ATI CAPSTONE MATERNAL NEWBORN ASSESSMENT
2022-203|AGRADE
1. A nurse is performing a vaginal exam on a client who is in active labor. The nurse notes
the umbilical cord protruding through the cervix. Which of the following actions should
the nurse take?
Administer oxytocin to the client via intravenous infusion.
Apply oxygen at 2 L/min via nasal cannula.
Prepare for insertion of an intrauterine pressure catheter.
Assist the client into the knee-chest position.
2. A nurse is assessing a newborn who is 48 hr old and is experiencing opioid withdrawals.
Which of the following findings should the nurse expect?
Hypotonicity
Moderate tremors of the extremities
Axillary temperature 36.1° C (96.9° F)
Excessive sleeping
3. A nurse is reviewing a client's medical record and notes that the client is taking
tamoxifen. The nurse should identify that tamoxifen is used to treat which of the
following conditions?
Non-Hodgkin's lymphoma
Endometriosis
Breast cancer
Polycystic ovary syndrome
4. A nurse is caring for a client who is receiving oxytocin to augment labor. The client has
an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring.
Which of the following is an indication that the nurse should discontinue the infusion?
Contraction frequency every 3 min
Contraction duration of 100 seconds
Fetal heart rate with moderate variability
, Fetal heart rate of 118/min
5. A nurse providing dietary teaching for a client who is at 29 weeks of gestation and has
phenylketonuria. Which of the following suggested foods should the nurse include in the
teaching?
A peanut butter sandwich on wheat bread
A sliced apple and red grapes
A chocolate chip cookie with a glass of skim milk
A scrambled egg with cheddar cheese
6. A nurse is reviewing a laboratory report for a client who is at 33 weeks of gestation and
has preeclampsia. Which of the following laboratory results should the nurse report to the
provider?
BUN 35 mg/dL
Hgb 15 mg/dL
Bilirubin 0.6 mg/dL
Hct 37%
7. A nurse is providing teaching about newborn safety to a client who is being admitted for
induction of labor. Which of the following client statements indicate an understanding of
the teaching?
"I will check the identication badge of anyone who removes my baby from our room."
"I should include a photo of my baby along with any public birth announcements to social
media."
"I will allow my baby to sleep on the bed in my room when I am in the shower."
"I should expect the nurses to carry my baby in their arms to the nursery."
8. A nurse is assessing a client who is at 31 weeks of gestation. Which of the following
findings should the nurse identify as an indication of a potential prenatal complication?
Periodic tingling of fingers
Absence of clonus
Leg cramps
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