? - CORRECT ANSWER>>> Vitamin C The clients bladder needs to be _____ before an ultrasound. - CORRECT ANSWER>>> Full biophysical profile (BPP) normal score is - CORRECT ANSWER>>> A biophysical profile (BPP) test measures the health of your baby (fetus) during pregnancy. 8 - 10 BPP abnormal score is - CORRECT ANSWER>>> < If a BPP comes back as 6..... - CORRECT ANSWER>>> It should be retested BPP assess for - CORRECT ANSWER>>> Fetal well being non-stress test ( NST) - CORRECT ANSWER>>> most widely used technique for antepartum evaluation of fetal well being performed during the third trimester.
Reactive NST - CORRECT ANSWER>>> FHR is a normal baseline rate with moderate variablity Two accelerations to 15 bpm for at least 15 secs in 20 min period A non reactive NST would indicate what about the fetus? - CORRECT ANSWER>>> The fetal heart rate does not accelerate adequately with fetal movement.
Latent phase of labor: - CORRECT ANSWER>>> 0 - 3 cm mild to moderate contractions irregular q 5-30 min lasts 30-40 sec Active phase of labor: - CORRECT ANSWER>>> 4 - 7 cm moderate to strong contractions regular q 3-5 min lasts 40-70 sec Transition phase of labor - CORRECT ANSWER>>> 8 - 10 cm strong to very strong contractions q 2-3 min lasts 45-90 sec Second stage of labor: - CORRECT ANSWER>>> Full dilation Intense contractions BIRTH!! Third stage of labor: - CORRECT ANSWER>>> Delivery of placenta Fourth stage: - CORRECT ANSWER>>> Maternal stabilization of vital signs First stage pain: - CORRECT ANSWER>>> internal visceral may be felt as back/leg pain
Second stage pain: - CORRECT ANSWER>>> somatic occurs with fetal descent and expulsion Third stage pain: - CORRECT ANSWER>>> similar to first stage pain Pain S&S: - CORRECT ANSWER>>> Increased BP Tachycardia Hyperventilation Absent or undetectable variability is considered: - CORRECT ANSWER>>> Non-reasurring Minimal variability: - CORRECT ANSWER>>> > undetectable but <5/min Moderate variability: - CORRECT ANSWER>>> 6 - 25/min Marked variability: - CORRECT ANSWER>>> >25/min Accelerations mean: - CORRECT ANSWER>>> Healthy fetal/placental exchange Fetal bradycardia means (less than 60) - CORRECT ANSWER>>> Uteroplacental insufficiency Umbilical cord prolapse Maternal hypotension Prolonged umbilical cord compression Fetal congenital heart block Anesthetic meds Fetal tachycardia means: - CORRECT ANSWER>>> Maternal infection Fetal anemia Fetal heart failure
Fetal cardiac dysrythmias Maternal use of cocaine or meth Maternal dehydration Decrease or loss of variability means: - CORRECT ANSWER>>> Meds that depress the CNS Fetal hypoxemia w/resulting acidosis Fetal sleep cycle congenital abnormalities Early decels mean: - CORRECT ANSWER>>> Compression of the fetal head resulting from uterine contraction Vaginal exam Fundal pressure Late decels mean: - CORRECT ANSWER>>> UPI causing inadequate fetal oxygenation Maternal hypotension placental abruption Uterine hyperstimulation w/pitocin Variable decels mean: - CORRECT ANSWER>>> Umbilical cord compression Short cord Prolapsed cord Nuchal cord Oligohydraminos Fetal descent and cervical dilation are caused by - CORRECT ANSWER>>> Frequency, duration, and strength of contractions What is the sensation the patient will feel when completion of dilation and fetal descent? - CORRECT ANSWER>>> She will feel like she needs to take a big ole poooo!
