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Maternal newborn ati proctored exam|304 Questions and Answers
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Maternal newborn ati proctored exam|304 Questions and Answers
A nurse is caring for a client who is at 32 wks gestation and is experiencing
preterm labor. What meds should the nurse plan to administer?
a. misoprostol
b. betamethasone
c. poractant alfa
d. methylergonovine - -b. betamethasone
-A nurse at a prenatal clinic is caring for a client who suspects she may be
pregnant and asks the nurse how the provider will confirm her pregnancy.
The nurse should inform the client that what lab test will be used to confirm
her pregnancy?
a. urine test for presence of HCG
b. urine test for the presence of HCS
c. blood test for presence of estrogen
d. blood test for the amount of circulating progesterone - -a. urine test for
presence of HCG
-A nurse is caring for a client who believes she may be pregnant. What
finding should the nurse identify as a positive sign of pregnancy?
a. palpable fetal movement
b. amenorrhea
c. chadwick's sign
d. positive pregnancy test - -a. palpable fetal movement
-A nurse is caring for a client who has oligohydraminios. What fetal
anomalies should the nurse expect?
a. renal agenesis
b. atrial septal defect
c. spina bifida
d. hydrocephalus - -a. renal agenesis
-A nurse is assessing a client who is at 37 wks gestation and has a
suspected pelvic fracture due to blunt abd trauma. What findings should the
nurse expect?
a. uterine contractions
b. bradycardia
c. seizures
d. bradypnea - -a. uterine contractions
The nurse should expect the client to be experiencing uterine contractions
due to abdominal trauma.
, -A nurse is assessing a client who is at 12 wks gestation and has
hydatidiform mole. What findings should the nurse expect?
a. hypothermia
b. dark brown vaginal discharge
c. fetal heart tones
d. decreased urinary output - -b. dark brown vaginal discharge
A hydatidiform mole, or a molar pregnancy, is a benign proliferative growth
of the chorionic villi, which gives rise to multiple cysts. The products of
conception transform into a large number of edematous, fluid-filled vesicles.
As cells slough off the uterine wall, vaginal discharge is usually dark brown
and can contain grapelike clusters.
-A nurse is assessing a client who is at 35 weeks of gestation and has mild
gestational HTN. What finding should the nurse identify as the priority?
a. 480 mL urine output in 24 hrs
b. 1+ protein in the urine
c. +2 edema of the feet
d. BP 144/92 - -a. 480 mL urine output in 24 hrs
When using the urgent vs. nonurgent approach to client care, the nurse
should determine that the priority finding is 480 mL of urine output in 24 hr
because the minimum acceptable urine output in an adult client is 30 mL/hr.
This can indicate progression of preeclampsia to preeclampsia with severe
features, which requires immediate intervention. Therefore, this is the
priority finding.
-A nurse is teaching a client who is at 12 wks gestation and has HIV. What
statement should the nurse include in the teaching?
a. you will be in isolation after delivery
b. abstain from sexual intercourse throughout pregnancy
c. breastfeed your newborn to provide passive immunity
d. you should continue to take zidovudine throughout the pregnancy - -d.
you should continue to take zidovudine throughout the pregnancy
-can be transmitted through breastfeeding
-she can continue to have sex
The nurse should inform the client that taking prescription antiviral
medication every day decreases the risk of transmission of HIV to her
newborn.
-A nurse is providing teaching to a client who is at 8 wks gestation about
manifestations to report to the provider during pregnancy. What info should
the nurse include in the teaching?
,a. nausea upon awakening
b. blurred or double vision
c. increase in white vaginal discharge
d. leg cramps when sleeping - -b. blurred or double vision
-A nurse is caring for a client who is in the latent phase of labor and is
receiving oxytocin via continuous IV infusion. The nurse notes that the client
is having contractions every 2 min which last 100-110 seconds that the fetal
heart rate is reassuring. What action should the nurse take?
a. decrease the dose of oxytocin by half
b. administer oxygen via nonrebreather mask
c. decrease the infusion rate of the maintenance IV fluid
d. administer terbutaline 0.25mg subq - -a. decrease the dose of oxytocin by
half
The nurse should decrease the dose of oxytocin by half because the client is
experiencing uterine tachysystole.
-A nurse is caring for a client who is in active labor and has meconium
staining of the amniotic fluid. The nurse notes a reassuring FHR tracing from
the external fetal monitor. What action should the nurse take?
a. prepare the client for emergency c-section
b. perform endotrach suctioning as soon as the fetal head is delivered
c. prepare equipment needed for newborn resuscitation
d. prepare the client for an ultrasound exam - -c. prepare equipment needed
for newborn resuscitation
The nurse should ensure that all supplies and equipment needed for
resuscitation of the newborn are readily available for every delivery.
Endotracheal suctioning is recommended in cases of meconium staining only
if the newborn has poor respiratory effort, decreased muscle tone, and
bradycardia after delivery.
-A nurse is reviewing the medical record of a client who is at 33 wks
gestation and has placenta previa and bleeding. What scripts should the
nurse clarify with the provider?
a. insert a large-bore IV catheter
b. perform a vaginal exam
c. perform continuous external fetal monitoring
d. obtain a blood sample for lab testing - -b. perform a vaginal exam
When a client has a placenta previa, the placenta implants in the lower part
of the uterus and obstructs the cervical os (the opening to the vagina). The
nurse should clarify this prescription because any manipulation can cause
tearing of the placenta and increased bleeding.
, -A nurse is caring for a client who is at 37 wks gestation and is undergoing a
nonstress test. The FHR is 130 without accelerations for the past 10 min.
What action should the nurse take?
a. request a script for an internal fetal scalp electrode
b. auscultate the FHR with a doppler transducer
c. report the nonreactive test result to the provider immediately
d. use vibroacoustic stim on the client's abd for 3 seconds - -d. use
vibroacoustic stim on the client's abd for 3 seconds
The nurse should use a vibroacoustic stimulator on the client's abdomen to
elicit fetal activity because the fetus is most likely sleeping. Fetal movement
should cause accelerations in the FHR.
-A nurse is reviewing lab results for a client who is at 37 wks gestation. The
nurse notes that the client is rubella non-immune, positive for group A beta-
hemolytic strep, and has a blood type O neg. What action should the nurse
take?
a. instruct the client to obtain a rubella immunization after delivery
b. request a script for an antibiotic until delivery
c. inform the client that she will have to deliver via c-section
d. administer a dose of Pho(D) immune globulin - -a. instruct the client to
obtain a rubella immunization after delivery
-A nurse is reviewing the med record of a client who is at 39 wks gestation
and has polyhydramnios. What finding should the nurse expect?
a. total pregnancy wt gain of 3.6 kg
b. fetal GI anomaly
c. gestational HTN
d. fundal height of 34 cm - -b. fetal GI anomaly
Polyhydramnios is the presence of excessive amniotic fluid surrounding the
unborn fetus. Gastrointestinal malformations and neurologic disorders are
expected findings for a fetus experiencing the effects of polyhydramnios.
-A nurse is teaching a client who has pre-eclampsia and is to receive
magnesium sulfate via continuous IV infusion about expected adverse
effects. What adverse effects should the nurse include in the teaching?
a. elevated BP
b. feeling of warmth
c. generalized pruritis
d. hyperactivity - -b. feeling of warmth
The nurse should tell the client to expect the feeling of warmth all over her
body while the magnesium sulfate is infusing.
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