ATI RN Maternal Newborn 2023 at Baton Rouge Community College
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Free ATI RN Maternal Newborn 2023 at Baton Rouge Community College Questions
A nurse is providing teaching about prenatal laboratory tests to a client who is at 8 weeks of gestation. Identify the sequence of routine screenings the client will undergo throughout pregnancy.
(Place the steps in the correct order.)
- Rubella titer test
- Maternal serum alpha-fetoprotein (MSAFP) level
- 1-hr glucose tolerance test
- Rectovaginal culture for group B streptococcus β-hemolytic
Which of the following sequences is correct?
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1, 2, 3, 4
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2, 1, 3, 4
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1, 3, 2, 4
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2, 3, 1, 4
Explanation
Explanation
- Rubella titer test
The rubella titer is obtained during the initial prenatal visit in the first trimester. This test determines whether the pregnant client has immunity to rubella, which is critical because infection during pregnancy can cause serious congenital anomalies. Since the rubella vaccine is contraindicated during pregnancy, identifying nonimmune clients early allows for postpartum vaccination planning. - Maternal serum alpha-fetoprotein (MSAFP) level
The maternal serum alpha-fetoprotein test is performed during the second trimester, usually between 15 and 20 weeks of gestation. This screening helps identify increased risk for neural tube defects, abdominal wall defects, and certain chromosomal abnormalities. Correct gestational dating is essential for accurate interpretation of results. - 1-hr glucose tolerance test
The 1-hour glucose tolerance screening is routinely completed between 24 and 28 weeks of gestation to assess for gestational diabetes mellitus. Placental hormones increase insulin resistance as pregnancy progresses, making this timeframe optimal for detecting abnormal glucose metabolism that could affect maternal and fetal health. - Rectovaginal culture for group B streptococcus β-hemolytic
The group B streptococcus rectovaginal culture is obtained late in pregnancy, typically between 36 and 37 weeks of gestation. This screening identifies maternal colonization so intrapartum antibiotic prophylaxis can be administered during labor, significantly reducing the risk of neonatal group B streptococcal infection.
Correct Answer Is:
A. 1, 2, 3, 4.A nurse is planning care for a client who is receiving epidural opioids during a cesarean birth. Which of the following assessments is the nurse's priority for the first 24 hr following birth?
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Urinary output
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Respiratory status
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Heart rate
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Pain level
Explanation
Explanation
Epidural opioids can cause delayed respiratory depression, which may occur several hours after administration and can be life-threatening if not promptly identified. For the first 24 hours following a cesarean birth, the nurse’s highest priority is closely monitoring respiratory rate, depth, and oxygen saturation. Early detection of hypoventilation allows for rapid intervention and prevents serious complications such as hypoxia, making respiratory assessment the top priority over pain, cardiac status, or urinary output.Correct Answer Is:
B. Respiratory status.A nurse is caring for a client who is in labor and reports having difficulty voiding. Which of the following actions should the nurse take?
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Help the client recline their back against the bed at a 45° angle.
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Have the client sip warm water through a straw.
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Use a squeeze bottle to pour warm water over the client's perineum.
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Place the client in a left lateral position.
Explanation
Explanation
Pouring warm water over the perineum helps stimulate the micturition reflex and relaxes the perineal muscles, making it easier for the client to void. During labor, bladder distention can interfere with fetal descent and increase discomfort, so facilitating urination is important. This noninvasive intervention is commonly effective and promotes bladder emptying without altering labor progression.Correct Answer Is:
C. Use a squeeze bottle to pour warm water over the client's perineum.A nurse is assessing a newborn who is 2 hr old. Which of the following findings is an indication of hypoglycemia?
(Select All That Apply.)
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Acrocyanosis
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Hypotonia
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Jitteriness
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Temperature instability
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Abdominal distention
Explanation
Explanation
B. Hypotonia
Hypotonia is a common sign of neonatal hypoglycemia and reflects inadequate glucose supply to the central nervous system. Low blood glucose levels impair neuromuscular function, leading to decreased muscle tone, lethargy, and poor feeding. This finding is concerning in the early newborn period and warrants prompt blood glucose evaluation and intervention.
C. Jitteriness
Jitteriness is a classic and early manifestation of neonatal hypoglycemia. It occurs due to increased neuromuscular excitability caused by insufficient glucose available to the brain. Unlike seizures, jitteriness typically stops when the affected limb is held. Persistent jitteriness in a newborn should prompt immediate assessment of blood glucose levels.
D. Temperature instability
Newborns rely heavily on glucose for thermoregulation. Hypoglycemia can impair the newborn’s ability to maintain body temperature, resulting in temperature instability, including hypothermia. This finding is especially significant in the first hours after birth and may be one of the earliest signs of low blood glucose requiring prompt evaluation and treatment.
