ATI Maternal Newborn Proctored Exam B 2019 – Practice Guide
60 Correct Questions & Answers
1. a nurse is caring for a client who is pregnant and is at the end of her first trimester. The nurse should
place the doppler ultrasound stethoscope in which of the following locations to begin assessing for the
fetal heart tones?
Just above the umbilicus: The nurse should assess FHT using the Doppler stethoscope just above the
umbilicus if the fetus is in a transverse or breech presentation and the client is at a minimum of 22 weeks of
gestation.
Just above the symphysis pubis: At the end of the first trimester of pregnancy, the client's uterus is
approximately the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis
pubis. Therefore, the nurse should begin assessing for FHT just above the symphysis pubis.
The right lower quadrant: At the end of the first trimester of pregnancy, the client's uterus is approximately
the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore, the
nurse might not hear FHT in the right lower quadrant.
The left lower quadrant: At the end of the first trimester of pregnancy, the client's uterus is approximately
the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore, the
nurse might not hear FHT in the left lower quadrant.
3. a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura.
Which of the following findings should the nurse expect?
Decreased platelet count: A client who has ITP has an autoimmune response that results in a
decreased platelet count.
Increased erythrocyte sedimentation rate (ESR): An increased ESR is an indication of chronic renal failure.
Decreased megakaryocytes: A client who has ITP will have megakaryocytes within the expected reference
range.
Increased WBC: An increased WBC is an indication of infection.
4. a nurse is assessing a newborn for manifestations of hypoglycemia, which of the following
findings should the nurse expect?
Jitteriness: Jitteriness, tachypnea, retractions, nasal flaring, lethargy, temperature instability, apnea,
abnormal cry, poor feeding, and seizures are expected findings of hypoglycemia. Newborns who are
small or large for gestational age and late preterm newborns are at an increased risk for hypoglycemia.
Hypertonia: Hypotonia, rather than hypertonia, is a manifestation of hypoglycemia. Hypertonia is a
manifestation of opioid withdrawal.
Abdominal distention: Abdominal distention is not a manifestation of hypoglycemia. Abdominal distention
is a finding in newborns who have hypocalcemia.
Mottling: Mottling is not a manifestation of hypoglycemia. It can be a normal variation seen in newborns.
Also, it is a manifestation of opioid withdrawal.
5. a nurse in a women’s health clinic is providing teaching about nutritional intake to a client who is at
8 weeks of gestation. The nurse should instruct the client to increase her daily intake of which of the
following nutrients?
,Calcium: The recommendation for calcium intake during pregnancy is the same as that for women who are
, not pregnant: 1,300 mg/day for women younger than 19 years old and 1,000 mg/day for women between the
ages of 19 and 50 years old.
Vitamin E: The recommendation for vitamin E intake during pregnancy is 15 mg/day, the same as that for
women who are not pregnant.
Iron: The recommendation for iron intake during pregnancy is higher than that for women who are
not pregnant. For women who are pregnant, it is 27 mg/day. For women who are not pregnant, it is 15
mg/day for women younger than 19 years old and 18 mg/day for women between the ages of 19 and 50
years old.
Vitamin D: The recommendation for vitamin D intake during pregnancy is 600 IU/day, the same as that for
women who are not pregnant.
6. a nurse is teaching a new parent about newborn safety. Which of the following instructions should
the nurse include in the teachings?
"You can share your room with your baby for the next few weeks.": The nurse should
recommend room-sharing during the first few weeks. This allows the parent to be readily available to
the newborn and learn the newborn's cues. However, the nurse should instruct the parent to avoid
placing the newborn in their bed as it increases the risk for sudden infant death syndrome.
"Cover your baby with a light blanket while sleeping.": The nurse should instruct the parents to place the
newborn in a sleep sack or a one-piece sleeper. Covering the newborn with a blanket or quilt increases the risk
for sudden infant death syndrome.
"Check the temperature of your baby's bath water with your hand.": The nurse should instruct the parents to
check the temperature of the newborn's bath water with their elbow, which is more sensitive to temperature
than the hand. The hot water heater should be set at or below 49° C (120.2° F) to prevent burns.
"Your baby can nap in the car seat during the daytime.": The nurse should instruct the parents to lay the
newborn in a bassinet or crib on her back to sleep. Sleeping in a supine position on a firm mattress decreases the
risk of sudden infant death syndrome.
7. a nurse is providing teaching about family planning to a client who has a new prescription for
a diaphragm, which of the following statements should the nurse include in the teaching?
"You should replace the diaphragm every 5 years.": The client should replace the diaphragm every 2 years.
"You should leave the diaphragm in place for at least 6 hours after intercourse.": The client should
keep the diaphragm in place for at least 6 hr after intercourse to provide protection against pregnancy.
"You should use an oil-based product as a lubricant when inserting the diaphragm.": The client should avoid
using oil-based products because they can weaken the rubber in the diaphragm.
"You should insert the diaphragm when your bladder is full.": The client should have an empty bladder
prior to inserting the diaphragm.
8. a nurse is reviewing the medical record of a client who is postpartum and has preeclampsia. Which
of the following laboratory results should the nurse report to the provider?
Hct 39%: An Hct of 39% is within the expected reference range and does not indicate a postpartum
complication.
