ATI MATERNAL NEWBORN QUIZ BANK - LATEST STUDY GUIDE

ATI MATERNAL NEWBORN QUIZ BANK - LATEST STUDY GUIDE 1. A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of the following is the correct interpretation of this data? a. The client is not experiencing a rubella infection at this time. b. The client is immune to the rubella virus. c. The client requires a rubella vaccination at this time. d. The client requires a rubella immunization following delivery. 3. A nurse is teaching a client who is at 23 weeks of gestation about immunizations. Which of the following statements should the nurse include in the teaching? a. "You should not receive the rubella vaccine while breastfeeding." b. "You should receive a vaccine before you deliver." c. "You can receive an influenza vaccination during pregnancy." i. It is recommended that pregnant women receive annual influenza vaccinations. d. "You cannot receive the Tdap vaccine until after you deliver." 4. The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above pre-pregnancy levels? a. Glucose b. Fibrinogen c. Hematocrit d. Bilirubin 5. A nurse is caring for a client who has a positive pregnancy test. The nurse is teaching the client about common discomforts in the first trimester of pregnancy as well as warning signs of potential danger. The nurse should instruct the client to call the clinic if she experiences which of the following manifestations? a. Leukorrhea b. Urinary frequency c. Nausea and vomiting d. Facial edema 6. A nurse is providing teaching about Kegel exercises to a group of clients who are in the third trimester of pregnancy. Which of the following statements by a client indicates understanding of the teaching? a. "These exercises help prevent constipation." b. "These exercises help pelvic muscles to stretch during birth." i. Kegel exercises improve the strength of perineal muscles, facilitating stretching and contracting during childbirth. c. "They can help reduce back aches." d. "They can prevent further stretch marks." 7. A nurse is caring for a client who is in her first trimester of pregnancy and asks the nurse if she can continue to exercise during pregnancy. Which of the following responses by the nurse is appropriate? a. "Exercising during pregnancy is not recommended." b. "Daily jogging for up to 30 minutes is fine throughout the pregnancy." i. While weight-bearing exercises might become uncomfortable in the last trimester, they are generally not contraindicated, providing the client stays hydrated and avoids becoming overheated for extended periods. c. "Activities that raise the body temperature, such as saunas and hot tubs, are safe until the third trimester." d. "It is recommended that pregnant clients limit their exercise routine to stretching activities on a mat several times a week." 8. A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client's current status? a. 4-0-1-2-2 i. This response correctly describes the client's current status: pregnant currently and had 3 prior pregnancies (G); no term births (T); one pregnancy resulted in the preterm birth (P) of twins; two pregnancies ended in abortion (A); and she has two living children (L). b. 3-0-2-0-2 c. 2-0-0-2-0 d. 4-2-0-2-2 9. A nurse is teaching a group of patients who are in their first trimester about exercise during pregnancy. Which of the following statements should the nurse include in the teaching? a. "Refrain from exercises that include stretching." b. "It is recommended to rest for 30 minutes before each new exercise." c. "It is recommended to increase your weight-bearing exercises." d. "Moderate exercise improves circulation." i. Improving circulation is just one of the many benefits of moderate exercise during pregnancy. It enhances well-being, promotes rest and relaxation, and improves muscle tone. 10. A nurse in a prenatal clinic is caring for a patient who asks what her estimated date of delivery will be if her last menstrual period was May 4, 2015. Which of the following is the appropriate response by the nurse? a. April 27, 2016 b. February 27, 2016 c. February 11, 2016 i. Subtracting 3 calendar months and adding 7 days plus one year will result in this estimated date of delivery. d. April 11, 2016 11. A nurse is caring for a patient during the first trimester of pregnancy. After reviewing the patient's blood work, the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella immunization? a. Shortly after giving birth i. The rubella immunization should be offered to the client following birth, preferably prior to discharge from the hospital. This prevents the client from contracting rubella during the current or subsequent pregnancies, which would put her fetus at risk for rubella syndrome. b. In the third trimester c. Immediately d. During her next attempt to get pregnant 12. A nurse is caring for a patient who is gravida 3, para 2, and is in active labor. The fetal head is at 3+ station after a vaginal examination. Which of the following actions should the nurse take? a. Apply fundal pressure. b. Observe for the presence of a nuchal cord. c. Observe for crowning. i. In the descent phase of the second stage of labor, crowning occurs when the fetal head is at +2 to +4 station. Because this is the client's third childbirth experience, it is reasonable to assume that delivery is imminent. d. Prepare to administer oxytocin. 