ATI PN MATERNAL
NEWBORN
PROCTORED EXAM
QUESTIONS
ANDANSWERS
A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks gest. Which of
the following manifestations should the RN ID as consistent with the diagnosis unilateral,
cramp-like abdominal pain
A nurse in a clinic is assessing a client who is 8 wks gest and has HG. findings to expect?
hx of migraines - first 20 wks
nulliparous - first trimester
twin gestation - increasing levels of estrogen, progesterone, HCG teaching fetal development
to group of clients at antenatal clinic, nurse include in the teaching? the baby's heart beat is
audible by a doppler stethoscope at 12 weeks of preg
sex is determined at conception
lanugo covers fetal body at 20wks and disappears by week 36
,quickening the feeling of fetal movement begins between weeks 14 to 16 in multiparous and
week 18 or later in nulliparous
assessing client at 3 days PP and is breastfeeding. then nurse notes that the fundus is three
fingerbreadths below the umbilicus, lochia rubra is moderate, and the breasts are hard and
warm on palpation. interpretations of these findings? additional intervention is not indicated at
this time. the fundal location and lochia are characteristics w/in normal range. breast
engorgement is typical, breast begin to produce milk. frequent BF and routine care can help
relieve engorgement. nurse in a prenatal clinic is reviewing client record who is 28 weeks of
gest. the hx includes 1 preg, terminated at 9 weeks, birth of twins at 36 weeks, abortion at 15
weeks. What is GTPAL? G 4
T0
P1
A2L2
nurse is teaching client PP and has new RX for injection of RHOGAM, what should be included
in teaching? it prevents formation of RH antibodies in mothers who are RH negative
given at 28week and following future preg Only $1/month teaching a newborn parent to care for
the umbilical cord stump. include which instructions? give sponge bath till cord falls off caring
for newborn, grandmother of the newborn asks if she can take the baby to the mothers room.
Appropriate response? have the mother call and I will take the baby to the room. a nurse
assessing a client who is 8hr PP and multiparous. Which of the following findings should alert
the nurse to the client's need to urinate?
fundus is three fingerbreadths above the umbilicus a nurse in the ED is admitting a pt who is
40 wks gest, has ruptured membranes, nurse observes NB head crowning. Client tells nurse she
wants to push. Correct reply? you should try to pant as the delivery proceeds
panting allows uterine forces to expel the fetus and permits controlled muscle expansion to
avoid rapid expulsion of fetal head a nurse is completing HX for client at 6wks gest. Client
informs the nurse that she smokes one pack of cig a day. the nurse should advise the client that
smoking places the clients NB at risk for...?
IUGR - intrauterine growth restriction placental abruption placenta previa preterm delivery
fetal death a nurse is caring for a client who is PP. nurse should recognize the following as
indication of inhibition of parenteral attachment?
i wish he had more hair, i will keep a hat on his head till he grow some a nurse caring for a
client who delivered a healthy NB via C-section birth. client asks the nurse, is there a chance
that i could deliver my next baby w/out have a c-section. best response?
the primary consideration is what type of incision was performed this time. a nurse is
preparing to administer MgSO4 IV to client, who is experiencing preterm labor. priority
nursing assessment for client?
RR
nurse is caring for a client who is primigravida at term, and having contractions, but stating that
she is not really sure if she is in labor or not. nurse should recognize as a sign of true labor?
change in cervix nurse is planning care for a NB who is SGA, which is priority intervention to
include in care? monitor blood glucose nurse is caring for a client 2 days PP, is BF, and reports
nipple soreness. Which measures would reduce discomfort during BF?
2
,apply BM to nipples before feeding
start on less sore nipple change
infant position on nipple
A nurse is s office is caring for a client who is 34 weeks and at risk for placental abruption. nurse
should recognize which common risk factor for abruption?
HTN
nurse in the ambulatory surgery center is providing discharge teaching to client who had a D&C,
following a spontenous miscarriage. include in the teaching? vaginal intercourse can be resumed
after 2 weeks
patient at 38 weeks, large amount of painless bright red vaginal bleeding. placed on fetal monitor;
indicating FHR of 138/min, no uterine contractions. client vital signs are BP: 98/52, HR 118/min,
RR 24/min, Temp 36.4 - 97.6,. priority action? initiate IV access - large-bore IV catheter
client is losing blood rapidly, HYPOTENSION - TACHYCARDIA - NEED fluids and blood to
be administered IF HYPOVOLEMIA develops
nurse is caring for client, first trimester, ask nurse if she can continue to exercise during
pregnancy. Appropriate response? daily jogging for 30/min/day is fine throughout preg
nurse is caring for a new mother, concerned her NBs eyes cross. therapeutic response?
