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 prenatal clinic is providing teaching for a client who is at 22 weeks of gestation. Which of the following statements should the nurse include?
- “You may notice that you are short of breath.”
- “It is recommended that you gain 2 to 2.5 pounds each week.”
- “You may notice intermittent mild headaches.”
- “You should abstain from sex during this trimester.”
Explanation
Explanation
Mild shortness of breath is a common and expected finding during the second trimester of pregnancy. As the uterus enlarges, it elevates the diaphragm and decreases lung expansion. In addition, progesterone increases respiratory drive, causing the client to feel short of breath even though oxygenation remains adequate. This symptom is considered normal as long as it is not severe or accompanied by chest pain or dizziness.Correct Answer Is:
A. “You may notice that you are short of breath.”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.)
- Acrocyanosis
- Hypotonia
- Jitteriness
- Temperature instability
- 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 reviewing the history of a client who is pregnant. Which of the following clinical data indicates the client is at risk for preterm delivery?
- Previous delivery at 37 weeks gestation
- Previous delivery of a newborn weighing 2.5 kg (5.5 lb)
- Previous reactive non-stress test
- Previous cervical cerclage
Explanation
Explanation
A history of cervical cerclage indicates cervical insufficiency, a condition in which the cervix shortens or dilates prematurely without contractions. This significantly increases the risk for preterm labor and delivery in future pregnancies. Clients with prior cerclage require close monitoring because structural cervical weakness can lead to early cervical dilation and preterm birth if not managed appropriately.Correct Answer Is:
D. Previous cervical cerclage.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?
- Report of warmth at IV site
- Urine output of 50 mL/hr
- Uterine atony with fundal massage
- 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 caring for a newborn who has herpes simplex virus as a result of in utero transmission. Which of the following actions should the nurse take?
- Initiate contact precautions.
- Withhold breastfeeding.
- Administer ampicillin IV.
- Immediately bathe the newborn.
Explanation
Explanation
Newborns with herpes simplex virus require contact precautions to prevent transmission of the virus to others and to protect healthcare personnel. HSV can be spread through direct contact with infected skin lesions or secretions. Implementing contact precautions, including the use of gloves and gowns, is essential when caring for affected newborns. Breastfeeding is permitted unless there are active herpetic lesions on the breast, antibiotics like ampicillin are ineffective against viral infections, and immediate bathing does not treat or prevent in utero HSV infection.Correct Answer Is:
A. Initiate contact precautions.A nurse is caring for a client who has had a vaginal birth and reports pain as 5 on a scale of 0 to 10. Which of the following medications should the nurse plan to administer?
- Nalbuphine
- Butorphanol tartrate
- Ibuprofen
- Secobarbital sodium
Explanation
Explanation
For moderate postpartum pain following a vaginal birth, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are the first-line treatment. Ibuprofen effectively reduces pain and inflammation associated with uterine involution, perineal discomfort, and musculoskeletal strain without causing sedation or respiratory depression. Opioids are reserved for more severe pain, while sedatives like secobarbital are not appropriate for routine postpartum pain management.Correct Answer Is:
C. Ibuprofen.A nurse is providing teaching about expected body changes during pregnancy for a primigravida client who is at 10 weeks of gestation. Which of the following statements indicates that the client understands the teaching?
- “During my pregnancy, I should lose weight during the third trimester.”
- “In another two weeks, I will see stretch marks on my belly.”
- “During my pregnancy, I will notice darkening of the areola.”
- “In another two weeks, I will notice my feet getting puffy.”
Explanation
Explanation
Darkening of the areola is a common and expected change that occurs early in pregnancy, often during the first trimester. Increased levels of estrogen, progesterone, and melanocyte-stimulating hormone cause increased pigmentation of the areola and nipples. This change prepares the breasts for breastfeeding and is a normal physiological response during early pregnancy, making this statement an accurate indication of understanding.Correct Answer Is:
C. “During my pregnancy, I will notice darkening of the areola.”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?
- Place a cool cloth at the site for 15 min before the procedure.
- Puncture the lateral side of the heel for the procedure.
- Select a 21-gauge needle to perform the procedure.
- 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 caring for a client who is in labor at 38 weeks of gestation.
Exhibit 1
Nurses' Notes
0900:
Client reports a gush of fluid from between their legs.
0930:
FHR: 90/min with absent variability
0931:
Prolonged deceleration noted.
Umbilical cord visible. Called for assistance.
After reviewing the assessment findings, which of the following actions should the nurse take?
(Select the 3 actions the nurse should take.)
- Administer oxygen therapy via nonrebreather mask.
- Assist the client into the Trendelenburg position.
- Apply suprapubic pressure.
- Increase the intravenous fluid rate.
- Replace the cord into the cervix.
Explanation
Explanation
A. Administer oxygen therapy via nonrebreather mask.
With a fetal heart rate of 90/min, absent variability, and a prolonged deceleration, the fetus is showing signs of significant compromise likely from cord compression and reduced oxygen delivery. Administering high-flow oxygen by nonrebreather mask increases maternal oxygenation and improves the amount of oxygen available for placental transfer. This is an immediate intrauterine resuscitation measure while preparing for urgent delivery.
B. Assist the client into the Trendelenburg position.
A visible umbilical cord indicates cord prolapse, which is an obstetric emergency because the presenting part can compress the cord and cut off fetal blood flow. Trendelenburg positioning uses gravity to move the fetus off the cord, decreasing compression and helping restore perfusion. This intervention is initiated immediately while awaiting definitive management, typically an emergent cesarean birth.
D. Increase the intravenous fluid rate.
Increasing IV fluids supports maternal circulating volume and improves uteroplacental perfusion, which can help stabilize fetal status during a nonreassuring tracing. With cord prolapse and fetal bradycardia, optimizing maternal blood flow is a key supportive intervention. A fluid bolus can help correct hypotension if present or prevent further compromise while the team prepares for rapid delivery.
Correct Answer Is:
A. Administer oxygen therapy via nonrebreather mask.B. Assist the client into the Trendelenburg position.
D. Increase the intravenous fluid rate.
A nurse manager is revising a maternal unit policy to ensure proper identification of newborns. Which of the following should the nurse include in the policy?
- Obtain an imprint of the infant's feet prior to taking him to the nursery.
- Require visitors to wear an identification band.
- Replace the infant's identification band after his name has been recorded.
- Check the newborn's identification using the crib card.
Explanation
Explanation
Obtaining a footprint of the newborn before separation from the parent is an accepted supplemental identification measure that helps ensure correct identification. Although identification bands are the primary method, footprints provide an additional layer of verification if bands are lost or questioned. Newborn identification must occur immediately after birth and before transport to reduce the risk of misidentification.Correct Answer Is:
A. Obtain an imprint of the infant's feet prior to taking him to the nursery.How to Order
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