First degree laceration extends through: - CORRECT ANSWER>>> skin of perineum Second degree laceration extends through: - CORRECT ANSWER>>> skin of perineum muscles of perineum Third degree laceration extends through: - CORRECT ANSWER>>> skin of perineum muscles of perineum anal sphincter Fourth degree laceration extends through: - CORRECT ANSWER>>> skin of perineum muscles of perineum anal sphincter anterior rectal wall Third stage: Signs of placental separation from the uterus are indicated by: - CORRECT ANSWER>>> fundus firmly contracting swift gush from introitus of dark blood umbilical cord appears to lengthen as placenta descends vaginal fullness of exam There is a high risk of _________ surrounding external cephalic version. - CORRECT ANSWER>>> Cord prolapse Regarding BISHOP scoring, when is a woman ready for labor? - CORRECT ANSWER>>> A score of 9 for nulliparas 5 or more for multiparas
Mechanical methods to ripen cervix: - CORRECT ANSWER>>> balloon caths hydroscopic dilators and sponges laminara tents synthetic dilators and sponges Methods of induction - CORRECT ANSWER>>> prostaglandins applied cervically admin of IV oxytocin amniotomy stripping of membranes nipple stimulation Dystocia - CORRECT ANSWER>>> prolonged, difficult labor Before administering pitocin, where should the fetus be? - CORRECT ANSWER>>> engaged in the birth canal at a minimum of 0 station. Discontinue oxytocin if: - CORRECT ANSWER>>> contraction frequency more often than every 2 mins contraction duration longer than 90 seconds no relaxation of uterus between contractions uterine resting tone greater than 20 mmHg between ctx Labor typically begins within ___ hours after ROM. - CORRECT ANSWER>>> 12 An amnioinfusion can be used to: - CORRECT ANSWER>>> Reduce severity of variable decelerations (cord compression) Dilute meconium-stained amniotic fluid Caput Succedaneum is: - CORRECT ANSWER>>> Normal Should resolve within 24 hrs
For breast engorgement: - CORRECT ANSWER>>> apply cool compresses b/t feedings apply warm compresses take warm shower b4 breast feeding Cold cabbage leaves - CORRECT ANSWER>>> may also be applied to breasts to decrease swelling and relive discomfort Postpartum the mother should not lift anything that is heavier than: - CORRECT ANSWER>>> the infant PP the mom should consume ______ to_______ ml of water each day. - CORRECT ANSWER>>> 2000 - 3000 Encourage women who are lactating to add an additional ___ calories/day to their prepregnancy diet. - CORRECT ANSWER>>> 500 Teach the clent to avoid sexual intercourse until: - CORRECT ANSWER>>> episiotomy/laceration is healed & vaginal discharge has turned white Postpartum disorders are: - CORRECT ANSWER>>> unexpected events or occurrences that may happen during the PP period Deep Vein Thrombosis S&S - CORRECT ANSWER>>> Leg pain Chills Unilateral swelling, warmth, redness Warm extremity Calf tenderness Elevated temp
Cough Tachycardia Thrombophlebitis: position arm: - CORRECT ANSWER>>> Above the lever of the heart Thrombosis tx drugs: - CORRECT ANSWER>>> Heparin Warfarin (coumadin) Pulmonary Embolus S&S - CORRECT ANSWER>>> Chills Apprehension Pleruitic Chest pain Dyspnea tachypnea hemoptysis heart murmurs peripheral edema distended neck veins elevated temp hypotension hypoxia DIC risk factors - CORRECT ANSWER>>> abruptio placenta AFE missed abortion fetal death in utero Severe preeclampsia or eclampsia (GHTN) Septicemia cardiopulmonary arrest hemorrhage
hydatiform mole Post partum hemorrhage is considered to occur if the client loses how much blood? - CORRECT ANSWER>>> more than 500 mL after vaginal birth more than 1000 mL after c/s Two complications that can occur following PP hemorrhage include: - CORRECT ANSWER>>> hypovolemic shock anemia PP hemorrhage VS findings: - CORRECT ANSWER>>> Tachycardia Hypotension Meds given to tx PP hemorrhage - CORRECT ANSWER>>> Oxytocin Methergine Cytotec Hemabate Subinvolution is when: - CORRECT ANSWER>>> The uterus remains enlarged with continued lochial discharge and may result in PP hemorrhage Subinvolution s&s - CORRECT ANSWER>>> increased vag bleeding uterus enlarged and higher than normal in the abd relative to umbilicus boggy uterus prolonged lochia d/c with irregular or excessive bleeding Risk factors for subinvolution of uterus: - CORRECT ANSWER>>> Pelvic infection and endometritis Retained placental fragments not completely expelled from the uterus Inversion of the uterus - CORRECT ANSWER>>> Retained placenta