this occurs because NBs lack muscle control to regulate eye movement nurse in prenatal clinic
is caring for client, first trimester, client tells nurse she is upset, planned pregnancy, but having
doubts and second thoughts. Appropriate response?
ambivalent feelings are quite common for women early in preg nurse on L&D unit, client
having difficult, prolonged labor with severe backache, contributing causes should the nurse
ID?
fetal position is persistent Occiput Posterior nurse is caring for client, 1hr PP, observes large
amount of lochia rubra, several small clots on pad. fundus is midline and firm at the
umbilicus. nurse action to take? document findings and continue to monitor the client.
expected findings.
nurse is caring for client, 1st stage of labor, observes umbilical cord protruding from the vagina.
first action to perform?
insert gloved hand into vagina to relieve pressure on the cord nurse in prenatal clinic, caring for
client at 7 weeks. client reports urinary frequency, asks if this will continue after delivery.
appropriate response?
it occurs during the first trimester and near the end of preg nurse in prenatal clinic, caring for
client suspected of having a hydatidform mole. findings to expect? excessive uterine enlargement
nurse is completing home visit to mother, 3 days PP, BF, mother expresses concern the amount of
weight the newborn lost since birth. response by nurse? this might be related to your baby having
3 stools a day. the NB is being BF typically has 3 or more stools per day during the first few
weeks. a nurse in L&D is caring for client undergoing EFM, nurse observes the FHR begins to
slow after the start of contraction. the lowest rate occurs after the peak of the contraction. first
action by nurse? place the client in the lateral position, LATE DECEL, fetal hypoxemia due to
insufficient placental perfusion. nurse is caring for a preterm newborn who is in an incubator to
maintain neural thermal environment. the father of the NB asks the nurse why is this necessary.
response? preterm NB lack adequate temperature control mechanisms nurse on L& D unit is
caring for client following vaginal exam, by provider which documents, -1, interpret? the present
, part is 1 cm above ischial spine a nurse is providing teaching about KEGELs to group of clients
who are in third trimester. indicates understanding of teaching? these exercises help pelvic
muscles to stretch during birth nurse in prenatal clinic is teaching client, new prescription for
dinoprostone gel. nurse include in the teaching? softens cervix stimulates uterine muscles nurse
caring for client who is in 1st stage of labor, using pattern-paced breathing. client states she feels
lightheaded, fingers are tingling. nurse should ? assist client to breathe into a paper bag nurse
caring for client, considering several methods of contraception, ID as being most reliable? IUD -
intrauterine device nurse providing teaching to client about nutrition, at first prenatal visit.
include in teaching? you will need to double your intake of iron during pregnancy nurse is
instructing woman, contemplating pregnancy about nutritional needs. to reduce risk of giving
birth to NB w/ neural tube defect, include in teaching?
consume foods fortified with folic acid nurse is completing discharge instructions for new
mother and 2 day old NB. mother asks, how will i know if my NB gets enough BF?
appropriate response?
your baby should have 6-9 wet diapers a day
nurse caring for adolescent PT who has PID as consequence of sexually transmitted infection,
will need IV antibiotic therapy. the client tells the nurse, my parents think i am a virgin, I don't
think i can tell them i have this kind of infection. appropriate response?
you seemed scared to talk to your parents nurse is caring for client in prenatal visit, BMI is
26.5, client ask how much weight she should gain during preg. appropriate response?
the recommendation for you is 15-25lbs
BMI
<18.5 - UNDERWT.
18 - 24.9 - NORMAL
25 - 29.9 OVERWT.
>30 - OBESE
nurse caring for client, scheduled for a maternal serum alpha fetoprotein test at 15
wks. explanation about test to client? SCREENING test for spinal defects in fetus
neural tube defects abdominal wall defects microcephaly
anencepaly
basis for possible further testing - Aminiocentesis and specialized ultrasounds
nurse is caring for client who is in preterm labor at 32 weeks . The client asks will my baby be
okay? appropriate response? you must be feeling scared and powerless nurse caring for client
beginning BF after delivery, new mother states, i don't want to take anything for pain because i
am BF, appropriate response? we can time your medication so that you have an hour or two
before next feeding nurse is caring for an antepartum client, lab findings indicate rubella titer.
correct interpretation of this data?
