ATI MATERNAL NEWBORN / OB

Q & A STUDY GUIDE

1) Nurse is caring for prenatal patient with parvovirus B19 (5th disease). Which 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.

ANS: Schedule an ultrasound examination:

- The nurse should schedule serial U/S exam to monitor the fetus during the pregnancy to

detect the possible development of fetal hydrops. Also, the virus can cause miscarriage,

intrauterine growth restriction, fetal anemia, or stillbirth.

Administer antiviral medication:

- Currently, there are no antiviral medications available to treat fifth disease.

Administer Haemophilus influenzae type b vaccine:

- The vaccine is given during infancy and childhood to protect against multiple infections

caused by Haemophilus influenzae type b, not fifth disease. Currently, there are no

vaccines to protect against fifth disease.

Schedule an indirect Coombs' test:

- determines whether the client has antibodies to the Rh antigen. The titer determines the

prenatal client's sensitization and if there is Rh incompatibility.

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2) Nurse creating a POC for patient who's postpartum and adheres to traditional Hispanic

cultural beliefs. Which cultural practices should the nurse include in POC?

a) Protect the client's head and feet from cold air.

b) Bathe the client within 12 hr. following birth.

c) Ambulate the client within 24 hr. following birth.

d) Offer the client a glass of cold milk with her first meal.

ANS: Protect the client's head and feet from cold air:

- this is a traditional Hispanic practice during the postpartum period.

Bathe the client within 12 hr following birth:

- traditional Hispanic practices include delaying bathing for 14 days following birth.

Ambulate the client within 24 hr following birth:

- traditional Hispanic practices include bed rest for 3 days following birth.

Offer the client a glass of cold milk with her first meal:

- traditional Hispanic practices include drinking warm beverages following birth.

3) Nurse is caring for patient that's 24 weeks gestation and has suspected placental

abruption. Which lab tests should the nurse expect the HCP to prescribe?

a) Kleihauer-Betke test

b) Progesterone serum level

c) Lecithin/sphingomyelin (L/S) ratio

d) Maternal Alpha-fetoprotein (AFP)

ANS: Kleihauer-Betke test:

- The nurse should expect the provider to prescribe a Kleihauer-Betke test for a client

who has suspected placental abruption to determine if fetal blood is in maternal

circulation. This test is useful to determine if Rho-(D) immune globulin therapy should be

administered to a client who is Rh-negative.

Progesterone serum level:

- helps to determine if a client is pregnant and if the pregnancy is ectopic.

Lecithin/sphingomyelin (L/S) ratio:

- is done as a part of an amniocentesis to evaluate fetal lung maturity.

Maternal Alpha-fetoprotein (AFP):

- a lab test used to assess for NTDs or chromosome disorders.

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4) Nurse is performing a vag exam on a patient who is in labor and observes the

umbilical cord protruding from the vagina. After calling for assistance, which 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.

ANS: Insert two gloved fingers into the vagina and apply upward pressure to the

presenting part.

- The nurse should quickly apply gloves and insert two fingers into the vagina toward the

cervix, exerting upward pressure onto the presenting part to relieve umbilical cord

compression and increase oxygenation to the fetus.

Wrap the visible cord tightly with sterile, dry gauze.

- The nurse should wrap the visible cord with a loose sterile towel saturated with warm

0.9% sodium chloride solution, rather than with sterile, dry gauze.

Apply oxygen to the client at 2 L/min via nasal cannula.

- The nurse should apply oxygen to the client at 8 to 10 L/min via non-breather mask.

Place the client in the lithotomy position and apply fundal pressure.

- The nurse should place the client into a modified Sims position, knee-chest position, or

extreme Trendelenburg to attempt to relieve the compression of the umbilical cord.

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5) Nurse is demonstrating how to bathe their newborn. Which order should the nurse

perform actions?

- The nurse should demonstrate how to bathe a newborn by using a head to

toe, clean to dirty, approach. Therefore, the nurse should first wipe the

newborn's eyes from the inner canthus outward using plain water. The nurse

should then wash the newborn's neck by lifting the newborn's chin. Next, the

nurse should cleanse the skin around the umbilical cord stump followed by

washing the newborn's legs and feet. The last step of the bath should be to

clean the newborn's diaper area. 

6) Nurse teaching the patient that's 10 weeks’ gestation about nutrition during

pregnancy. Which statements by patient indicates an understanding of teaching?

a) "I should increase my protein intake to 60 grams each day."

b) "I should drink 2 liters of water each day."

c) "I should increase my overall daily caloric intake by 300 calories."

d) "I should take 600 micrograms of folic acid each day."

ANS: "I should take 600 micrograms of folic acid each day.":

- A client who is pregnant should increase folic acid intake to 600 mcg daily. Folic acid

assists with preventing neural tube birth defects.

"I should increase my protein intake to 60 grams each day.":

- A client who is pregnant should increase protein intake to 71 g each day during the

second and third trimesters.

"I should drink 2 liters of water each day.":

- A client who is pregnant should consume 3 L of water each day.

"I should increase my overall daily caloric intake by 300 calories.":

- A client who is pregnant should increase caloric intake by 340 cal during the second

trimester and by 452 cal during the third trimester.

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7) Nurse is admitting a patient who's in labor. Patient admits to cocaine use. Which

complications should the nurse assess?

a) Abruptio placenta

b) Placenta previa

c) Preeclampsia

d) Maternal bradycardia

ANS: Abruptio placenta:

- Cocaine use increases the risk for vasoconstriction and possible abruptio placenta.

Placenta previa:

- This is not a common complication associated with cocaine use.

Preeclampsia:

- This is not a common complication associated with cocaine use.

Maternal bradycardia:

- This is not a common complication associated with cocaine use

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