Uterine atony Excessive fundal pressure Abnormally adherent placental tissue Multiparity Fundal implantation of the placenta Extremem traction applied to the umbilical cord Leiomyomas Inversion of uterus s&s - CORRECT ANSWER>>> pain in lower abd vag bleeding dizziness low BP pallor Retained placenta: - CORRECT ANSWER>>> Placenta or fragments of the placenta remain in the uterus preventing the uterus from contracting which leads to uterine atony or subinvolution Med given: oxytocin....if unsuccessful then tocolytic for d&c APGAR scoring is: - CORRECT ANSWER>>> a brief physical exam done immediately following birth to rule out abnormalities. APGAR of 0-3 indicates - CORRECT ANSWER>>> severe distress APGAR or 4-6 indicates - CORRECT ANSWER>>> moderate distress APGAR of 7-10 indicates - CORRECT ANSWER>>> no distres APGAR
Heart rate scoring - CORRECT ANSWER>>> 0= absent 1= < 2= > APGAR RR scoring - CORRECT ANSWER>>> 0= absent 1= slow, weak cry 2= good cry APGAR Muscle tone scoring - CORRECT ANSWER>>> 0= Flaccid 1= some flexion 2= well-flexed APGAR Reflex irritability - CORRECT ANSWER>>> 0= none 2= grimace 3= cry APGAR Color scoring - CORRECT ANSWER>>> 0= Blue, pale 1= pink body, cyanotic hands and feet (acrocyanosis) 2= Completely pink Normal newborn weight range: - CORRECT ANSWER>>> 2500 - 4000 grams Low birth weight - CORRECT ANSWER>>> less than 2500 grams Term birth - CORRECT ANSWER>>> between 38 weeks and 42 weeks
Grunting and nasal flaring are: - CORRECT ANSWER>>> signs of respiratory distress crackles and wheezing are signs of - CORRECT ANSWER>>> fluid or infection in the lungs Newborn BP should be - CORRECT ANSWER>>> 60 - 80 systolic and 40-50 diastolic Newborn temp should be - CORRECT ANSWER>>> 97.7-98. Milia - CORRECT ANSWER>>> small raised white spots on nose, chin, and forehead mongolian spots - CORRECT ANSWER>>> bluish purple spots of pigmentation telangectiatic nevi - CORRECT ANSWER>>> flat pink or red marks that easily blanch and are found on the newborns back of the neck, nose, upper eye lids, and middle of the forehead nevus flammues (port wine stains) - CORRECT ANSWER>>> a capillary angioma below the surface of the skin that is purple or red, varies in size and shape, is commonly seen on face and does not blanch or disappear. erythema toxicum - CORRECT ANSWER>>> pink rash that appears suddenly anywhere on the body of a term newborn during the first 3 weeks. caput succadaneum - CORRECT ANSWER>>> localized swelling of the soft tissues of the scalp caused by pressure on the head during labor.........normal finding......crosses suture line cephalhematoma - CORRECT ANSWER>>> collection of blood between periosteum and skull bone that it covers does not cross suture line results from trauma during birth
normal newborn RR - CORRECT ANSWER>>> 30 - 60 When can bathing by immersion be done? - CORRECT ANSWER>>> When the newborn's umbilical cord has fallen off and the circumcision has healed on males How long should the newborn nurse? - CORRECT ANSWER>>> 15 - 20 minutes (but don't educate the mother on the timing) Newborns who are formula fed should be burped: - CORRECT ANSWER>>> every 15-30 mLs Newborns should have how many diapers a day? - CORRECT ANSWER>>> 6 - 8 wet diapers 3 - 4 stools per day Cord infection s&s: - CORRECT ANSWER>>> moist and red foul odor purulent drainage Chlamydia s&s - CORRECT ANSWER>>> Vulvar itching Vag spotting White, watery vaginal discharge Gonorrhea S&S - CORRECT ANSWER>>> Urethral discharge Painful urination Frequency Yellowish-green vag discharge Reddended vulava & vag walls GBS can be tested when? - CORRECT ANSWER>>> 35 - 37 week GA
