MATERNAL NEWBORN ATI PROCTORED
EXAM FULL ANSWERS QUESTIONS
AND COMPLETE SOLUTIONS A+
GRADE 2024
A nurse is caring for a client who is at 32 wks gestation and is experiencing preterm
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labor. What meds should the nurse plan to administer? - ANS-betamethasone
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A nurse at a prenatal clinic is caring for a client who suspects she may be pregnant
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and asks the nurse how the provider will confirm her pregnancy. The nurse should
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inform the client that what lab test will be used to confirm her pregnancy? - ANS-
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urine test for presence of HCG
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A nurse is caring for a client who believes she may be pregnant. What finding should
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the nurse identify as a positive sign of pregnancy?
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a. palpable fetal movement - ANS-palpable fetal movement
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A nurse is caring for a client who has oligohydraminios. What fetal anomalies should
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the nurse expect? - ANS-renal agenesis
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A nurse is assessing a client who is at 37 wks gestation and has a suspected pelvic
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fracture due to blunt abd trauma. What findings should the nurse expect? - ANS-
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uterine contractions ,m
The nurse should expect the client to be experiencing uterine contractions due to
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abdominal trauma.
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A nurse is assessing a client who is at 12 wks gestation and has hydatidiform mole.
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What findings should the nurse expect? - ANS-dark brown vaginal discharge
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A hydatidiform mole, or a molar pregnancy, is a benign proliferative growth of the
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chorionic villi, which gives rise to multiple cysts. The products of conception transform
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into a large number of edematous, fluid-filled vesicles. As cells slough off the uterine
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wall, vaginal discharge is usually dark brown and can contain grapelike clusters.
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A nurse is assessing a client who is at 35 weeks of gestation and has mild gestational
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HTN. What finding should the nurse identify as the priority? - ANS-480 mL urine
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output in 24 hrs
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,When using the urgent vs. nonurgent approach to client care, the nurse should
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determine that the priority finding is 480 mL of urine output in 24 hr because the
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minimum acceptable urine output in an adult client is 30 mL/hr. This can indicate
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progression of preeclampsia to preeclampsia with severe features, which requires
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immediate intervention. Therefore, this is the priority finding.
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A nurse is teaching a client who is at 12 wks gestation and has HIV. What statement
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should the nurse include in the teaching? - ANS-you should continue to take
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zidovudine throughout the pregnancy
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-can be transmitted through breastfeeding
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-she can continue to have sex
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The nurse should inform the client that taking prescription antiviral medication every
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day decreases the risk of transmission of HIV to her newborn.
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A nurse is providing teaching to a client who is at 8 wks gestation about
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manifestations to report to the provider during pregnancy. What info should the nurse
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include in the teaching? - ANS-blurred or double vision
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A nurse is caring for a client who is in the latent phase of labor and is receiving
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oxytocin via continuous IV infusion. The nurse notes that the client is having
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contractions every 2 min which last 100-110 seconds that the fetal heart rate is
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reassuring. What action should the nurse take? - ANS-decrease the dose of oxytocin
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by half
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The nurse should decrease the dose of oxytocin by half because the client is
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experiencing uterine tachysystole.
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A nurse is caring for a client who is in active labor and has meconium staining of the
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amniotic fluid. The nurse notes a reassuring FHR tracing from the external fetal
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monitor. What action should the nurse take? - ANS-prepare equipment needed for
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newborn resuscitation
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The nurse should ensure that all supplies and equipment needed for resuscitation of
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the newborn are readily available for every delivery. Endotracheal suctioning is
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recommended in cases of meconium staining only if the newborn has poor
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respiratory effort, decreased muscle tone, and bradycardia after delivery.
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A nurse is reviewing the medical record of a client who is at 33 wks gestation and has
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placenta previa and bleeding. What scripts should the nurse clarify with the provider?
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- ANS-perform a vaginal exam
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When a client has a placenta previa, the placenta implants in the lower part of the
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uterus and obstructs the cervical os (the opening to the vagina). The nurse should
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,,m clarify this prescription because any manipulation can cause tearing of the placenta
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,m and increased bleeding.
