ATI RN MATERNAL NEWBORN PROCTORED EXAM Test Bank 36 Versions With 100% Correct Solutions

ATI RN MATERNAL NEWBORN PROCTORED EXAM Test Bank 36 Versions With 100% Correct Solutions 1. A nurse is caring for a client undergoing an oxytocin-stimulated contraction test. The nurse notes three contractions in 10 min with late decelerations occurring with two of the contractions. Which of the following findings should the nurse report to the provider a. Reactive b. Nonreactive c. Positive- Indicates an adverse reaction by the fetus and should be reported to the provider d. Negative 2. A nurse is providing family planning education to a client who has decided to use a diaphragm. Which of the following should the nurse include in the plan of care? a. You should replace the diaphragm every 3 years b. You should leave the diaphragm in place for at least 6 hours after intercourse c. You should use an oil based product as a lubricant when inserting the diaphragm d. You should insert he diaphragm when your bladder is full 3. A nurse is providing discharge teaching to a client who is postpartum about resuming sexual activity. Which of the following instructions should the nurse include in the teaching? a. You should use a water soluble gel for lubrication- This will prevent discomfort b. You can resume sexual activity in 10 days c. Your physical reaction to sexual stimulation ill not be altered d. You will not ovulate for 3 months after delivery 4. 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- Cocaines increases the risk for vasoconstriction and possible abruption placenta b. Placenta previa c. Preeclampsia d. Maternal bradycardia 5. A nurse is providing dietary teaching with a client who has hyperemesis gravidarum. Which of the following statements by the client indicates an understanding of the teaching? a. I should eat to taste instead of trying to balance my meals- Eat to taste to avoid nausea b. I will avoid having a snack at bedtime c. I will have 8 oz of hot tea with each meal d. I should pair my sweets with a starch instead of eating them alone 6. A nurse is caring for a client who is in active labor and reports back pain. The nurse performs a vaginal exam and determines the client is 8cm dilated, 100% effaced, and -2 station. The fetus is in the occiput posterior position. Which of the following is an appropriate intervention? a. Perform effleurage during contractions b. Place the client in lithotomy position c. Assist the client to the hands and knees position- Helps relieve back pain and help the fetus rotate d. Apply a fetal scalp electrode 7. A nurse is assessing a client during a weekly prenatal visit that is at 38 weeks of gestation. Which of the following client findings should the nurse report to the provider? a. Blood pressure 136/88 b. Report of insomnia c. Weight gain of 2.2 kg- Above the expected reference range and could indicate complications d. Report of Braxton-Hicks contractions 8. A nurse is caring for a client who is pregnant and has epilepsy. The nurse observes the client having a seizure. After turning the client’s head to one side, which of the following actions should the nurse take next? a. Monitor the fetal heart rate b. Assess uterine activity c. Administer oxygen via a non-breather mask d. Start a bolus of IV fluids 9. A nurse is providing discharge instructions to a client who had a vaginal delivery and is breastfeeding her newborn. Which of the following statements indicates an understanding of the teaching? a. I will need to eat an additional 330 calories a day while I’m breastfeedingb. I will change my perineal pad at least twice a day c. I will massage my uterus daily for 7 days d. I will breastfeed my baby every 2 hours 10. 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. Assessment of dilation and effacement b. Leopold maneuvers- helps the nurse assess the position of the fetus to best determine the optimal placement for the fetal monitoring transducer. c. Sterile speculum exam d. Nitrazine test 11. A client who is pregnant presents to a prenatal clinic for her first visit. She tells the nurse that her last normal menstrual period began Oct 13. Using Nagele’s rule, the nurse should determine the client’s estimated date of delivery as which of the following? a. July 6 b. July 13 c. July 20- Add a year, subtract 3 months, add 7 days d. July 27 12. A nurse is caring for a client undergoing an oxytocin-stimulated contraction test. The nurse notes three contractions in 10 min with late decelerations occurring with two of the contractions. Which of the following findings should the nurse report to the provider a. Reactive b. Nonreactive c. Positive- Indicates an adverse reaction by the fetus and