ATI Maternal Newborn Proctored Exam 2023 PDF

## Question: 1 of 70 A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a new prescription for misoprostol. The nurse is assessing the client 30 min later. How should the nurse interpret the findings? | Findings 30 min later | Unrelated to diagnosis | Indication of...

## Question: 1 of 70 A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a new prescription for misoprostol. The nurse is assessing the client 30 min later. How should the nurse interpret the findings? | Findings 30 min later | Unrelated to diagnosis | Indication of potential improvement | Indication of potential worsening condition | |---|---|---|---| | Fundus at level of umbilicus | | ☑ | | | Cloudy urine | | | ☑ | | Blood pressure 80/50 mm Hg | | | ☑ | | Moderate lochia rubra | | ☑ | | | Thready pulse | | | ☑ | | Fundus firm to palpation | | ☑ | | ## Question: 5 of 70 A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication? - Hyperglycemia - **Bilateral crackles** - Hypotension - Polyuria ## Question: 6 of 70 A nurse is providing teaching to a client who is at 35 weeks of gestation and has a prescription for an amniocentesis. Which of the following client statements indicates an understanding of the teaching? - **"I should empty my bladder before the procedure."** - "I will be lying on my side during the procedure." - "I will be asleep during the procedure." - "I should start fasting 24 hours before the procedure." ## Question: 7 of 70 A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take? - Monitor blood glucose level every hr. - Place the infant on his back with legs extended. - **Initiate seizure precautions.** - Provide a stimulating environment. ## Question: 8 of 70 A nurse is administering a hepatitis B vaccine to a newborn. Which of the following actions should the nurse take? - **Administer the injection into the vastus lateralis muscle.** - Vigorously massage the site following the injection. - Insert the needle at a 45° angle for injection. - Use a 21-gauge needle for the injection. ## Question: 9 of 70 A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take? - Replace the surgical dressing. - **Evaluate urinary output.** - Apply an ice pack to the incision site. - Administer 500mL lactated Ringer's IV bolus. ## Question: 10 of 70 A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia? - Abdominal distention - Petechiae - Increased muscle tone - **Jitteriness** ## Question: 11 of 70 A nurse is collecting data from a client who is at 30 weeks of gestation. Which of the following findings should the nurse identify as a manifestation of pyelonephritis? - Epigastric discomfort - **Flank pain** - Temperature 37.7° C (99.8° F) - Abdominal cramping ## Question: 12 of 70 A nurse is providing teaching to the parents of a newborn about the Plastibell circumcision technique. Which of the following information should the nurse include? - "The Plastibell will be removed 4 hours after the procedure." - "Make sure the newborn's diaper is snug." - "Yellow exudate will form at the surgical site in 24 hours." - **"Notify the provider if the end of your baby's penis appears dark red."** ## Question: 13 of 70 A nurse is providing discharge teaching to a client following tubal ligation. Which of the following statements by the client indicates an understanding of the teaching? - "Premenstrual tension will no longer be present." - "My monthly menstrual period will be shorter." - "Hormone replacements will be needed following this procedure." - **"Ovulation will remain the same."** ## Question: 14 of 70 A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take? - Administer betamethasone IM. - Avoid performing sterile vaginal examinations. - **Anticipate a prescription for misoprostol.** - Obtain a specimen for a Kleihauer-Betke test. ## Question: 15 of 70 A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Nägele's Rule, which of the following is the client's estimated date of delivery? - May 13 - **May 17** - May 3 - May 20 ## Question: 16 of 70 A nurse is caring for a client who is at 36 weeks of gestation and has methicillin-resistant Staphylococcus aureus. Which of the following types of isolation precautions should the nurse initiate? - Droplet - **Contact** - Protective environment - Airborne ## Question: 17 of 70 A nurse is caring for a client immediately following the delivery of a stillborn fetus. Which of the following actions should the nurse take? - Limit the amount of time the fetus is in the client's room. - **Provide the client with photos of the fetus.