Correct Answer Is:
B. HypotoniaC. Jitteriness
D. Temperature instability.
A nurse is assessing a client who is in labor. Which of the following fetal heart rate patterns indicates a need for immediate intervention?
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Minimal variability
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Early deceleration
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Late deceleration
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Moderate variability
Explanation
Explanation
Late decelerations are a nonreassuring fetal heart rate pattern that indicates uteroplacental insufficiency and fetal hypoxia. They occur after the peak of a uterine contraction and return to baseline after the contraction ends, showing that the fetus is not tolerating labor stress well. Immediate nursing interventions are required, such as repositioning the client, administering oxygen, increasing IV fluids, and notifying the provider, to prevent fetal compromise.Correct Answer Is:
C. Late deceleration.A nurse is caring for a client who has a prescription for metronidazole 250 mg PO three times daily. Available is metronidazole 500 mg tablets. How many tablet(s) should the nurse plan to administer per dose?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
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0.25 tablet
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0.5 tablet
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1 tablet
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2 tablets
Explanation
Explanation
The prescribed dose is 250 mg, and the available tablet strength is 500 mg. To calculate the number of tablets needed, divide the prescribed dose by the available dose: 250 mg ÷ 500 mg = 0.5 tablet. This means the nurse should administer half of a tablet per dose. Rounded to the nearest tenth, the correct amount remains 0.5 tablet.Correct Answer Is:
B. 0.5 tablet.A nurse is teaching a client who is at 39 weeks of gestation about manifestations of early labor. Which of the following should the nurse include?
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Decrease in frequency of bowel movements
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Blood-tinged vaginal discharge
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Increase in fetal movements
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Weight gain of up to 1.4 kg (3 lb) in 1 week
Explanation
Explanation
Blood-tinged vaginal discharge, often referred to as the “bloody show,” is a common sign of early labor. It occurs as the cervix begins to soften, efface, and dilate, causing the mucus plug to be expelled and small cervical blood vessels to rupture. This finding indicates that labor is approaching or has begun and is an expected manifestation at term.Correct Answer Is:
B. Blood-tinged vaginal discharge.A nurse is reviewing the medical record of a client who is at 6 weeks of gestation. The nurse should identify that which of the following medications is contraindicated for this client?
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Isotretinoin
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Metformin
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Azithromycin
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Nifedipine
Explanation
Explanation
Isotretinoin is absolutely contraindicated during pregnancy because it is a known teratogen with a very high risk of causing severe congenital malformations, including craniofacial, cardiac, central nervous system, and thymic defects. Exposure during early pregnancy, particularly the first trimester, is strongly associated with fetal harm and pregnancy loss. Strict pregnancy prevention programs are required for clients taking this medication.Correct Answer Is:
A. Isotretinoin.A nurse is caring for a newborn 4 hr after birth. Which of the following findings should the nurse report to the provider?
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Pale blue hands and feet
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Soft grunting noises with respiration
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Blood-tinged discharge from the vagina
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Positive Babinski reflex
Explanation
Explanation
Grunting is an abnormal respiratory finding in a newborn and indicates respiratory distress. It occurs when the newborn partially closes the glottis during expiration in an attempt to maintain positive airway pressure and improve oxygenation. Even soft or intermittent grunting can signal conditions such as retained lung fluid, respiratory distress syndrome, or infection. This finding requires prompt evaluation and intervention to prevent worsening hypoxia and respiratory failure.Correct Answer Is:
B. Soft grunting noises with respiration.A nurse is caring for a client at a 10-week prenatal visit. The provider diagnoses the client with a missed spontaneous abortion confirmed by ultrasound, and the nurse is discussing the plan of care with the client. Which of the following statements should the nurse make?
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“I have found that it is best to avoid seeing the fetal remains after the procedure.”
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“Once the fetus is passed the provider will likely be able to determine what caused the pregnancy loss.”
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“It can be helpful to talk about your loss with others who have experienced a pregnancy loss.”
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“It is okay to feel some grief now, even though it is so early in the pregnancy for a loss.”
Explanation
Explanation
This statement demonstrates therapeutic communication by acknowledging and validating the client’s feelings without minimizing the loss. Grief can occur at any stage of pregnancy, and recognizing this helps normalize the client’s emotional response. Providing emotional support and permission to grieve is a priority nursing intervention following pregnancy loss and promotes healthy coping and psychological healing.Correct Answer Is:
D. “It is okay to feel some grief now, even though it is so early in the pregnancy for a loss.”How to Order
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