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 in a clinic is reviewing newborn hygiene with a group of clients. Which of the following instructions should the nurse include in the teaching?
- “Bathe your newborn every day.”
- “Cleanse your newborn's cord site using hydrogen peroxide.”
- “Use cotton-tipped swabs to cleanse your newborn's ears.”
- “Start by washing your newborn's face and then the rest of their body.”
Explanation
Explanation
When bathing a newborn, the nurse should instruct caregivers to begin with the face and then proceed to the rest of the body. The face is the cleanest area and should be washed first using plain water without soap to avoid irritation, especially around the eyes. Washing from the cleanest area to the dirtiest helps prevent the spread of microorganisms and promotes safe, hygienic bathing practices for newborns.Correct Answer Is:
D. “Start by washing your newborn's face and then the rest of their body.”A nurse is caring for a client who is receiving terbutaline to treat preterm labor. Which of the following findings should the nurse identify as a potential adverse effect of this medication?
- Bradycardia
- Shortness of breath
- Hot flashes
- Heart palpitations
Explanation
Explanation
Terbutaline is a beta-adrenergic agonist used as a tocolytic to suppress uterine contractions. Because it stimulates beta-1 and beta-2 receptors, common adverse effects include tachycardia, heart palpitations, tremors, nervousness, and hyperglycemia. Palpitations occur due to increased heart rate and myocardial stimulation and should be closely monitored, as excessive cardiovascular effects may require discontinuation of the medication.Correct Answer Is:
D. Heart palpitations.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?
- 1, 2, 3, 4
- 2, 1, 3, 4
- 1, 3, 2, 4
- 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 in a clinic is caring for an adolescent client who requests a prescription for birth control. Which of the following questions should the nurse ask?
- “What do you know about contraception?”
- “Why are you requesting a prescription for birth control?”
- “Are you sure your partner loves you?”
- “Is your partner pressuring you to have sex?”
Explanation
Explanation
Asking what the adolescent already knows about contraception is an open-ended, nonjudgmental question that supports therapeutic communication and client-centered care. It allows the nurse to assess the client’s level of understanding, correct misconceptions, and tailor education appropriately. This approach respects the adolescent’s autonomy, encourages honest dialogue, and aligns with best practices for providing reproductive health counseling without implying judgment, pressure, or assumptions about the client’s motivations or relationships.Correct Answer Is:
A. “What do you know about contraception?”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?
- “I have found that it is best to avoid seeing the fetal remains after the procedure.”
- “Once the fetus is passed the provider will likely be able to determine what caused the pregnancy loss.”
- “It can be helpful to talk about your loss with others who have experienced a pregnancy loss.”
- “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.”A nurse in a provider's office is caring for a client who is at 30 weeks of gestation.
Exhibit 1
Vital Signs
0830:
Oral temperature 36.9°C (98.4° F)
Heart rate 89/min
Respiratory rate 16/min
Blood pressure 110/60 mm Hg
SaO2 97% on room air
Exhibit 2
Nurses' Notes
0830:
Client is at 30 weeks of gestation, Gravida 2 Para 1 with no prenatal care. Presents with reports of low back pain and abdominal cramping for 2 days. History of cesarean birth x 1 for
breech presentation. Client reports smoking a half a pack of cigarettes per day. BMI is greater than 30. The client is grimacing. External electronic fetal monitor applied, and fetal
heart rate is 148/min. Positive fetal movement noted. Abdomen is soft and nontender to palpation. Denies leakage of amniotic fluid. Fundal height is 28 cm (11 in). Sterile vaginal examination (SVE) 2 cm, 80%, -1 station. Mucous vaginal discharge and small amount of bleeding observed.
0845:
Uterine contractions occurring every 2 to 3 minutes in moderate strength.
Exhibit 3
Diagnostic Results
0900:
Hgb 11 g/dL (greater than 11 g/dL)
Hct 32% (greater than 33%)
WBC count 20,000/mm3 (5,000 to 10,000/mm3)
Maternal Blood Type O negative
A nurse is assessing the client. Which of the following findings require follow-up?
(Select All That Apply.)