4
NEWBORN
PROCTORED EXAM
QUESTIONS
ANDANSWERS
A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks gest. Which of
the following manifestations should the RN ID as consistent with the diagnosis unilateral,
cramp-like abdominal pain
A nurse in a clinic is assessing a client who is 8 wks gest and has HG. findings to expect?
hx of migraines - first 20 wks
nulliparous - first trimester
twin gestation - increasing levels of estrogen, progesterone, HCG teaching fetal development
to group of clients at antenatal clinic, nurse include in the teaching? the baby's heart beat is
audible by a doppler stethoscope at 12 weeks of preg
sex is determined at conception
lanugo covers fetal body at 20wks and disappears by week 36
,quickening the feeling of fetal movement begins between weeks 14 to 16 in multiparous and
week 18 or later in nulliparous
assessing client at 3 days PP and is breastfeeding. then nurse notes that the fundus is three
fingerbreadths below the umbilicus, lochia rubra is moderate, and the breasts are hard and
warm on palpation. interpretations of these findings? additional intervention is not indicated at
this time. the fundal location and lochia are characteristics w/in normal range. breast
engorgement is typical, breast begin to produce milk. frequent BF and routine care can help
relieve engorgement. nurse in a prenatal clinic is reviewing client record who is 28 weeks of
gest. the hx includes 1 preg, terminated at 9 weeks, birth of twins at 36 weeks, abortion at 15
weeks. What is GTPAL? G 4
T0
P1
A2L2
nurse is teaching client PP and has new RX for injection of RHOGAM, what should be included
in teaching? it prevents formation of RH antibodies in mothers who are RH negative
given at 28week and following future preg Only $1/month teaching a newborn parent to care for
the umbilical cord stump. include which instructions? give sponge bath till cord falls off caring
for newborn, grandmother of the newborn asks if she can take the baby to the mothers room.
Appropriate response? have the mother call and I will take the baby to the room. a nurse
assessing a client who is 8hr PP and multiparous. Which of the following findings should alert
the nurse to the client's need to urinate?
fundus is three fingerbreadths above the umbilicus a nurse in the ED is admitting a pt who is
40 wks gest, has ruptured membranes, nurse observes NB head crowning. Client tells nurse she
wants to push. Correct reply? you should try to pant as the delivery proceeds
panting allows uterine forces to expel the fetus and permits controlled muscle expansion to
avoid rapid expulsion of fetal head a nurse is completing HX for client at 6wks gest. Client
informs the nurse that she smokes one pack of cig a day. the nurse should advise the client that
smoking places the clients NB at risk for...?
IUGR - intrauterine growth restriction placental abruption placenta previa preterm delivery
fetal death a nurse is caring for a client who is PP. nurse should recognize the following as
indication of inhibition of parenteral attachment?
i wish he had more hair, i will keep a hat on his head till he grow some a nurse caring for a
client who delivered a healthy NB via C-section birth. client asks the nurse, is there a chance
that i could deliver my next baby w/out have a c-section. best response?
the primary consideration is what type of incision was performed this time. a nurse is
preparing to administer MgSO4 IV to client, who is experiencing preterm labor. priority
nursing assessment for client?
RR
nurse is caring for a client who is primigravida at term, and having contractions, but stating that
she is not really sure if she is in labor or not. nurse should recognize as a sign of true labor?
change in cervix nurse is planning care for a NB who is SGA, which is priority intervention to
include in care? monitor blood glucose nurse is caring for a client 2 days PP, is BF, and reports
nipple soreness. Which measures would reduce discomfort during BF?
2
,apply BM to nipples before feeding
start on less sore nipple change
infant position on nipple
A nurse is s office is caring for a client who is 34 weeks and at risk for placental abruption. nurse
should recognize which common risk factor for abruption?
HTN
nurse in the ambulatory surgery center is providing discharge teaching to client who had a D&C,
following a spontenous miscarriage. include in the teaching? vaginal intercourse can be resumed
after 2 weeks
patient at 38 weeks, large amount of painless bright red vaginal bleeding. placed on fetal monitor;
indicating FHR of 138/min, no uterine contractions. client vital signs are BP: 98/52, HR 118/min,
RR 24/min, Temp 36.4 - 97.6,. priority action? initiate IV access - large-bore IV catheter
client is losing blood rapidly, HYPOTENSION - TACHYCARDIA - NEED fluids and blood to
be administered IF HYPOVOLEMIA develops
nurse is caring for client, first trimester, ask nurse if she can continue to exercise during
pregnancy. Appropriate response? daily jogging for 30/min/day is fine throughout preg
nurse is caring for a new mother, concerned her NBs eyes cross. therapeutic response?