should be reported to the provider d. Negative 13. A nurse is providing family planning education to a client who has decided to use a diaphragm. Which of the following should the nurse include in the plan of care? a. You should replace the diaphragm every 3 years b. You should leave the diaphragm in place for at least 6 hours after intercourse c. You should use an oil based product as a lubricant when inserting the diaphragm d. You should insert he diaphragm when your bladder is full 14. A nurse is providing discharge teaching to a client who is postpartum about resuming sexual activity. Which of the following instructions should the nurse include in the teaching? a. You should use a water soluble gel for lubrication- This will prevent discomfort b. You can resume sexual activity in 10 days c. Your physical reaction to sexual stimulation ill not be altered d. You will not ovulate for 3 months after delivery 15. 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- Cocaines increases the risk for vasoconstriction and possible abruption placenta b. Placenta previa c. Preeclampsia d. Maternal bradycardia 16. A nurse is providing dietary teaching with a client who has hyperemesis gravidarum. Which of the following statements by the client indicates an understanding of the teaching? a. I should eat to taste instead of trying to balance my meals- Eat to taste to avoid nausea b. I will avoid having a snack at bedtime c. I will have 8 oz of hot tea with each meal d. I should pair my sweets with a starch instead of eating them alone 17. A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn? a. Warm the heel prior to the puncture b. Request a prescription for IM analgesic c. Use a manual lance blade to pierce the skin d. Swaddle the newborn after the heel puncture- Effective technique to diminish the pain experience for the newborn. 18. A nurse is conducting an initial prenatal visit for a client who is at 6 weeks gestation. Which of the following laboratory tests should be performed? a. 24 hour urine for protein b. Group B streptococcus culture c. 3-hr glucose tolerance d. Rubella titer- Obtained at the initial prenatal visit to determine immunity to rubella 19. A nurse is caring for a newborn who was transferred to the nursery 30 min after delivery. Which of the following actions should the nurse take first? a. Confirm the newborn’s Apgar score b. Verify the newborn’s identification- Mandatory to continue ongoing identification of the newborn whenever the newborn is removed from the mother’s direct presence and care. c. Administer vitamin K IM to the newborn d. Determine the obstetrical risk factors 20. A nurse is assessing a young adult client in a women’s health clinic who asks for a contraceptive. The client reports to the nurse a familial history of osteoporosis. Which of the following contraceptive methods is contraindicated for this client? a. Combined estrogen-progestin oral contraceptives b. An intrauterine device 21. A nurse is teaching a client about Rho(D) immunoglobulin (RhoGAM). Which of the following statements by the client indicated an understanding of the teaching? a. I will receive this medication if my baby is Rh-negative b. I will receive this medication at time of delivery c. I will need a second dose of this medication when my baby is 6 weeks old d. I will need this medication if I have an amniocentesis- Recommended because of the potential of fetal RBCs entering the maternal circulation 22. A nurse is caring for a client who is to receive oxytocin (Pitocin) to augment her labor. Which of the following contraindicates the initiation of the oxytocin infusion and requires notification of the provider? a. Late decelerations- Oxytocin is contraindicated based on late decelerations noted on fetal assessment findings because they indicate uteroplacental insufficiency. b. Baseline variability c. Cessation of uterine dilation d. Prolonged active phase of labor 23. A nurse on the newborn unit is planning discharge for four clients. Which of the following will require care beyond that of a standard follow-up visit with the provider after delivery? a. A newborn being sent home after 22 hr after birth- Screening tests must be repeated if they were performed before he newborn was 24 hr. old. b. A newborn at 38 weeks of gestational age c. A newborn who is bottle feeding d. Twin newborns with Apgar scores of 8 and 9 24. A nurse is assessing a newborn who has a weak cry and is grimacing. The nurse notes the newborn has a heart rate of 102/min, blueish extremities, and a flaccid muscle tone. Which of the following reflects the appropriate APGAR score? a. 4 b. 5 c. 6 d. 7 25. A nurse is caring for a client who has a history of rheumatic