ATI N3610 Quiz 1 Questions With Verified
Answers.
A nurse is admitting a client who is at 38 weeks of gestation and is in the first stage of labor.
Which of the following assessment findings should the nurse report to the provider first?
A. Expulsion of a blood-tinged mucous plug
B. Continuous...
A nurse is admitting a client who is at 38 weeks of gestation and is in the first stage of labor.
Which of the following assessment findings should the nurse report to the provider first?
A. Expulsion of a blood-tinged mucous plug
B. Continuous contraction lasting 2 min
C. Pressure on the perineum causing the client to bear down
D. Expulsion of clear fluid from the vagina - answer✔B. Continuous contraction lasting 2 min
i: A uterus contracting for more than 90 seconds is a sign of tetany and could lead to uterine
rupture, which is the greatest risk to the client at this time. The nurse should report this finding
immediately.
A nurse is providing teaching about nutrition to a client at her first prenatal visit. Which of the
following statements by the nurse should be included in the teaching?
A. "You will need to increase your calcium intake during breastfeeding."
B. "Prenatal vitamins will meet your need for increased vitamin D during pregnancy."
C. "Vitamin E requirements decline during pregnancy due to the increase in body fat."
D. "You will need to double your intake of iron during pregnancy." - answer✔D. "You will need
to double your intake of iron during pregnancy."
i: During pregnancy, the need for iron increases to allow transfer of the appropriate amounts to
the fetus and to support expansion of the client's red blood cell volume.
A nurse is teaching about fetal development to a group of clients in the antenatal clinic. Which of
the following statements should the nurse include in the teaching?
A. "The baby's heart beat is audible by a Doppler stethoscope at 12 weeks of pregnancy."
B. "The sex of the baby is determined by week 8 of pregnancy."
C. "Very fine hairs, called lanugo, cover your baby's entire body by week 36 of pregnancy."
D. "You will first feel your baby move in week 24 of pregnancy." - answer✔A. "The baby's heart
beat is audible by a Doppler stethoscope at 12 weeks of pregnancy."
i: The fetal heartbeat is audible by Doppler stethoscope between 8 to 17 weeks of gestation.
A nurse on the labor and delivery unit is caring for a client following a vaginal examination by
the provider which is documented as: -1. Which of the following interpretations of this finding
should the nurse make?
A. The presenting part is 1cm above the ischial spines.
B. The presenting art is 1cm below the ischial spines.
C. The cervix is 1cm dilated.
D. The cervix is effaced 1cm. - answer✔A. The presenting part is 1cm above the ischial spines.
i: Station is the relation of the presenting part to the ischial spines of the maternal pelvis and is
measured in centimeters above, below, or at the level of the spines. If the station is minus 1, then
the presenting part is 1cm above the ischial spines.
A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled
for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure.
Which of the following is an appropriate response by the nurse?
A. "This will determine is there is more than one fetus."
B. "It is useful for estimating fetal age."
C. "It assists in identifying the location of the placenta and fetus."
D. "This is a screening tool for spina bifida." - answer✔C. "It assists in identifying the location
of the placenta and fetus."
i: Identifying the positions of the fetus, placenta, and amniotic fluid pockets immediately prior to
the amniocentesis increases the safety of this test by assisting with correct placement of the
needle.
A nurse on a labor unit is admitting a client who reports painful contractions. The nurse
determines that the contractions have a durtiong of 1min and a frequency of 3min. The nurse
obtains the following vitals: fetal heart rate 130/min, maternal heart rate 128/min, and maternal
blood pressure 92/54mmHg. Which of the following is the priority action for the nurse to take?
A. Notify the provider of the findings.
B. Position the client with one hip elevated.
C. Ask the client if she needs pain medication.
D. Have the client void. - answer✔B. Position the client with one hip elevated.
i: Based on Maslow's hierarchy of needs, the client's need for an adequate blood pressure to
perfuse herself and her fetus is a physiological need that requires immediate intervention. Supine
hypotension is a frequent cause of low blood pressure in clients who are pregnant. By turning the
client on her side and retaking her blood pressure, the nurse is attempting to correct the low
blood pressure and reassess.
A nurse is caring for a group of clients on an intrapartum unit. Which of the following findings
should be reported to the provider immediately?
A. A tearful client who is at 32 weeks of gestation and is experiencing irregular, frequent
contractions.
B. A client who is at 28 weeks of gestation and receiving terbutaline reports fine tremors.
C. A client who has a diagnosis of preeclampsia has 2+ proteinuria and 2+ patellar reflexes.
D. A client who has a diagnosis of preeclampsia reports epigastric pain and unresolved headache.
- answer✔D. A client who has a diagnosis of preeclampsia reports epigastric pain and unresolved
headache.
i: These findings indicate that the client's condition is worsening and are signs of severe
preeclampsia. They should be reported to the provider immediately. Other manifestations of
severe preeclampsia include: blood pressure of 160/100 mm Hg or greater, proteinuria 3+ to 4+,
oliguria, visual disturbances, such as blurred vision, hyperreflexia with clonus, nausea, vomiting,
epigastric pain, and right upper-quadrant pain.
A nurse is caring for a client who is at 40 weeks gestation and is in active labor. The client has
6cm of cervical dilation and 100% cervical effacement. The nurse obtains the client's blood
pressure reading as 82/52mmHg. Which of the following nursing interventions should the nurse
perform?
A. Prepare for a cesarean birth.
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