ATI RN Maternal Newborn 2023 Past Paper PDF

ATI RN Maternal Newborn 2023 230 1.A nurse in providers 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 **a. This procedure determines if your baby has...

ATI RN Maternal Newborn 2023 230 1.A nurse in providers 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 **a. This procedure determines if your baby has genetic or congenital disorders.** 2\. A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase take od vitamins B. Which of the following should the nurse recommend? **a. Fortified soy milk** 3\. A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as complication of this birth method? **A. Facial Palsy** 4.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 parents indicates an understanding of the teaching? **B. My baby will need a car seat challenge test before discharge** 5.A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect? **A. Excessive crying** 6\. 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? **A. Close the newborn's eyes before applying eyepatches** 7.A nurse is teaching about car seat safety to the parents of a newborn who has delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching. **B. My baby will need a car seat challenge test before discharge** 8.A nurse is providing teaching to a client who is 2days postpartum and wants to continue using her diaphragm for contraception.which of the following instructions should the nurse include? **A. You should have your provider refit you for a new diaphragm.\"** 9\. A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include? **A. Breast tenderness** 10\. 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? **C. \"How much protein do you eat in a day?\"** 11\. A nurse is caring for a client immediately following the delivery of a stillborn fetus. Which of the following actions should the nurse take? **A. Instruct the client that an autopsy should be performed within 24 hr.** 12\. A nurse is caring for a client immediately following the delivery of a stillborn fetus. Which of the following actions should the nurse take? **C. Provide the client with photos of the fetus.** 13\. 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? **C. Contact** 14\. A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B. Which of the following foods should the nurse recommend? **D. Fortified soy milk** 15\. 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? **C. \"Has your back labor improved?\"** 16\. 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? **A. Lentils** 17\. A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include? **A. Allow the baby to feed at least every 3 hr.** 18\. 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? **B. Verify that informed consent is obtained prior to administration.** 19\. A nurse is discussing fertility treatment options with a client and their partner. Which of the following nonpharmacological treatments should the nurse suggest? **D. Maintain a healthy weight.** 20\. 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? **C. Postpartum hemorrhage** 21\. 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? **A. Subconjunctival hemorrhage** 22\. 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? **A. Administer oxygen at 10 L/min via nonrebreather facemask.** 23\. 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? **A. \"Transmission can occur via the saliva and urine of the newborn.\"** 24\. 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? **A. Massage the client\'s fundus.** 25\. A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect? **D. Uterine tenderness** 26\. A nurse in a prenatal clinic is caring for a group of clients. The nurse should recognize that which of the following clients has a contraindication for a contraction stress test? **B. A client who has a previous classical incision** 27\. 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? **B. Facial palsy** 28\. 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? **B. Third-degree perineal laceration** 29\. A nurse at an antepartum clinic is caring for four clients. Which of the following clients should the nurse assess first? **B. A client who is at 8 weeks of gestation and reports severe vomiting** 30\. A nurse in a prenatal clinic is caring for a group of clients. The nurse should recognize that which of the following clients has a contraindication for a contraction stress test? **B. A client who has a previous classical incision** 31\. 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? **B. Ask the client if they are taking the medication as prescribed.** 32\. 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? **D. May 17** 33\. A nurse is caring for a client who has bladder distention following a vaginal birth. Which of the following actions should the nurse take first? **B. Assist the client to the bathroom.** 34\. 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? **B. To allow manifestations of infection to be identified** 35\. 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? **C. Evaluate urinary output.** 36\. 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.) **A. Vacuum-assisted delivery** **C. History of uterine atony** ***D. Labor induction with oxytocin*** 37\. 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? **D. Malodorous discharge** 38\. A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should identify which findings as an adverse effect of the medication? **D. Hypotension** 39\. 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? **C. Assess blood pressure twice daily.** 40\. 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? **C. Fasting blood glucose 180 mg/dL (74 to 106 mg/dL)** 41\. 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? **B. Flank pain** 42\. 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? **B. Cover the umbilical cord with a sterile saline-saturated tow** 43\. 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? **B. Cleanse the site with povidone -iodine** 44.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? **B. Cleanse the site with povidone-iodine.** 45\. A nurse is assessing a newborn who was born 2 hr ago and was admitted to the neonatal intensive care unit with chest wall retractions and blue discoloration of the hands and feet. Which of the following findings indicates a decline in the newborn\'s status? **C. Oxygen saturation of 89%** 46\. 