** - Instruct the client that an autopsy should be performed within 24 hr. - Inform the client that the law requires them to name the fetus. ## Question: 18 of 70 A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.) - **Labor induction with oxytocin** - Newborn weight 2.948 kg (6 lb 8 oz) - **Vacuum-assisted delivery** - **History of uterine atony** - History of human papillomavirus ## Question: 19 of 70 A nurse is caring for a client who is receiving oxytocin via continuous IV infusion and is experiencing persistent late decelerations in the FHR. After discontinuing the infusion, which of the following actions should the nurse take? - Instruct the client to bear down and push with contractions. - **Administer oxygen at 10 L/min via nonrebreather facemask.** - Place the client in a supine position. - Initiate an amnioinfusion ## Question: 20 of 70 A nurse is assessing a client who is at 6 weeks of gestation and adheres to a vegan diet. Which of the following questions should the nurse ask to assess the client's dietary intake? - **"How much protein do you eat in a day?"** - "Are you taking a Vitamin C supplement?" - "Have you considered eating shellfish?" - "When was the last time you ate meat?" ## Question: 21 of 70 A nurse is caring for a client who is in active labor with a fetus in the occipitoposterior position. The nurse assists the client into a hands-and-knees position. Which of the following questions should the nurse ask to evaluate the effectiveness of this intervention? - "Does that lessen your suprapubic pain?" - "Are you feeling relief from your pelvic pressure?" - "Do your contractions feel further apart?" - **"Has your back labor improved?"** ## Question: 22 of 70 A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum. Which of the following actions should the nurse take? - Apply a moist, warm compress to the perineum. - **Provide the client with a cool sitz bath.** - Administer methylergonovine 0.2 mg IM. - Apply povidone-iodine to the client's perineum after she voids. ## Question: 23 of 70 A nurse is discussing fertility treatment options with a client and their partner. Which of the following nonpharmacological treatments should the nurse suggest? - Use a lubricant during intercourse. - Drink herbal tea two times daily. - **Maintain a healthy weight.** - Take daily hot baths. ## Question: 24 of 70 A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider? - Hematocrit 37% (37% to 47%) - Creatinine 0.9 mg/dL (0.5 to 1 mg/dL) - WBC count 11,000/mm³ (5,000 to 10,000/mm³) - **Fasting blood glucose 180 mg/dL (74 to 106 mg/dL)** ## Question: 25 of 70 A nurse is teaching about home safety with a client who is 2 days postpartum. Which of the following instructions should the nurse include in the teaching? - "Bathe your baby immediately after a feeding." - "Place a bumper pad in your baby's crib." - "Put a soft mattress in your baby's crib." - **"Wash your baby's face with plain water."** ## Question: 26 of 70 A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of this birth method? - Polycythemia - Hypoglycemia - Bronchopulmonary dysplasia - **Facial palsy** ## Question: 28 of 70 A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include? - **Breast tenderness** - Tinnitus - Urinary frequency - Chills ## Question: 29 of 70 A nurse is caring for a newborn immediately following birth. For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment? - To allow manifestations of infection to be identified. - The newborn weighs less than 2.5 kg (5.5 lb). - The newborn was delivered via cesarean birth. - **To facilitate bonding between the newborn and parent.** ## Question: 30 of 70 A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin. Which of the following actions should the nurse take to best evaluate the client's medication adherence? - Ask the client if they are taking the medication as prescribed. - Assess the client's kidney function. - Determine the client's apical pulse rate. - **Check the client's serum medication level.** ## Question: 31 of 70 A nurse in a provider's office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make? - "You cannot have an amniocentesis until you are at least 35 years of age." - **"This procedure determines if your baby has genetic or congenital disorders."** - "Your provider will schedule a chorionic villus sampling to determine the sex of your baby." - "We can schedule the procedure for later today if you'd like." ## Question: 32 of 70 A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching? - "Mothers will receive prophylactic treatment with acyclovir prior to delivery." - **"Transmission can occur via the saliva and urine of the newborn."** - "Lesions are visible on the mother's genitalia." - "This infection requires that airborne precautions be initiated for the newborn." ## Question: 33 of 70 A nurse is providing teaching about increasing dietary fiber to an antepartum client who reports constipation. Which of the following food selections has the highest fiber content per cup? - **Oatmeal** - Cabbage - Asparagus - Lentils ## Question: 34 of 70 A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include? - Feed the newborn 5 to 10 min per breast. - Offer the newborn 30 mL (1 oz) of water between feedings. - Expect two to four wet diapers every 24 hr. - **Allow the baby to feed at least every 3 hr.