this occurs because NBs lack muscle control to regulate eye movement nurse in prenatal clinic
is caring for client, first trimester, client tells nurse she is upset, planned pregnancy, but having
doubts and second thoughts. Appropriate response?
ambivalent feelings are quite common for women early in preg nurse on L&D unit, client
having difficult, prolonged labor with severe backache, contributing causes should the nurse
ID?
fetal position is persistent Occiput Posterior nurse is caring for client, 1hr PP, observes large
amount of lochia rubra, several small clots on pad. fundus is midline and firm at the
umbilicus. nurse action to take? document findings and continue to monitor the client.
expected findings.
nurse is caring for client, 1st stage of labor, observes umbilical cord protruding from the vagina.
first action to perform?
insert gloved hand into vagina to relieve pressure on the cord nurse in prenatal clinic, caring for
client at 7 weeks. client reports urinary frequency, asks if this will continue after delivery.
appropriate response?
it occurs during the first trimester and near the end of preg nurse in prenatal clinic, caring for
client suspected of having a hydatidform mole. findings to expect? excessive uterine enlargement
nurse is completing home visit to mother, 3 days PP, BF, mother expresses concern the amount of
weight the newborn lost since birth. response by nurse? this might be related to your baby having
3 stools a day. the NB is being BF typically has 3 or more stools per day during the first few
weeks. a nurse in L&D is caring for client undergoing EFM, nurse observes the FHR begins to
slow after the start of contraction. the lowest rate occurs after the peak of the contraction. first
action by nurse? place the client in the lateral position, LATE DECEL, fetal hypoxemia due to
insufficient placental perfusion. nurse is caring for a preterm newborn who is in an incubator to
maintain neural thermal environment. the father of the NB asks the nurse why is this necessary.
response? preterm NB lack adequate temperature control mechanisms nurse on L& D unit is
caring for client following vaginal exam, by provider which documents, -1, interpret? the present
, part is 1 cm above ischial spine a nurse is providing teaching about KEGELs to group of clients
who are in third trimester. indicates understanding of teaching? these exercises help pelvic
muscles to stretch during birth nurse in prenatal clinic is teaching client, new prescription for
dinoprostone gel. nurse include in the teaching? softens cervix stimulates uterine muscles nurse
caring for client who is in 1st stage of labor, using pattern-paced breathing. client states she feels
lightheaded, fingers are tingling. nurse should ? assist client to breathe into a paper bag nurse
caring for client, considering several methods of contraception, ID as being most reliable? IUD -
intrauterine device nurse providing teaching to client about nutrition, at first prenatal visit.
include in teaching? you will need to double your intake of iron during pregnancy nurse is
instructing woman, contemplating pregnancy about nutritional needs. to reduce risk of giving
birth to NB w/ neural tube defect, include in teaching?
consume foods fortified with folic acid nurse is completing discharge instructions for new
mother and 2 day old NB. mother asks, how will i know if my NB gets enough BF?
appropriate response?
your baby should have 6-9 wet diapers a day
nurse caring for adolescent PT who has PID as consequence of sexually transmitted infection,
will need IV antibiotic therapy. the client tells the nurse, my parents think i am a virgin, I don't
think i can tell them i have this kind of infection. appropriate response?
you seemed scared to talk to your parents nurse is caring for client in prenatal visit, BMI is
26.5, client ask how much weight she should gain during preg. appropriate response?
the recommendation for you is 15-25lbs
BMI
<18.5 - UNDERWT.
18 - 24.9 - NORMAL
25 - 29.9 OVERWT.
>30 - OBESE
nurse caring for client, scheduled for a maternal serum alpha fetoprotein test at 15
wks. explanation about test to client? SCREENING test for spinal defects in fetus
neural tube defects abdominal wall defects microcephaly
anencepaly
basis for possible further testing - Aminiocentesis and specialized ultrasounds
nurse is caring for client who is in preterm labor at 32 weeks . The client asks will my baby be
okay? appropriate response? you must be feeling scared and powerless nurse caring for client
beginning BF after delivery, new mother states, i don't want to take anything for pain because i
am BF, appropriate response? we can time your medication so that you have an hour or two
before next feeding nurse is caring for an antepartum client, lab findings indicate rubella titer.
correct interpretation of this data?
4
