Maternal Newborn Nursing ATI Review Questions, Exams of Nursing

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Maternal Newborn Nursing ATI THOUROGH

REVISION QUESTIONS

A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse see first? A. A client who is at 11 weeks of gestation and reports abdominal cramping B. A client who is at 15 weeks gestation and reports tingling and numbness in right hand C. A client who is at 20 weeks of gestation and reports constipation for the past 4 days D. A client who is at 8 weeks of gestation and reports having 3 bloody noses in the past week - - CORRECT ANS- A. A client who is at 11 weeks of gestation and reports abdominal cramping Abdominal cramping can indicate an ectopic pregnancy or manifestations of spontaneous abortion A nurse is providing teaching about nonpharmacological pain management to a client who is breastfeeding and has engorgement. The nurse should recommended the application of which of the following items? A. Cold cabbage leaves B. Purified lanolin cream C. A snug-fitting support bra D. Breast shells - -CORRECT ANS- A. Cold cabbage leaves The application of fresh, raw cabbage leaves that have been chilled is an effective nonpharmacological method to relieve pain associated with engorgement A nurse is observing a new parent caring for their crying newborn who is bottle feeding. Which of the following actions by the parent should the nurse recognize as a positive parenting behavior? A. Lays the newborn across their lap and gently sways

B. Places the newborn in the crib in a prone position C. Offers the newborn a pacifier dipped in formula D. Prepares a bottle of formula mixed with rice cereal - -CORRECT ANS- A. Lays the newborn across their lap and gently sways This is the correct technique for quieting a newborn A nurse is caring for a client who is at 26 weeks of gestation and has epilepsy. The nurse enters the room and observes the client having a seizure. After turning the client's head to one side, which of the following actions should the nurse immediately after the seizure? A. Monitor the FHR B. Assess uterine activity C. Administer oxygen via a nonrebreather mask D. Start a bolus of IV fluids - -CORRECT ANS- C. Administer oxygen via a nonrebreather mask When using the ABCs of patient care, the nurse should place priority on administering oxygen to ensure adequate oxygenation to the fetus A nurse is caring for a client who is at 36 weeks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests? A. Biophysical profile B. Amniocentesis C. Cordocentesis D. Kleihauer-Betke test - -CORRECT ANS- A. Biophysical profile A positive contraction stress test indicates that further evaluation of the fetus is necessary

A nurse is caring for a client who is at 30 weeks of gestation and has a prescription for magnesium sulfate IV to treat preterm labor. The nurse should notify the provider of which of the following adverse effects? A. Client reports nausea B. Urinary output of 40 mL/hr C. Respiratory rate 10/min D. Client reports feeling flushed - -CORRECT ANS- C. Respiratory rate of 10/min A nurse is admitting a client to the labor and delivery unit when the client states, "My water just broke." Which of the following interventions is the nurse's priority? A. Perform Nitrazine testing B. Assess the fluid C. Check cervical dilation D. Begin FHR monitoring - -CORRECT ANS- D. Begin FHR monitoring The greatest risk to the client and her fetus following a rupture of membranes is umbilical cord prolapse. The nurse should monitor the fetus closely to ensure well-being. A nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actions should the nurse take? A. Administer antiviral medication B. Schedule an ultrasound examination C. Administer Haemophilus influenzae type b vaccine D. Schedule an indirect Coombs' test - -CORRECT ANS- B. Schedule an ultrasound examination To monitor the fetus during the pregnancy to detect the possible development of fetal hydrops