- Low back pain
- Fetal heart rate
- Abdominal assessment
- Fundal height
- Uterine contractions
- Abdominal cramping
Explanation
Explanation
A. Low back pain
At 30 weeks of gestation, persistent low back pain—especially when paired with cramping, cervical change (2 cm, 80% effaced), and vaginal bleeding—can be a sign of preterm labor rather than simple musculoskeletal discomfort. Low back pain can reflect uterine activity and pressure from cervical effacement/dilation. Because this client has frequent contractions and cervical change, the back pain should be treated as a warning sign that needs prompt follow-up.
E. Uterine contractions
Contractions every 2 to 3 minutes with moderate strength at 30 weeks are abnormal and strongly suggest preterm labor, particularly with cervical dilation (2 cm), effacement (80%), and a small amount of bleeding. This frequency increases the risk of progressive cervical change and preterm birth. The nurse must follow up urgently by notifying the provider and anticipating interventions such as tocolytics (if appropriate), corticosteroids for fetal lung maturity, IV fluids, and continuous monitoring.
F. Abdominal cramping
Abdominal cramping for 2 days at 30 weeks, combined with regular contractions and cervical change, is concerning for preterm labor. Cramping can represent uterine contractions that the client perceives as menstrual-like cramps and may be an early sign of labor progression. Because the cervix is already dilated and effaced with contractions occurring frequently, this symptom requires immediate follow-up to prevent preterm delivery and related maternal-fetal complications.
Correct Answer Is:
A. Low back painE. Uterine contractions
F. Abdominal cramping.
A nurse is caring for a client who is in labor and has spontaneous rupture of membranes. The nurse notes that the umbilical cord is protruding from the client’s vagina. After calling for help, which of the following actions should the nurse take first?
- Wrap the cord in a sterile towel and moisten with warm sterile normal saline.
- Use fingers to exert upward pressure on the presenting part.
- Administer a tocolytic medication.
- Apply oxygen via facemask to the client.
Explanation
Explanation
Umbilical cord prolapse is an obstetric emergency because compression of the cord reduces fetal oxygenation and can quickly lead to hypoxia or fetal death. The nurse’s immediate priority is to relieve pressure on the umbilical cord by inserting two fingers into the vagina and manually elevating the presenting part off the cord. This action helps restore blood flow through the cord until definitive treatment, usually an emergency cesarean birth, can be performed. Other interventions, such as oxygen administration or covering the cord with saline-soaked gauze, are supportive but do not take priority over relieving cord compression.Correct Answer Is:
B. Use fingers to exert upward pressure on the presenting part.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.)
- 0.25 tablet
- 0.5 tablet
- 1 tablet
- 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 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.)
- Newborn weight 2.948 kg (6 lb 8 oz)
- History of human papillomavirus
- History of uterine atony
- Labor induction with oxytocin
- Vacuum-assisted delivery
Explanation
Explanation
C. History of uterine atony
A prior history of uterine atony is a significant risk factor for postpartum hemorrhage. Uterine atony occurs when the uterus fails to contract effectively after delivery, preventing compression of blood vessels at the placental site. Clients with a previous episode are more likely to experience recurrence and require close monitoring during the postpartum period.
D. Labor induction with oxytocin
Prolonged or high-dose oxytocin use can overstimulate the uterus during labor, leading to uterine muscle fatigue. After delivery, a fatigued uterus may not contract adequately, increasing the risk of uterine atony and excessive bleeding. Clients who receive oxytocin induction or augmentation are therefore at increased risk for postpartum hemorrhage.
E. Vacuum-assisted delivery
Operative vaginal deliveries, such as vacuum-assisted births, increase the risk of postpartum hemorrhage due to potential trauma to the cervix, vagina, or perineum. Tissue injury and lacerations can contribute to excessive bleeding even if the uterus is firm, making this a recognized risk factor for postpartum hemorrhage.
Correct Answer Is:
C. History of uterine atonyD. Labor induction with oxytocin
E. Vacuum-assisted delivery.
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?
- Monitor for clonus.
- Administer magnesium sulfate.
- Assess for edema.
- Assess blood pressure twice daily.
Explanation
Explanation
Peripartum cardiomyopathy is a form of heart failure that occurs during the last month of pregnancy or in the postpartum period. Impaired cardiac function leads to fluid retention and decreased cardiac output. Assessing for edema helps the nurse identify worsening heart failure, fluid overload, and ineffective circulation. Early recognition of edema supports prompt intervention to prevent pulmonary edema, respiratory distress, and further cardiac decompensation.Correct Answer Is:
C. Assess for edema.How to Order
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