Candida Albicans S&S - CORRECT ANSWER>>> Vulvar itching Thick, creamy white vag discharge Vulvar redness White patches on vag walls Gray white patches on tongue and gums Terbutaline (Brethine) - CORRECT ANSWER>>> Uses to relax uterine smooth muscle to inhibit uterine activity Indomethacin - CORRECT ANSWER>>> is an NSAID that suppresses preterm labor & uterine contraction. Betamethoasone - CORRECT ANSWER>>> Glucocorticoid given to enhance fetal lung maturity and surfactant production. MSAFP screening done when? - CORRECT ANSWER>>> 15 - 22 weeks Calendar method - CORRECT ANSWER>>> ovulation occurs 14 days before onset of next menstrual cycle and avoids intercourse during that period, days 8-19 is fertile period spinnbarkeit sign - CORRECT ANSWER>>> the ability for the mucus to stretch between the fingers is greatest during ovulation Basal Body temp - CORRECT ANSWER>>> temp drops during ovulation diagphragm - CORRECT ANSWER>>> inserted up to 6 hours before and stay in 6 hours after refitted every 2 years cervical cap - CORRECT ANSWER>>> guidelines are the same as diaphragm, 6 hours before and leave in 6 hours after replaced every 2 years
contraceptive sponge - CORRECT ANSWER>>> leave in for 6 hours after intercourse progestin pills - CORRECT ANSWER>>> are safe for breast feeding mothers nuva ring - CORRECT ANSWER>>> replace ring every 3 weeks insertion same day of every month can be removed up to 3 hours how soon can pregnancy be detected? - CORRECT ANSWER>>> HCG beings production detected as early as 7-8 days higher levels of HCG - CORRECT ANSWER>>> can indicate multifetal pregnancy, down syndrome low levels of HCG - CORRECT ANSWER>>> Miscarriage or ectopic pregnancy anticonvulsants - CORRECT ANSWER>>> cause false positive pregnancy tests weaken birth control medications When should you start measuring the fundal height? - CORRECT ANSWER>>> 18 - 32 weeks gestation Parity - CORRECT ANSWER>>> number of pregnancies greater than 20 weeks not the number of fetuses gravidity - CORRECT ANSWER>>> number of pregnancies ultrasound - CORRECT ANSWER>>> needs to have full bladder amniocentesis - CORRECT ANSWER>>> needs to have empty bladder
bishop score - CORRECT ANSWER>>> 9 nullipara 5 multipara how many lbs should the mother gain? - CORRECT ANSWER>>> 25 - 35 lbs 4 lbs 1st trimester the rest of the trimesters is a pound a week FHR variables - CORRECT ANSWER>>> 2 means good scoring is 0- 2 Ballottment - CORRECT ANSWER>>> positioning of fetus its a presumptive sign of pregnancy prenatal assessment - CORRECT ANSWER>>> 16 - 28 weeks monthly 29 - 36 every 2 weeks 36 weeks until birth is every week when can fundal height be measured? - CORRECT ANSWER>>> 2nd trimester GBS testing - CORRECT ANSWER>>> 35 - 27 weeks gest fetal movement - CORRECT ANSWER>>> less than 3 per hour or movements cease for 12 hours needs further eval usually it's 2-3 times a day for 2 hours after meals or bedtime iron intake for pregnant women - CORRECT ANSWER>>> 27 mg/dl calcium intake for pregnant women - CORRECT ANSWER>>> 1000 folic acid intake for pregnant women - CORRECT ANSWER>>> 600 mg
calories per day for pregnant women - CORRECT ANSWER>>> 500 calories how soon can a amniocentesis be performed? - CORRECT ANSWER>>> 14 weeks Kelihauer-Betke Test - CORRECT ANSWER>>> used to measure the amount of fetal hemoglobin transferred from a fetus to a mother's bloodstream this is done to make sure there is not too much blood from infant in mothers bloodstream what is the ratio for lecithin sphingomyelin - CORRECT ANSWER>>> 2:1 indicates fetal lung maturity What is the advantage of chorionic villus sampling versus amniocentesis - CORRECT ANSWER>>> you are able to do it earlier it assesses the portion of developing placenta high levels of afp - CORRECT ANSWER>>> neural tube defects low levels of afp - CORRECT ANSWER>>> down syndrome when is the Maternal Serum alpha fetoprotein test performed? - CORRECT ANSWER>>> to detect neural tube defects and is done between 16-18 weeks of gestation cvs versus amniocentesis bladder difference - CORRECT ANSWER>>> cvs is full bladder and amnio is empty spontaneous abortion - CORRECT ANSWER>>> less than 20 weeks Ectopic pregnancy - CORRECT ANSWER>>> referred shoulder pain IUD usage history stabbing pain and tenderness in lower abdominal quadrant