The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions regarding the newborn should the nurse anticipate? SATA A. Instruct the mother to discontinue breastfeeding B. Administer scheduled dose of oral morphine C. Give a one-time dose of naloxone IM D. Maintain low-stimulus environment E. Initiate NAS scoring - -CORRECT ANS- B. Administer scheduled dose of oral morphine D. Maintain low-stimulus environment E. Initiate NAS scoring A nurse is caring for a client who is receiving oxytocin to augment her labor. Which of the following findings CI the initiation of the oxytocin infusion and should be reported to the provider? A. Late decelerations B. Moderate variability of the FHR C. Cessation of uterine dilation D. Prolonged active phase of labor - -CORRECT ANS- A. Late decelerations They are indicative of uteroplacental insufficiency A nurse is assessing a client who received carboprost for postpartum hemorrhage. Which of the following findings is an adverse effect of this medication? A. Hypertension B. Hypothermia C. Constipation D. Muscle weakness - -CORRECT ANS- A. Hypertension

A nurse is providing teaching to a client who is at 40 weeks of gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching? A. "I can administer oxytocin 4 hrs after the insertion of the med" B. "You will need a full bladder prior to the insertion of the med" C. "Remain in a side-lying position for 15 mins after the med is inserted" D. An antacid will be given 20 mins prior to the insertion of the med" - -CORRECT ANS- A. "I can administer oxytocin 4 hours after the insertion of the medication" A nurse is performing a physical assessment of a newborn upon admission to the nursery. Which of the following manifestations should the nurse expect? SATA A. Yellow sclera B. Acrocyanosis C. Posterior fontanel larger than the anterior fontanel D. Positive Babinski reflex E. Two umbilical arteries visible - -CORRECT ANS- B. Acrocyanosis D. Positive Babinski reflex E. Two umbilical arteries visible A nurse in a clinic is caring for a 16 yo adolescent. Which of the following findings should the nurse report to the provider? SATA A. Abdominal assessment B. Vaginal discharge C. Heart rate D. Temperature E. Dyspareunia F. Condom usage - -CORRECT ANS- A. Abdominal assessment

B. Vaginal discharge D. Temperature E. Dyspareunia F. Condom usage Gonorrhea consistent signs - -CORRECT ANS- Abdominal pain, greenish discharge, pain on urination, absence of condom use Trichomoniasis consistent signs - -CORRECT ANS- Greenish discharge, pain on urination, absence of condom use Candidiasis consistent signs - -CORRECT ANS- Diabetes, pain on urination, absence of condom use The nurse is reviewing the adolescent's medical record. Which of the following conditions in the client most likely developing? - -CORRECT ANS- The adolescent is most likely developing Pelvic Inflammatory Disease as evidenced by C-reactive protein The nurse is planning care for the adolescent. Which of the following prescriptions should the nurse expect the provider to prescribe? - -CORRECT ANS- Ceftriaxone and doxycycline Ceftriaxone is an anti-infective Doxycycline is an anti-infective The nurse is reviewing the provider's prescriptions in the adolescent's medical chart. The nurse should first implement ____ and ____ - -CORRECT ANS- Providing education on medication; administering ceftriaxone

A nurse is assessing a client who is 1 day postpartum and has a vaginal hematoma. Which of the following manifestations should the nurse expect? A. Elevated temperature B. Boggy uterus C. Client report of vaginal pain D. Client report of yellow exudate vaginal drainage - -CORRECT ANS- C. Client report of vaginal pain Due to localized swelling A nurse is reviewing the prenatal laboratory results for a client who is at 12 weeks of gestation following an initial prenatal visit. Which of the following laboratory findings should the nurse report to the provider? A. Hemoglobin 10g/dL B. WBC count 10,000/mm C. Platelets 250,000/mm D. Fasting blood glucose 90 mg/dL - -CORRECT ANS- A. Hemoglobin 10g/dL Below expected reference range of greater than 11 g/dL for a client who is pregnant A nurse is caring for a client who is at 15 weeks gestation, is Rh-negative, and has just had an amniocentesis. Which of the following intervention is the nurse's priority following the procedure? A. Check the client's temperature B. Observe for uterine contraction C. Administer Rho(D) immune globulin D. Monitor the FHR - -CORRECT ANS- D. Monitor the FHR