60 Correct Questions & Answers
1. a nurse is caring for a client who is pregnant and is at the end of her first trimester. The nurse should
place the doppler ultrasound stethoscope in which of the following locations to begin assessing for the
fetal heart tones?
Just above the umbilicus: The nurse should assess FHT using the Doppler stethoscope just above the
umbilicus if the fetus is in a transverse or breech presentation and the client is at a minimum of 22 weeks of
gestation.
Just above the symphysis pubis: At the end of the first trimester of pregnancy, the client's uterus is
approximately the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis
pubis. Therefore, the nurse should begin assessing for FHT just above the symphysis pubis.
The right lower quadrant: At the end of the first trimester of pregnancy, the client's uterus is approximately
the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore, the
nurse might not hear FHT in the right lower quadrant.
The left lower quadrant: At the end of the first trimester of pregnancy, the client's uterus is approximately
the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore, the
nurse might not hear FHT in the left lower quadrant.
3. a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura.
Which of the following findings should the nurse expect?
Decreased platelet count: A client who has ITP has an autoimmune response that results in a
decreased platelet count.
Increased erythrocyte sedimentation rate (ESR): An increased ESR is an indication of chronic renal failure.
Decreased megakaryocytes: A client who has ITP will have megakaryocytes within the expected reference
range.
Increased WBC: An increased WBC is an indication of infection.
4. a nurse is assessing a newborn for manifestations of hypoglycemia, which of the following
findings should the nurse expect?
Jitteriness: Jitteriness, tachypnea, retractions, nasal flaring, lethargy, temperature instability, apnea,
abnormal cry, poor feeding, and seizures are expected findings of hypoglycemia. Newborns who are
small or large for gestational age and late preterm newborns are at an increased risk for hypoglycemia.
Hypertonia: Hypotonia, rather than hypertonia, is a manifestation of hypoglycemia. Hypertonia is a
manifestation of opioid withdrawal.
Abdominal distention: Abdominal distention is not a manifestation of hypoglycemia. Abdominal distention
is a finding in newborns who have hypocalcemia.
Mottling: Mottling is not a manifestation of hypoglycemia. It can be a normal variation seen in newborns.
Also, it is a manifestation of opioid withdrawal.
5. a nurse in a women’s health clinic is providing teaching about nutritional intake to a client who is at
8 weeks of gestation. The nurse should instruct the client to increase her daily intake of which of the
following nutrients?
,Calcium: The recommendation for calcium intake during pregnancy is the same as that for women who are
, not pregnant: 1,300 mg/day for women younger than 19 years old and 1,000 mg/day for women between the
ages of 19 and 50 years old.
Vitamin E: The recommendation for vitamin E intake during pregnancy is 15 mg/day, the same as that for
women who are not pregnant.
Iron: The recommendation for iron intake during pregnancy is higher than that for women who are
not pregnant. For women who are pregnant, it is 27 mg/day. For women who are not pregnant, it is 15
mg/day for women younger than 19 years old and 18 mg/day for women between the ages of 19 and 50
years old.
Vitamin D: The recommendation for vitamin D intake during pregnancy is 600 IU/day, the same as that for
women who are not pregnant.
6. a nurse is teaching a new parent about newborn safety. Which of the following instructions should
the nurse include in the teachings?
"You can share your room with your baby for the next few weeks.": The nurse should
recommend room-sharing during the first few weeks. This allows the parent to be readily available to
the newborn and learn the newborn's cues. However, the nurse should instruct the parent to avoid
placing the newborn in their bed as it increases the risk for sudden infant death syndrome.
"Cover your baby with a light blanket while sleeping.": The nurse should instruct the parents to place the
newborn in a sleep sack or a one-piece sleeper. Covering the newborn with a blanket or quilt increases the risk
for sudden infant death syndrome.
"Check the temperature of your baby's bath water with your hand.": The nurse should instruct the parents to
check the temperature of the newborn's bath water with their elbow, which is more sensitive to temperature
than the hand. The hot water heater should be set at or below 49° C (120.2° F) to prevent burns.
"Your baby can nap in the car seat during the daytime.": The nurse should instruct the parents to lay the
newborn in a bassinet or crib on her back to sleep. Sleeping in a supine position on a firm mattress decreases the
risk of sudden infant death syndrome.
7. a nurse is providing teaching about family planning to a client who has a new prescription for
a diaphragm, which of the following statements should the nurse include in the teaching?
"You should replace the diaphragm every 5 years.": The client should replace the diaphragm every 2 years.
"You should leave the diaphragm in place for at least 6 hours after intercourse.": The client should
keep the diaphragm in place for at least 6 hr after intercourse to provide protection against pregnancy.
"You should use an oil-based product as a lubricant when inserting the diaphragm.": The client should avoid
using oil-based products because they can weaken the rubber in the diaphragm.
"You should insert the diaphragm when your bladder is full.": The client should have an empty bladder
prior to inserting the diaphragm.
8. a nurse is reviewing the medical record of a client who is postpartum and has preeclampsia. Which
of the following laboratory results should the nurse report to the provider?
Hct 39%: An Hct of 39% is within the expected reference range and does not indicate a postpartum
complication.