disease, but no physical symptoms prior to pregnancy. The client begins to experience dyspnea, orthopnea, and pulmonary edema. Which of the following biological alterations explains this change? a. Increased maternal weight b. Increased blood volume- Increase in blood volume during pregnancy increase the workload of the heart, which causes the symptoms c. Change in hematocrit levels d. Change in heart size 26. A nurse is providing teaching about nonpharmacological pain management for a postpartum client who is breastfeed and has engorgement. Which of the following methods should the nurse recommend? a. Cold cabbage leaves- Application of this is an effective nonpharmacological method to relieve pain associated with engorgement b. Modified lanolin cream c. A breast binder d. Breast shells 27. A nurse is providing discharge teaching to a client who is postpartum about resuming sexual activity. Which of the following instructions should the nurse include in the teaching? a. You should use a water soluble gel for lubrication- This will prevent discomfort b. You can resume sexual activity in 10 days c. Your physical reaction to sexual stimulation ill not be altered d. You will not ovulate for 3 months after delivery 28. 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- Cocaines increases the risk for vasoconstriction and possible abruption placenta b. Placenta previa c. Preeclampsia d. Maternal bradycardia 29. A nurse is providing dietary teaching with a client who has hyperemesis gravidarum. Which of the following statements by the client indicates an understanding of the teaching? a. I should eat to taste instead of trying to balance my meals- Eat to taste to avoid nausea b. I will avoid having a snack at bedtime c. I will have 8 oz of hot tea with each meal d. I should pair my sweets with a starch instead of eating them alone 30. A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn? a. Warm the heel prior to the puncture b. Request a prescription for IM analgesic c. Use a manual lance blade to pierce the skin d. Swaddle the newborn after the heel puncture- Effective technique to diminish the pain experience for the newborn. 31. A nurse is conducting an initial prenatal visit for a client who is at 6 weeks gestation. Which of the following laboratory tests should be performed? a. 24 hour urine for protein b. Group B streptococcus culture c. 3-hr glucose tolerance d. Rubella titer- Obtained at the initial prenatal visit to determine immunity to rubella 32. A nurse is caring for a newborn who was transferred to the nursery 30 min after delivery. Which of the following actions should the nurse take first? a. Confirm the newborn’s Apgar score b. Verify the newborn’s identification- Mandatory to continue ongoing identification of the newborn whenever the newborn is removed from the mother’s direct presence and care. c. Administer vitamin K IM to the newborn d. Determine the obstetrical risk factors 33. A nurse is assessing a young adult client in a women’s health clinic who asks for a contraceptive. The client reports to the nurse a familial history of osteoporosis. Which of the following contraceptive methods is contraindicated for this client? a. Combined estrogen-progestin oral contraceptives b. An intrauterine device c. Medroxyprogestrone acetate (Depo-provera)- causes a decrease in bone mineral density and places the client at risk for the development of osteoporosis d. Norelgestromin/ethinyl estradiol (Ortho Evra) 34. A nurse is admitting a client to the labor and delivery unit when the client states, “my water just broke”, which of the following is the priority intervention for the nurse to take? a. Perform Nitrazine testing b. Assess the amniotic fluid c. Check cervical dilation d. Monitor the fetal heart rate- Rupture of the membranes places the fetus at risk for umbilical cord prolapse. 35. A nurse in a clinic is caring for a client who is at 32 weeks of gestation. Which of the following clinical findings should alert the nurse to a potential complication? a. Fundal height is 34 cm b. Client reports diarrhea for 3 days- Indicates illness or infection c. Client reports ankle edema d. Blood pressure is 130/80 36. A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The fetal monitor shows uterine contractions every 6 min, lasting 20-25 seconds, and an FHR of 150/min. The provider prescribed betamethasone (celestone) 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- Given to stimulate fetal lung maturity and prevent respiratory distress d. Increased production of antibodies in the Newborn 37. A nurse is caring for a client newly admitted to the PACU following a cesarean birth. Which of the following is the priority