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? **B. \"Notify the provider if the end of your baby\'s penis appears dark red.\"** 47\. A nurse is administering a hepatitis B vaccine to a newborn. Which of the following actions should the nurse take? **C. Administer the injection into the vastus lateralis muscle.** 48\. 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? **D. Assess the newborn\'s latch while breastfeeding.** 49\. 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? **D. \"Ovulation will remain the same.\"** 50\. 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? **C. \"Wash your baby\'s face with plain water.\"** 51\. A nurse is assessing a client who is 3 days postpartum. Which of the following findings should the nurse report to the provider? **B. Cool clammy skin** 52\. 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? **A. Assist the client in pulling their knees toward their abdomen.** 53\. 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? **B. Turn the client to a side-lying position k** 54\. 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? **C. Provide the client with a cool sitz bath.** 55\. 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? **B. Anticipate a prescription for misoprostol.** 56\. A nurse is caring for a newborn who is 5 days old. Medical History History of maternal opioid use prior to pregnancy and prescribed methadone use during pregnancy. Maternal and neonatal positive urine drug screens for methadone. Newborn is exhibiting clinical findings of neonatal abstinence syndrome (NAS). Which of the following actions should the nurse take? Select all that apply. **A. Maintain a low stimulation environment.** **C. Instruct the parent to avoid breastfeeding** **E. Perform Ballard newborn screening each shift.** **F. Weigh the newborn daily.** **G. Swaddle the newborn with flexed extremities** 57\. 31. 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, placing them in the selected order of performance. Use all the steps) Correct Answer: C,A,B,D,E **C. Instruct the client to empty their bladder.** **A. Position the client supine with knees flexed and place a small rolled towel under one of their hips.** **B. Palpate the fetal part positioned in the fundus.** **D. Palpate the fetal parts along both sides of the uterus.** **E. Palpate the fetal part positioned above the symphysis pubis.** 58\. A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis Vital Signs Blood Pressure 130/72 mm Hg Heart rate 90/min Respiratory rate 18/min Temperature 37\" C (98.6\" F) The nurse is assessing the client 24 hr later. How should the nurse interpret the findings? For each finding dick to specify whether the finding is unrelated to the diagnosis, an indication that the client\'s condition is improving, or an indication that the client\'s condition is worsening Correct Answers **Leukocytosis: Indication of Worsening Condition,** **Redness in the extremity: Indication of Worsening Condition,** **Scant lochia rubra: Indication of Improving Condition,** **Increased warmth in the extremity: Indication of Worsening Condition,** **Tachycardia: Indication of Worsening Condition,** **Decreased extremity edema: Indication of Improving Condition,** 59\. A nurse is caring for a client who is at 33 weeks of gestation. Medical History Gravida 2 Para 1 Preeclampsia The nurse is assessing the client 24 hr later. How should the nurse interpret the findings? **Platelet count 90.000/mm3: Sign of potential worsening condition** **Hematuria: Sign of potential worsening condition,** **Positive clonus: Sign of potential worsening condition,** **Proteinuria 2+: Sign of potential worsening condition,** **Leukorrhea: Sign of potential improvement,** **BUN 40 mg/dL: Sign of potential worsening condition,** 60\. A nurse is assessing a postpartum client who delivered vaginally 8 hr ago. Nurses Notes 0700: Breasts soft nipples intact. Uterus palpated firm, midline, and at level of umbilicus. Moderate amount of lochia rubra. Episiotomy site well approximated with mild edema and ecchymosis. Client reports pain as 2 on a scale of 0 to 10. Able to void spontaneously, no bladder distention. Deep tendon reflexes 1+. Peripheral edema 2+ in bilateral lower extremities 1100: Breasts soft, nipples intact. Uterus palpated soft with lateral deviation and 1 cm above the umbilicus. Large amount of lochia rubra. Episiotomy site well approximated with mild edema and ecchymosis. Client reports pain as 3 on a scale of 0 to 10. Deep tendon reflexes 1+ Peripheral edema 2+ in bilateral lower extremities. Select the 3 findings that require immediate follow-up. **C. Lateral deviation of the uterus** **G. Large amount of lochia rubra** **H. Uterine tone** 61\. A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a new prescription for misoprostol. Medication Administration Record Misoprostol 800 mcg rectally x 1 dose now Nifedipine 20 mg PO twice daily Ketorolac 30 mg IV every 6 hr The nurse is assessing the client 30 min later. How should the nurse interpret the findings? **Blood pressure 80/50 mm Hg: Indication of potential worsening condition,** **Cloudy urine: Indication of potential worsening condition,** **Moderate lochia rubra: Indication of potential worsening condition,** **Fundus firm to palpation: Indication of potential improvement,** **Fundus at level of umbilicus: Indication of potential worsening condition**, 62.A nurse is caring for a term newborn who is 48 hr old. Physical Examination High-pitched cry Mild tremors when disturbed Increased muscle tone Sneezing six times within 1 hr Excessive sucking Color: Consistent with genetic background Excoriation of the chin Watery stools Projectile vomiting Hyperactive Moro reflex The nurse is assessing the newborn 24 hr later. How should the nurse interpret the findings? **Regurgitation: Sign of potential worsening,** **Mottling: Sign of potential worsening,** **Transient strabismus: Sign of potential Improvement,** **Continuous high-pitched cry: Sign of potential worsening,** **Respiratory rate 70/min: Sign of potential worsening,** **Loose stools: Sign of potential worsening,**