** ## Question: 35 of 70 A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B12. Which of the following foods should the nurse recommend? - **Fortified soy milk** - Raw carrots - Fresh citrus fruits - Brown rice ## Question: 36 of 70 A nurse is assisting the provider to administer a dinoprostone insert to induce labor for a client. Which of the following actions should the nurse take? - Allow the medication to reach room temperature prior to administration. - Place the client in a semi-Fowler's position for 1 hr after administration. - Instruct the client to avoid urinary elimination until after administration. - **Verify that informed consent is obtained prior to administration.** ## Question: 37 of 70 A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect? - Telangiectatic nevi - **Facial petechiae** - Periauricular papillomas - Erythema toxicum ##Question: 38 of 70 A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider? - **Single palmar creases** (Sign of Down Syndrome) - Rust-stained urine - Transient circumoral cyanosis - Subconjunctival hemorrhage ## Question: 39 of 70 A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions? - Ectopic pregnancy - Hyperemesis gravidarum - Incompetent cervix - **Postpartum hemorrhage** ## Question: 40 of 70 A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect? - Temperature 37.4° C (99.3° F) - WBC count 9,000/mm³ - **Uterine tenderness** - Scant lochia ## Question: 41 of 70 A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver. Which of the following actions should the nurse take? - Apply pressure to the client's fundus. - Press firmly on the client's suprapubic area. - Move the client onto their hands and knees. - **Assist the client in pulling their knees toward their abdomen.** ## Question: 42 of 70 A nurse is assessing a client who is 1 hr postpartum following a vaginal birth. The nurse notes that the client has excessive vaginal bleeding. Which of the following actions should the nurse take first? - **Massage the client's fundus.** - Administer oxytocin to the client. - Empty the client's bladder. - Provide oxygen to the client via nonrebreather face mask. ## Question: 45 of 70 A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next? - Perform a vaginal examination by applying upward pressure on the presenting part. - **Cover the umbilical cord with a sterile saline saturated towel.** - Administer oxygen via nonrebreather mask at 8 L/min. - Initiate an infusion of IV fluids for the client. ## Question: 46 of 70 A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect? - Diminished deep tendon reflexes - **Excessive crying** - Decreased muscle tone - Absent Moro reflex ## Question: 47 of 70 A nurse is obtaining a 2-hr postprandial blood glucose from a client. Which of the following actions should the nurse take? - Puncture the finger while still damp with antiseptic solution. - Smear the blood onto the reagent strip. - Hold the finger above the heart prior to puncture. - **Select the lateral side of the finger for puncture.** ## Question: 48 of 70 A nurse is assessing a newborn who was born postterm. Which of the following findings should the nurse expect? - Large deposits of subcutaneous fat - **Thin covering of fine hair on shoulders and back** - Nails extending over tips of fingers - Pale, translucent skin ## Question: 49 of 70 A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching? - "I can use a sleep sack to keep my baby warm in the car seat." - "My baby will need a car seat challenge test before discharge." - **"The car seat should be positioned in the car at a 45-degree angle."** - "When my baby is 1 year old, I can turn their car seat facing forward." ## Question: 50 of 70 A nurse is caring for a client who is hypotensive following the administration of epidural anesthesia. Which of the following actions should the nurse take? - **Turn the client to a side-lying position.** - Apply oxygen at 2 L/min via nasal canula. - Massage the client's fundus. - Assist the client to empty their bladder. ## Question: 51 of 70 A nurse is planning care for a client who is 1 hr postpartum and has peripartum cardiomyopathy. Which of the following actions should the nurse plan to take? - Obtain a prescription for misoprostol. - Assess blood pressure twice daily. - **Restrict daily oral fluid intake.