nursing assessment? a. Parent-child attachment b. Amount of postpartum lochia- The greatest risk to the client is bleding. The amount of lochia can assist the nurse in determining if excessive bleeding is occurring. Assess the client for postpartum hemorrage. c. Patency of the IV cathether d. Quality and quantity of urine output 38. A nurse is caring for a client whose labor is not progressing due to should sytocia of the infant. Which of the following actions should the nurse take? a. Apply fundal pressure b. Apply suprapubic pressure- can be used to attempt to push the shoulder to go under the symphysis pubis and thus pass through the birth canals c. Place the client in the trendelenburg position d. Place the client in the fowlers position 39. A nurse is preparing to initiate IV oxytocin for a client who is admitted for induction of labor. Oxytocin 30 units is available in 500 ml. At what rate should the nurse set the infusion pump to deliver 2mu/min? a. 30units/500ml = 0.06units/ml b. 0.06units=60mU c. 60mU/1=2mU/xmL d. x=0.03mL/min 0.03x60=1.8mL/hr 40. A nurse is planning care for a client who is to undergo a nonstress test. Which of the following should the nurse include in the plan of care? a. Maintain the client NPO throughout the procedure b. Place the client in a supine position c. Instruct the client to massage the abdomen to stimulate fetal movement d. Instruct the client to press the provided button each time fetal movement is detectedFetal movement may not be evident on the fetal monitor and tracing. 41. A nurse is caring for a client who has been hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following assessment findings by the nurse should be reported to the provider? a. BUN 25 – Elevated BUN can indicate dehydration and should be reported to the provider b. Serum creatinine 0.8 c. Urine output 280 mL in 8 hr d. Weight gain of 0.9kg in 24 hr 42. A nurse is assessing a fetal heart monitor tracing of a client receiving oxytocin at 10 milliunits/min. Uterine contractions are noted every 60 to 90 seconds. After turning the client to a side-lying position, which of the following actions should the nurse take next? a. Discontinue the medication infusion- Prolonged contractions reduce the blood flow to the placenta and result in FHR decelerations; oxytocin should be discontinued. b. Prepare to administer terbutaline subcutaneously c. Administer oxygen at 8 to 10 L/min by face mask d. Increase the maintenance IV fluid rate. 43. A nurse is teaching a prenatal class about infant safety. Which of the following statements made by a parent indicated a need for further teaching? a. I will set my hot water heater no higher than 130F- To avoid burns to the infant, the hot water should be set no higher than 49F b. I will make sure the crib slats are no more than 2 3/8 inches apart c. I will refrain from using a comforter in the crib d. I will place the infant carrier on the floor when my baby is inside it 44. A nurse is assessing a newborn. Which of the following images indicate an appropriate technique to assess a newborn? a. A nurse should measure the newborn’s head circumference by positioning the tape measure above the newborn’s eyebrows and ears to obtain an accurate head circumference. 45. A nurse is caring for a client who is using jet hydrotherapy during labor. The nurse is aware that which of the following methods of monitoring the fetal heart rate is contraindicated? a. A Doppler device b. A fetoscope c. A wireless external monitor device d. An internal electrode 46. A nurse is assessing a newborn. Which of the following findings are expected? a. Slight yellow skin b. Breast nodule is 6 mm- up to 10 mm can occur c. Posterior fontanel larger than the anterior fontanel- anterior should be larger d. Overlapping suture lines e. Lanugo over the shoulders 47. A nurse is caring for a client who has had a perinatal death. Which of the following statements is an appropriate response by the nurse? a. This happens for a reason b. This must be hard for you-reflects on the feelings of the mother c. I understand how you feel d. You’re young and will be able to have other children 48. A nurse is assessing a newborn who is 24 hr old. Which of the following is an appropriate action for the nurse to take? a. Initiate oxygen via nasal canula b. Administer IV bolus of .9 NS c. Obtain a blood glucose level d. Place the newborn in a warmer 49. A nurse is providing discharge instructions to client whose infant was circumcised using the clamp the technique. Which of the following responses by the client indicates an understanding of the teaching? a. I will apply the diaper loosely if bleeding occurs b. I will put petroleum jelly around the glans