HCG rules out ectopic if elevated methotrexate - CORRECT ANSWER>>> disolves pregnancy Abrutpio placentae - CORRECT ANSWER>>> premature separation of placenta from uterus dark red bleeding pain boardlike uterus fetal distress hgb and hctz decreased DIC risk kleihauer betke test to detect fetal blood in marternal circulation get ready for blood transfusion risk factors for abruptio placentae - CORRECT ANSWER>>> smoking cocaine blunt abdominal trauma medication for syphillis - CORRECT ANSWER>>> penicillin G IM single dose med choice for gonorrhea - CORRECT ANSWER>>> ceftriaxone erthromycin - CORRECT ANSWER>>> administered for infant to prevent gonorrhea and chlamydia med for HIV positive - CORRECT ANSWER>>> retrovir which immunization is contraindicated for pregnant women? - CORRECT ANSWER>>> Rubella hyperglycemia - CORRECT ANSWER>>> the 5 P's
polydipsia, polyphagia, polyuria, nausea positive blood glucose screening reading - CORRECT ANSWER>>> 130 - 140 mg/dl mild preeclampsia - CORRECT ANSWER>>> proteinuria plus 1 severe preeclampsia - CORRECT ANSWER>>> 160/110 mg/dl proteinuria greater than 3+ Eclampsia - CORRECT ANSWER>>> seizure or coma onset HELLP - CORRECT ANSWER>>> variant of gestational hypertension Hemolysis Elevated liver Low platelets Nitrazine paper - CORRECT ANSWER>>> to test for amniotic fluid to indicate rupture of membranes positive is blue when does menses resume after birth? - CORRECT ANSWER>>> 4 - 6 weeks postpartum how often should bp and puse be assessed with newborn after birth? - CORRECT ANSWER>>> every 15 minutes for the first 2 hours of birth Where should the fundus be immediately after delivery? - CORRECT ANSWER>>> midline with umbilicus fundus at 12 hr postpartum? - CORRECT ANSWER>>> 1 cm above umbilicus after how many days is the fundus no longer palpable? - CORRECT ANSWER>>> 10 days
how much protein is needed during pregnancy? - CORRECT ANSWER>>> 71 grams terbutaline side effects - CORRECT ANSWER>>> hypokalemia, hyperglycemia, hypotension expected reference range for newborn's length - CORRECT ANSWER>>> 45 - 55 cm expected range for weight - CORRECT ANSWER>>> 2.5-4 kg greatest risk with amniotomy - CORRECT ANSWER>>> infection simethicone - CORRECT ANSWER>>> Gas-X deep tendon reflexes - CORRECT ANSWER>>> tested with a reflex hammer that is used to strike a tendon +2 is ideal for pregnant woman FHR - CORRECT ANSWER>>> 110 - 160 rr for newborn - CORRECT ANSWER>>> 30 - 60 stages of labor - CORRECT ANSWER>>> 1. dilation
when does gestational diabetes usually disapate? - CORRECT ANSWER>>> 6 weeks and they are restested at 6 weeks and every 3 years oxytocin uses postpartum - CORRECT ANSWER>>> flaccid uterus and excess vaginal bleeding early decel causes - CORRECT ANSWER>>> fetal head compression newborn screening - CORRECT ANSWER>>> make sure child ate 24 hours prior to obtaining If the water breaks first priority it what? - CORRECT ANSWER>>> check FHR Adolescent pregnancy requires them to consume more what? - CORRECT ANSWER>>> 3 to 4 servings of calcium what are early decels usually considered? - CORRECT ANSWER>>> benign carboprost - CORRECT ANSWER>>> promotes contractions and used for hemorrhage se is hypertension fever diarrhea when should meconium be passed? - CORRECT ANSWER>>> 24 - 48 hr following birth temp to report to provider of mother - CORRECT ANSWER>>> 100.4 leopold manuever - CORRECT ANSWER>>> identify fetal part determine location of fetal back palpate for inlet
palpate cephalic prominence