** - Administer an IV bolus of lactated Ringer's. ## Question: 52 of 70 A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, pacing them in the selected order of performance. Use all the steps.) | Step Number | Instructions | |---|---| | **1** | Position the client supine with knees flexed and place a small, rolled towel under one of their hips. | | **2** | Instruct the client to empty their bladder. | | **3** | Palpate the fetal part positioned in the fundus. | | **4** | Palpate the fetal parts along both sides of the uterus. | | **5** | Palpate the fetal part positioned above the symphysis pubis. | ## Question: 54 of 70 A nurse is caring for a client who is at 37 weeks of gestation and is being tested for group B streptococcus B-hemolytic (GBS). The client is multigravida and multipara with no history of GBS. She asks the nurse why the test was not conducted earlier in her pregnancy. Which of the following is an appropriate response by the nurse? - "You didn't report any symptoms of GBS during your pregnancy." - "Your previous deliveries were all negative for GBS." - "There was no indication of GBS in your earlier prenatal testing." - **"We need to know if you are positive for GBS at the time of delivery."** ## Question: 53 of 70 A nurse is caring for a client who is at 20 weeks of gestation and has trichomoniasis. Which of the following findings should the nurse expect? - **Malodorous discharge** - Thick, white vaginal discharge - Urinary frequency - Vulva lesions ## Question: 55 of 70 A nurse is caring for a client who is 1 day postpartum and breastfeeding her newborn. The client reports sore nipples. Which of the following actions should the nurse take? - Instruct the client to wait 4 hr between daytime feedings. - **Assess the newborn's latch while breastfeeding.** - Have the client limit the length of breastfeeding to 5 min per breast. - Offer supplemental formula between the newborn's feedings. ## Question: 56 of 70 A nurse is assessing a client who is 3 days postpartum. Which of the following findings should the nurse report to the provider? - **Cool, clammy skin** - Moderate lochia serosa - Heart rate 89/min - BP 120/70 mm Hg ## Question: 57 of 70 A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care? - **Administer broad-spectrum antibiotics.** - Monitor the rectal temperature every 4 hr. - Cleanse the site with povidone-iodine. - Prepare for surgical closure after 72 hr. ## Question: 58 of 70 A nurse is caring for a newborn who has jaundice and a new prescription for phototherapy. Which of the following actions should the nurse take? - Provide the newborn with 15 mL glucose water after each feeding. - Turn the newborn every 4 hr. - Apply hydrating lotion to the newborn's skin prior to treatment. - **Close the newborn's eyes before applying eyepatches.** ## Question: 59 of 70 A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include? - **"You should have your provider refit you for a new diaphragm."** - "You should use an oil-based vaginal lubricant when inserting your diaphragm." - "You should keep the diaphragm in place for at least 4 hours after intercourse." - "You should store your diaphragm in sterile water after each use." ## Question: 60 of 70 A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery and reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository? - Vaginal candidiasis - Abdominal distention - Afterpains - **Third-degree perineal laceration** ## Question: 61 of 70 A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) - **8** tablets ## Question: 64 of 70 A nurse is caring for a newborn who was born at 39 weeks of gestation and is 36 hr old. Which of the following findings should the nurse report to the provider? (Select all that apply.) - **Coombs test result** - **Mucous membrane assessment** - Intake and output - **Respiratory rate** - Head assessment finding - **Heart rate** - **Sclera color** - Glucose level ## Question: 67 of 70 A nurse is caring for a client who is at 33 weeks of gestation. The nurse is assessing the client 24 hr later. How should the nurse interpret the findings? | Findings 24 hr later | Unrelated to diagnosis | Indication of potential Improvement | Indication of potential worsening condition | |---|---|---|---| | Hematuria | | | ☑ | | Proteinuria 2+ | | | ☑ | | Leukorrhea Positive clonus | | | ☑ | | BUN 40 mg/dL | | | ☑ | | Platelet count | | | ☑ | ## Question: 69 of 70 A nurse is caring for a client who is at 32 weeks of gestation and has complete placenta previa. Which of the following assessment findings requires immediate follow-up? (Select all that apply.) - **Vaginal bleeding** - **Hct** - RBC count - Fetal heart rate - Hgb - WBC count - Fundal height ## Question: 70 of 70 A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis. The nurse is assessing the client 24 hr later. How should the nurse interpret the findings? | Findings 24 Hr later | Unrelated to diagnosis | Indication of Improving Condition | Indication of Worsening Condition | |---|---|---|---| | Increased warmth in the extremity | | | ☑ | | Tachycardia| | ☑ | | | Leukocytosis | | ☑ | | | Scant lochia rubra | | | ☑ | | Decreased extremity edema | | ☑ | | *** Please note: Some pages were too difficult to read to provide a complete answer, and required guessing based on incomplete information provided.