during each diaper change c. I will wipe off any yellow exudate that forms on the glans d. I will remove the plastic ring after 7 days 50. A client in the transitional phase of labor is using breathing techniques to manage her pain. Which of the following actions by the client should indicate to the nurse that the clients plan of care should be altered? a. The client can talk but not walk through contractions b. The client increases her rate of breathing to relax c. The client requests to move fro the chair to the bed d. The client reports tingling sensations in her fingers- Indicates the client is hyperventilating. This causes respiratory alkalosis. Can be reversed by having the client breathe into her cupped hands or placing a paper bag tightly around her mouth and nose to breath carbon dioxide. 51. A nurse on an antepartum unit is reviewing the assessment findings of four clients who are in the third trimester of pregnancy. Which of the following assessment findings is the highest priority? a. A client who has gestational diabetes and a fasting blood glucose of 120 b. A client who is reporting epigastric pain- Indicator of hepatic involvement and is a clinical manifestation of severe preeclampsia. This should be reported immediately. Lifethreatening for the mother and the fetus if left untreated. c. A client who has a HgB of 10 d. A client who reports urinary frequency and burning upon urination 52. A nurse is providing education for a client who is in her third trimester and is scheduled for a biophysical profile. The nurse should tell the client that which of the following variables is included in the test? a. Gestational age b. L/S ratio c. Amniotic fluid index d. Doppler flow analysis 53. A nurse is performing a newborn assessment 12 hr after delivery. Which of the following findings indicate possible neonatal sepsis? a. Temperature instability b. Tachypnea c. Hypertonicity d. Nasal flaring e. Irritability 54. A nurse is caring for a client in labor who is reporting excessive pain. Which of the following interventions requires the nurse to hold an additional certification or licensure? a. Acupuncture- A pain control technique that involves the insertion of fine needles into specific body areas, should be performed by a trained certified therapists. b. Aromatherapy c. Effleurage d. Counterpressure 55. A nurse is caring for a client who is at 32-weeks of gestation and has gonorrhea. This infection places the client at increased risk for which of the following during pregnancy? a. Excessive bleeding b. Oligohydraminos c. Premature rupture of membranes d. Proteinuria 56. A nurse is observing a mother caring for her newborn who is crying. Which of the following actions by the mother should the nurse recognize as a positive parenting behavior? a. Lays the newborn across her lap and gently sways b. Places the newborn in the crib in a prone position c. Offers the newborn a pacifier dipped in milk d. Prepares a bottle of milk mixed with rice cereal 57. A nurse is caring for a client who is postpartum and has a history of preeclampsia. Upon assessment, the nurse observes petechiae and serosanguineous fluid oozing from the IV insertion site. Which of the following findings should be reported to the provider? a. HCT 39% b. Serum albumin 4.5 c. WBC count of 9,000 d. Platelet count of 50,000- Below the reference range and indicates disseminated intravascular coagulation and should be reported to the provider. 58. A nurse is providing education about family bonding to parents who recently adopted a newborn. The nurse should make which of the following suggestions to enable the family’s 7year-old to accept the new family member? a. Allow the sibling to hold the newborn during the bath b. Make sure the sibling kisses the newborn each night c. Encourage the sibling to sing to help soothe the newborn- Interaction with the baby helps make a connection d. Switch the sibling’s room with the nursery. 59. A nurse is caring for a client who is at 38 weeks of gestation and is in labor. The nurse notes late decelerations on the fetal monitor. a. Reposition the client on her side b. Elevate the client’s legs c. Increase the maintenance IV solution d. Palpate the uterus to assess for tachysystole and then administer oxygen via face mask at 8L/min 60. A nurse is teaching a client who is in preterm labor about terbutaline (brethine). Which of the following statements by the client indicates an understanding of the teaching? a. I will get injections of the medication once a day until my labor stops b. My blood sugar may be low while I’m on this medication c. I will have blood tests because my potassium might decrease- adverse effect results into hypokalemia