A nurse is providing discharge teaching to a client who had a cesarean birth 3 days ago. Which of the following instructions should the nurse include? A. "You can resume sexual activity in 1 week" B. "You won't need to do Kegel exercises since you had a cesarean" C. "You can still become pregnant if you are breastfeeding" D. "You are safe to start adding sit-ups to your exercise routine in 2 weeks" - -CORRECT ANS- C. "You can still become pregnant if you are breastfeeding" A nurse is assessing a newborn 12 hr after birth. Which of the following manifestations should the nurse report to the provider? A. Acrocyanosis B. Transient strabismus C. Jaundice D. Caput succedaneum - -CORRECT ANS- C. Jaundice Jaundice occurring within the first 24 hr of birth is associated with ABO incompatibility, hemolysis, or Rh-isoimmunization. A nurse is performing a routine assessment on a client who is at 18 weeks of gestation. Which of the following findings should the nurse expect? A. Deep tendon reflexes 4+ B. Fundal height 14 cm C. Urine protein 2+ D. FHR 152/min - -CORRECT ANS- D. FHR 152/min Expected FHR 160/min at 20 weeks of gestation

A nurse is developing a plan of care for a newborn who is to undergo phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan? A. Feed the newborn 1 oz of water every 4 hr B. Apply lotion to the newborn's skin three times a day C. Remove all clothing from the newborn except the diaper D. Discontinue therapy if the newborn develops a rash - -CORRECT ANS- C. Remove all clothing from the newborn except the diaper A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverse effect of this medication? A. Depression B. Polyuria C. Hypotension D. Urticaria - -CORRECT ANS- A. Depression A nurse is caring for a client who is at 36 weeks of gestation and has a prescription for an amniocenteses. For which of the following reasons should the nurse prepare the client for an ultrasound? A. To estimate the fetal weight B. To locate a pocket of fluid C. To determine multiparity D. To prescreen for fetal anomalies - -CORRECT ANS- B. To locate a pocket of fluid This decreases the risk of injury to the fetus

A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the following outcomes should the nurse expect? A. Decreased uterine contractions B. An increase in the client's hemoglobin levels C. A reduction in respiratory distress in the newborn D. Increased production of antibodies in the newborn - -CORRECT ANS- C. A reduction in respiratory distress in the newborn Glucocorticoid that stimulate fetal lung maturity A nurse in a provider's office is reviewing the medical record of a client who is in the first trimester of pregnancy. Which of the following findings should the nurse identify as a risk factor for the development of preeclampsia? A. Singleton pregnancy B. BMI of 20 C. Maternal age of 32 years D. Pre-gestational diabetes mellitus - -CORRECT ANS- D. Pre-gestational diabetes mellitus A nurse is caring for a client who is at 38 weeks of gestation. Which of the following actions should the nurse take prior to applying an external transducer for fetal monitoring? A. Determine progression of dilation and effacement B. Perform Leopold maneuvers C. Complete a sterile speculum exam D. Prepare a Nitrazine paper test - -CORRECT ANS- B. Perform Leopold maneuvers To assess the position of the fetus to best determine the optimal placement for the external fetal monitor

D. Offer the client a glass of cold milk with her first meal - -CORRECT ANS- A. Protect the client's head and feet from cold air A nurse is performing a vaginal exam on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take? A. Insert two gloved fingers into the vagina and apply upward pressure to the presenting part B. Wrap the visible cord tightly with sterile, dry gauze C. Apply oxygen to the client at 2 L/min via nasal cannula D. Place the client in the lithotomy position and apply fundal pressure - -CORRECT ANS- A. Insert two gloved fingers into the vagina and apply upward pressure to the presenting part A nurse is assessing a newborn who was delivered vaginally and experience a tight nuchal cord. Which of the following findings should the nurse expect? A. Bruising over the buttocks B. Hard nodules on the roof of the mouth C. Petechiae over the head D. Bilateral periauricular papilloma - -CORRECT ANS- C. Petechiae over the head Nuchal cord being wrapped tightly around the neck, can cause bruising and petechiae over the face, head and neck A nurse is admitting a client who is in labor. The client admits to recent cocaine use. For which of the following complications should the nurse assess? A. Abruptio placenta B. Placenta previa C. Preeclampsia D. Maternal bradycardia - -CORRECT ANS- A. Abruptio placenta