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A nurse is caring for a client who is at 37 wks gestation and is undergoing a
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nonstress test. The FHR is 130 without accelerations for the past 10 min. What
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action should the nurse take? - ANS-use vibroacoustic stim on the client's abd for 3
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seconds
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The nurse should use a vibroacoustic stimulator on the client's abdomen to elicit fetal
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activity because the fetus is most likely sleeping. Fetal movement should cause
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accelerations in the FHR.
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A nurse is reviewing lab results for a client who is at 37 wks gestation. The nurse
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notes that the client is rubella non-immune, positive for group A beta-hemolytic strep,
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and has a blood type O neg. What action should the nurse take? - ANS-instruct the
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client to obtain a rubella immunization after delivery
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A nurse is reviewing the med record of a client who is at 39 wks gestation and has
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polyhydramnios. What finding should the nurse expect? - ANS-fetal GI anomaly
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Polyhydramnios is the presence of excessive amniotic fluid surrounding the unborn
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fetus. Gastrointestinal malformations and neurologic disorders are expected findings
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for a fetus experiencing the effects of polyhydramnios.
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A nurse is caring for a client who is in the latent phase of labor and is experiencing
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low back pain. What action should the nurse take? - ANS-apply pressure to the
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client's sacral area during contractions
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A nurse is teaching a client who has pre-eclampsia and is to receive magnesium
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sulfate via continuous IV infusion about expected adverse effects. What adverse
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effects should the nurse include in the teaching? - ANS-feeling of warmth
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The nurse should tell the client to expect the feeling of warmth all over her body while
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the magnesium sulfate is infusing.
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A nurse is teaching a client who is at 12 wks gestation about manifestations of
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potential complications that she should report to her provider. What info should the
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nurse include in the teaching? - ANS-swelling of the face
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A nurse is teaching a client who is at 10 wks gestation about an abd. ultrasound in
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the first trimester. What info should the nurse include in the teaching? - ANS-you will
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need to have a full bladder during the ultrasound
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MY ANSWER ,m
, The nurse should tell the client that a full bladder helps to lift the gravid uterus out of
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the pelvis during the examination. Therefore, it is important to ensure that the client
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has a full bladder to obtain the most accurate image of the fetus.
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A nurse is assessing a client who is 34 wks gestation and has mild placental
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abruption. What finding should the nurse expect? - ANS-dark red vaginal bleeding
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The nurse should expect the client who has a mild placental abruption to have
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minimal dark red vaginal bleeding.
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A nurse is caring for a client whose last menstrual period began july 8. Using Nageles
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rule, the nurse should identify the client's estimated DOB as what? - ANS-. april 15
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A nurse is caring for a client who is at 39 wks gestation and is in the active phase of
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labor. The nurse observes late decels in the FHR. What finding should the nurse
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identify as the cause of late decels? - ANS-uteroplacental insufficiency
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A nurse is assessing a client who is at 35 wks gestation and is receiving magnesium
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sulfate via continuous IV infusion for severe pre-eclampsia. What finding should the
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nurse report to the provider? - ANS-urinary output 20 mL/hr
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The nurse should report a urinary output of 20 mL/hr because this can indicate
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inadequate renal perfusion, increasing the risk of magnesium sulfate toxicity. A
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decrease in urinary output can also indicate a decrease in renal perfusion secondary
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to a worsening of the client's pre-eclampsia.
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A nurse is teaching a client who is at 13 wks gestation about the treatment of
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incompetent cervix with cervical cerclage. What statement by the client indicates an
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understanding of teaching? - ANS-I should go to the hospital if I think I may be in
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labor
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Cervical cerclage prevents premature opening of the cervix during pregnancy. The
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client should immediately go to a facility for evaluation if she experiences any
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manifestations of labor while the cerclage is in place. If the client experiences
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preterm uterine contractions she might require tocolytic therapy.
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A nurse is admitting a client who is in labor and experiencing moderate bright red
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vaginal bleeding. What action should the nurse take? - ANS-obtain blood samples for
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baseline lab values
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The nurse should obtain samples of the client's blood for baseline testing of
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hemoglobin and hematocrit levels.
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A nurse is caring for a client who is at 38 wks of gestation and reports no fetal
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movement for 24 hr. What action should the nurse take? - ANS-auscultate for a FHR
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