ATI_RN Maternal Newborn 2023
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Free ATI_RN Maternal Newborn 2023 Questions
A nurse is caring for a client who requests information about a subdermal contraceptive implant. Which of the following information should the nurse include?
- A. The implant slowly releases a consistent level of estrogen.
- B. The implant is effective for at least 3 years.
- C. The implant has an annual failure rate of 5%.
- D. The implant protects against some sexually transmitted infections.
Explanation
Explanation
Subdermal contraceptive implants release a progestin hormone and provide long-acting, reversible contraception. Once inserted, the implant is effective for at least 3 years by suppressing ovulation, thickening cervical mucus, and thinning the endometrial lining. It is one of the most effective contraceptive methods available, with a failure rate of less than 1%. The implant does not contain estrogen and does not protect against sexually transmitted infections.Correct Answer Is:
B. The implant is effective for at least 3 years.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?
- A. 1, 2, 3, 4
- B. 2, 1, 3, 4
- C. 1, 3, 2, 4
- D. 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 caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client with which of the following vaccines?
(Select All That Apply.)
- A. Diphtheria-acellular pertussis
- B. Human papillomavirus
- C. Inactivated influenza
- D. Varicella
- E. Measles, mumps, and rubella
Explanation
Explanation
A. Diphtheria-acellular pertussis
The Tdap vaccine is recommended during each pregnancy, ideally between 27 and 36 weeks of gestation. Administering Tdap during this window allows the mother to develop antibodies that cross the placenta and provide passive immunity to the newborn, protecting the infant from pertussis during the first months of life when the risk of severe illness is highest.
C. Inactivated influenza
The inactivated influenza vaccine is recommended for pregnant clients during any trimester of pregnancy, including at 30 weeks of gestation. Pregnancy increases the risk of severe complications from influenza due to physiological changes in the immune and respiratory systems. Vaccination protects both the pregnant client and the newborn, as maternal antibodies are passed to the infant after birth.
Correct Answer Is:
A. Diphtheria-acellular pertussisC. Inactivated influenza.
A nurse is caring for a client who is scheduled for a cesarean birth. Which of the following actions should the nurse take?
- A. Initiate an oxytocin infusion.
- B. Ensure the client's bladder is full.
- C. Place a wedge under the client's left hip.
- D. Position the client in a modified left-lateral position.
Explanation
Explanation
Placing a wedge under the client’s left hip provides left uterine displacement, which prevents compression of the inferior vena cava by the gravid uterus. This intervention improves venous return, cardiac output, and uteroplacental perfusion, reducing the risk of supine hypotensive syndrome during cesarean birth. Maintaining adequate maternal circulation is essential to ensure sufficient oxygen delivery to both the client and the fetus during the procedure.Correct Answer Is:
C. Place a wedge under the client's left hip.A nurse is caring for a newborn 4 hr after birth. Which of the following findings should the nurse report to the provider?
- A. Pale blue hands and feet
- B. Soft grunting noises with respiration
- C. Blood-tinged discharge from the vagina
- D. 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 preparing to perform a heel stick on a newborn who has a prescription for a total serum bilirubin. Which of the following actions should the nurse take?
- A. Place a cool cloth at the site for 15 min before the procedure.
- B. Puncture the lateral side of the heel for the procedure.
- C. Select a 21-gauge needle to perform the procedure.
- D. Apply an alcohol pad to the site after the procedure.
Explanation
Explanation
When performing a heel stick on a newborn, the nurse should puncture the lateral or medial plantar surface of the heel to avoid injury to the calcaneus bone, nerves, and blood vessels. These areas provide adequate capillary blood flow while minimizing the risk of complications such as osteomyelitis or nerve damage. The center of the heel should be avoided, and only approved lancets—not large needles—should be used for safety.Correct Answer Is:
B. Puncture the lateral side of the heel for the procedure.A nurse is assessing a client following an amniocentesis. Which of the following findings should the nurse recognize as complications?
(Select All That Apply.)
- A. Leakage of amniotic fluid
- B. Amnionitis
- C. Urinary tract infection
- D. Preterm labor
- E. Polyhydramnios
Explanation
Explanation
A. Leakage of amniotic fluid
Leakage of amniotic fluid following an amniocentesis indicates possible rupture of membranes, which is a known complication of the procedure. Loss of fluid can increase the risk of infection, fetal compromise, and preterm labor. Any vaginal fluid leakage after amniocentesis requires immediate evaluation by the provider.
B. Amnionitis
Amnionitis, also known as chorioamnionitis, is a serious complication that can occur if bacteria are introduced into the amniotic sac during the procedure. Signs may include maternal fever, uterine tenderness, foul-smelling amniotic fluid, or fetal tachycardia. Prompt recognition is critical to prevent severe maternal and fetal outcomes.
D. Preterm labor
Amniocentesis can stimulate uterine activity, leading to preterm contractions or labor, particularly when performed later in pregnancy. Clients should be monitored for abdominal cramping, regular contractions, or back pain following the procedure, as these may indicate the onset of preterm labor requiring immediate intervention.
Correct Answer Is:
A. Leakage of amniotic fluidB. Amnionitis
D. Preterm labor.
A nurse is caring for a client who is on IV magnesium sulfate 12 hours postpartum. The client had a vaginal birth following induction of labor at 35 weeks due to preeclampsia. Which of the following should the nurse recognize as an adverse effect of this treatment?
- A. Report of warmth at IV site
- B. Urine output of 50 mL/hr
- C. Uterine atony with fundal massage
- D. Report of uterine afterpains of 8 on a scale of 0 to 10
Explanation
Explanation
Magnesium sulfate is a central nervous system and smooth muscle depressant. While it is effective for preventing seizures in preeclampsia, it can also relax uterine smooth muscle. This relaxation may interfere with the uterus’s ability to contract effectively after birth, increasing the risk of uterine atony and postpartum hemorrhage. Uterine atony despite fundal massage is a concerning adverse effect that requires prompt recognition and intervention when a client is receiving magnesium sulfate.Correct Answer Is:
C. Uterine atony with fundal massage.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?
- A. Urinary output
- B. Respiratory status
- C. Heart rate
- D. 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 assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?
- A. Absent Moro reflex
- B. High-pitched crying
- C. Diminished deep tendon reflexes
- D. Decreased muscle tone
Explanation
Explanation
Neonatal abstinence syndrome occurs when a newborn withdraws from substances, most commonly opioids, that were used during pregnancy. A hallmark manifestation of withdrawal is a high-pitched, shrill cry caused by central nervous system hyperirritability. Affected newborns are often difficult to console and may cry excessively. Reflexes are typically exaggerated rather than absent, and muscle tone is usually increased rather than decreased.Correct Answer Is:
B. High-pitched crying.How to Order
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