Cocaine use increases the risk for vasoconstriction and possible abruptio placenta A nurse is assessing a client who is receiving morphine via IV bolus for pain following a cesarean birth. The nurse notes a respiratory rate of 8/min. Which of the following medications should the nurse administer? A. Fentanyl B. Butorphanol C. Naloxone D. Meperidine - -CORRECT ANS- C. Naloxone A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. which of the following findings should the nurse report to the provider? A. BUN 25 mg/dL B. Serum creatinine 0.8 mg/dL C. Urine output of 280 mL within 8 hr D. Urine negative for ketones - -CORRECT ANS- A. BUN 25 mg/dL Elevated - indicate dehydration When does the "4th Stage Labor" begin - -CORRECT ANS- Begins with delivery of the placenta How long does "4th Stage Labor last - -CORRECT ANS- 1-4 hours Parent/Newborn bonding should begin when - -CORRECT ANS- during "4th Stage Labor" What is main goal immediately Post Partum - -CORRECT ANS- PREVENT HEMORRAGE

A firm and contracted uterus prevents excess bleeding and? - -CORRECT ANS- hemorrage What are uncomfortable uterine cramps called - -CORRECT ANS- Afterpains What hormones decrease after placenta is delivered - -CORRECT ANS- Estrogen, progesterone, placental enzyme insulinase a decrease in Estrogen, progesterone and placental enzyme insulinase will result in decreases in what? - -CORRECT ANS- blood glucose levels, estrogen levels, and progesterone levels what is diaphoresis - -CORRECT ANS- profuse perspiration what is diuresis - -CORRECT ANS- increased formation and excretion of urine Decreased estrogen is associated with what? - -CORRECT ANS- Breast engorgement, Diaphoresis, and diuresis Decreased estrogen also causes? - -CORRECT ANS- diminished vaginal lubrication, local dryness and intercourse discomfort (which may persist until ovarian function and menses returns Decreased progesterone results in - -CORRECT ANS- increased muscle tone throughout body ` - -CORRECT ANS- UC relaxation time- when is it dangerous, prolonged/resting phase - -CORRECT ANS- > greater than 30 seconds - Dangerous: Prolonged 90 sec

Resting phase: <30 seconds After a cesarean delivery due to dysfunctional labor, a client and her partner express their disappointment to the nurse that they did not have natural childbirth. Which of the following is an appropriate nursing response? - -CORRECT ANS- "It sounds like you are feeling sad that things didn't go as planned." With this response, the nurse is using the therapeutic communication technique of restating to encourage the couple to continue to communicate their feelings. Herbal supplement that decreases effect of oral contraceptives - -CORRECT ANS- St. John's Wort Assessment for suspected placenta previa. What 3 things should you NOT do? - -CORRECT ANS- Apply EFM (ext. fetal monitor) DO NOT: vag exam, rectal exam, or apply ice to peri area After 12 hours post-vag delivery, where should fundus be? How about following days? - - CORRECT ANS- after 12 hours - level of umbilicus; then recede 1-2 cm each day What meds are given if suspect PRETERM labor? - -CORRECT ANS- Tocolytics i.e. Mg Sulfate & Indocin Priority newborn assessment post-C section, why? - -CORRECT ANS- ABC assessment for respiratory distress.

• during vag delivery, pressure through canal helps release AF in lungs and stimulates resp. with C-section, they don't go through canal thus increased risk for resp. issues.