ATI RN Maternal Newborn Online Practice 2019 A

1. A nurse is assessing a client who has gestational diabetes mellitus and is experiencing

hyperglycemia. Which of the following findings should the nurse expect?

a. Reports increased urinary output

i. MY ANSWER: Increased urinary output, nausea and vomiting, reports of

thirst, abdominal pain, constipation, drowsiness, and headaches are

manifestations of hyperglycemia. Other manifestations include weak rapid

pulse, fruity breath odor, urine positive for sugar and acetone, and a blood

glucose level greater than 200 mg/dL.

b. Diaphoresis. Diaphoresis or clammy skin is a finding of hypoglycemia. Flushed, dry

skin is a manifestation of hyperglycemia.

c. Reports blurred vision. Blurred or double vision is a finding of hypoglycemia. A

report of dim vision is a manifestation of hyperglycemia.

d. Shallow respirations. Shallow respirations are a finding of hypoglycemia. Rapid

breathing is a manifestation of hyperglycemia.

2. A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which

of the following actions should the nurse take?

a. Administer penicillin G 2.4 million units IM to the client. The nurse should

administer penicillin G 2.4 million units IM to a client who has syphilis.

b. Instruct the client to schedule an annual pelvic examination. The nurse should

instruct the client to schedule a pelvic examination every 6 months.

c. Tell the client she will start medication for HIV immediately after delivery.

The nurse should tell the client that treatment for HIV will be during the

prenatal and perinatal periods. Treatment with antiretroviral prophylaxis such as

zidovudine, triple-drug antiretroviral therapy (ART), or highly active antiretroviral

therapy (HAART) during pregnancy have been reported to decrease the

transmission of the virus to the newborn.

d. Report the client's condition to the local health department.

i. MY ANSWER. The nurse should report the condition to the local health

department. HIV is one of the conditions on the list of Nationally Notifiable

Infectious Conditions that is required to be reported.

3. 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 the medication?

a. Depression.

i. MY ANSWER. The nurse should instruct the client that depression is a

common adverse effect of combined oral contraceptives. Other common

adverse effects of the medication include amenorrhea, weight gain,

headache, nausea, breakthrough bleeding, and breast tenderness.

b. Polyuria. Fluid retention can occur due to an excess of estrogen. Polyuria is not a

common adverse effect of the medication.

c. Hypotension. Hypertension, rather than hypotension, is a common adverse effect

of combined oral contraceptives.

d. Urticaria. Urticaria is not a common adverse effect of combined oral

contraceptives.

4. 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 instruction should the nurse include

in the teaching?

a. "I can administer oxytocin 4 hours after the insertion of the medication."

i. MY ANSWER. The nurse can administer oxytocin no sooner than 4 hr after

the last dose of misoprostol. Oxytocin can be administered following

misoprostol for clients who have cervical ripening and have not begun

labor.

b. "You will need a full bladder prior to the insertion of the medication."The nurse

should instruct the client to void prior to the administration of the medication.

c. "Remain in a side-lying position for 15 minutes after the medication is

inserted."The nurse should instruct the client to remain in a side-lying position for

30 to 40 min after the insertion.

d. "An antacid will be given 20 minutes prior to the insertion of the medication."The

nurse should avoid administering aluminum hydroxide and magnesium-containing

antacids with misoprostol.

5. 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. Currently, there are no antiviral medications

available to treat fifth disease.

b. Schedule an ultrasound examination.

i. MY ANSWER: The nurse should schedule serial ultrasound examinations 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.

c. Administer Haemophilus influenzae type b vaccine. The Haemophilus influenzae

type b 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.

d. Schedule an indirect Coombs' test. 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.