ATI Maternal Newborn Proctored Exam

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A.T.I Maternal Newborn

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 Low urine output (<30mL per hour)

7.A nurse is teaching a client who is at 12 weeks of gestation about the manifestations of

potential complications that she should report to her provider. Which information should the

nurse include in the teaching?

 Swelling of the face

8.A nurse is reviewing lab results for a client who is at 37 weeks of gestation. The nurse notes

that the client is rubella non-immune, positive for group A beta-hemolytic strep, and has a blood

type of O negative. Which action should the nurse take?

 Instruct the client to obtain a rubella immunization after delivery

9.A nurse is caring for a client who has oligohydramnios. Which fetal anomaly should the nurse

expect?

 Renal agenesis

10.A nurse is caring for a client who believes she may be pregnant. Which finding should the

nurse identify as a positive sign of pregnancy?

 Palpable fetal movement

11.A nurse is assessing a client who is at 37 weeks of gestation and has a suspected pelvic

fracture due to blunt abdominal trauma. What finding should the nurse expect?

 Uterine contractions

12.A nurse is caring for a client at 26 weeks of gestation and reports constipation. How should

the nurse respond?

 "You should walk for at least 30 min/day"

13.A nurse is caring for a client who is in the latent phase of labor and is experiencing low back

pain. Which action should the nurse take?

 Apply pressure to the client's sacral area during contractions

14.A nurse is assessing a client who is at 35 weeks of gestation and is receiving magnesium

sulfate via continuous IV infusion for severe pre-eclampsia. Which finding should the nurse

report to the provider?

 Urinary output 20mL/hour

15.A nurse is teaching a client who is at 10 weeks of gestation about an abdominal ultrasound in

the first trimester. What should the nurse include in the teaching?

 "You will need to have a full bladder during the ultrasound"

16.A nurse is caring for a client who is at 35 weeks of gestation and has severe pre-eclampsia.

Which assessment provides the most accurate reading of fluid and electrolyte status?

 Daily weight

17.Which lab test confirms pregnancy (edited question)?

 A urine test for human chorionic gonadotropin

18.A nurse is caring for a client whose LMP began July 8. What is her EDB?

 April 15

19.A nurse is caring for a client who is at 38 weeks of gestation and reports no fetal movement

for 24hr. What should the nurse do?

 Auscultate for a FHR

20.A nurse is assessing a client who is at 12 weeks of gestation and has a hyatidiform mole.

What finding should the nurse expect?

 Dark brown vaginal discharge

21.A nurse is caring for a client in their latent phase of labor and is receiving oxytocin via

continuous IV infusion. The client is having contractions every 2 min which last 100 to 110

seconds and the FHR is reassuring. What should the nurse do?

 Decrease the dose of oxytocin by half

22.A nurse is teaching a client who is at 8 weeks of gestation and has a uterine fibroid about

potential effects of the fibroid during pregnancy. What information should they include in the

teaching?

 The fibroid can increase the risk for postpartum hemorrhage

23.A nurse is providing teaching to a client who is at 8 weeks of gestation about manifestations

to report to the provider during pregnancy. What information should the nurse include in the

teaching?

 Blurred or double vision

24.A nurse is admitting a client who is in labor and experiencing moderate bright red vaginal

bleeding. Which of the following actions should the nurse take?

 Obtain blood samples for baseline laboratory values

25.A nurse is teaching a client who is at 12 weeks of gestation and has HIV. What should the

nurse include in the teaching?

 "You should continue to take zidovudine throughout the pregnancy"

26.A nurse is teaching a client who is 13 week of gestation about the treatment of incompetent

cervix with cervical cerglage. Which statement by the client indicates an understanding?

 "I should go to the hospital if I think I may be in labor"

27.A nurse is caring for a client in active labor and has mec stained fluid. The nurse notes a

reassuring FHR tracing from the external fetal monitor. What should the nurse do?

 Prepare equipment needed for newborn resuscitation

28.A nurse is caring for a client who is at 39 weeks of gestation and is in the active phase of

labor. The nurse observes late decals in the FHR. Which finding causes late decels?

 Uteroplacental insufficiency

29.(Edited question) which order should be questioned with placenta previa?

 Perform a vaginal exam

30.A nurse is caring for a client at 37 weeks and is undergoing a nonstress test. The FHR is 130

without accelerations for the past 10 min. What should the nurse do?

 Use vibroacoustic stimulation on the client's abdomen for 3 seconds

31.A nurse is planning care for a newborn who is receiving phototherapy for an elevated

bilirubin level. What action should the nurse take?

 use photometer to monitor the lamp's energy

32.A nurse is assessing a 4 hr old newborn who is to breastfeed and notes hands and feet that are

cool and slightly blue What action should the nurse take?

place the naked newborn on the mothers bare chest and cover both with a blanket

33.A nurse is caring for a newborn immediately following delivery. What actions should the

nurse take first?

 place the newborn directly on the client's chest

34.A nurse is providing teaching to the parents of a newborn about home safety. What statement

by the parents indicates an understanding of the teaching?

 I will place my baby on his back when it is time for him to sleep

35.A nurse is assessing a newborn 1 min after birth and notes a hr of 136/min, resp 36, well

flexed extremities, responding to stimuli with a cry, blue hands and feet. What Apgar score

should the nurse assigned to the newborn?

 9

36.A nurse is assessing a client who is 14 hr postpartum and has a 3rd degree perineal laceration.

The client's temp is 37.8 C (100F), her fundus is firm and slightly deviated to the right. The

client reports a gush of blood when she ambulates and no bm since delivery. What action should

the nurse take?

 assist the client to empty her bladder

37.A nurse is preparing to administer morphine oral solution 0.04 mg/kg to a newborn who

weighs 2.5kg. The amount available is 0.4 mg/ml. how many ml should the nurse administer?

 0.25

38.A nurse is assessing a 12 hr old newborn and notes a resp rate of 44 with shallow respirations

and periods of apnea lasting up to 10 seconds. What action should the nurse take?

 continue routine monitoring

39.A nurse is caring for a client who reports intestinal gas pain following a c-section. What

action should the nurse take?

 assist the client to ambulate in the hallway

40.A nurse is caring for a newborn who is premature at 30 wks gestation. What finding should

the nurse expect?

 abundant lanugo

41.A nurse is assessing a newborn 1 hr after birth. What assessment findings should the nurse

report to the provider?