13. A nurse on the labor and delivery unit is caring for a patient following a vaginal examination by the provider which is documented as: -1. Which of the following interpretations of this finding should the nurse make? a. The presenting part is 1 cm above the ischial spines. i. Station is the relation of the presenting part to the ischial spines of the maternal pelvis and is measured in centimeters above, below, or at the level of the spines. If the station is minus 1, then the presenting part is 1cm above the ischial spines. b. The presenting part is 1 cm below the ischial spines. c. The cervix is 1 cm dilated. d. The cervix is effaced 1 cm 14. A nurse midwife is examining a patient who is a primigravida at 42 weeks of gestation and states that she believes she is in labor. Which of the following findings confirm to the nurse that the patient is in labor? a. Amniotic fluid in the vaginal vault b. Brownish vaginal discharge c. Report of pain above the umbilicus d. Cervical dilation i. Cervical dilation and effacement are indications of true labor. 15. A nurse is caring for a patient who is in the active phase of the first stage of labor. When monitoring the uterine contractions, which of the following findings should the nurse report to the provider? a. Contractions occurring every 3 to 5 min b. Contractions are strong in intensity c. Contractions lasting longer than 90 seconds d. Client reports feeling contractions in lower back 16. A nurse is admitting a client who is at 38 weeks of gestation and is in the first stage of labor. Which of the following assessment findings should the nurse report to the provider first? a. Expulsion of a blood-tinged mucous plug b. Continuous contraction lasting 2 min i. A uterus contracting for more than 90 seconds is a sign of tetany and could lead to uterine rupture, which is the greatest risk to the client at this time. The nurse should report this finding immediately c. Pressure on the perineum causing the client to bear down d. Expulsion of clear fluid from the vagina 17. A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse? a. "This will determine is there is more than one fetus." b. "It is useful for estimating fetal age." c. "It assists in identifying the location of the placenta and fetus." i. Identifying the positions of the fetus, placenta, and amniotic fluid pockets immediately prior to the amniocentesis increases the safety of this test by assisting with correct placement of the needle. d. "This is a screening tool for spina bifida." 18. A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1min and a frequency of 3min. The nurse obtains the following vitals: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 92/54mmHg. Which of the following is the priority action for the nurse to take? a. Notify the provider of the findings. b. Position the client with one hip elevated. i. Based on Maslow's hierarchy of needs, the client's need for an adequate blood pressure to perfuse herself and her fetus is a physiological need that requires immediate intervention. Supine hypotension is a frequent cause of low blood pressure in clients who are pregnant. By turning the client on her side and retaking her blood pressure, the nurse is attempting to correct the low blood pressure and reassess. c. Ask the client if she needs pain medication. d. Have the client void. 19. A nurse is caring for a client who is at 40 weeks gestation and is in active labor. The client has 6cm of cervical dilation and 100% cervical effacement. The nurse obtains the client's blood pressure reading as 82/52mmHg. Which of the following nursing interventions should the nurse perform? a. Prepare for a cesarean birth. b. Assist the client to an upright position. c. Prepare for an immediate vaginal delivery. d. Assist the client to turn onto her side. i. Maternal hypotension results from the pressure of the enlarged uterus on the inferior vena cava. Turning the client to her right side relieves this pressure and restores blood pressure to the expected reference range. 20. A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate is 130 to 150/min, but there has been no fetal movement for 15min. Which of the following actions should the nurse perform? a. Immediately report the situation to the client's provider and prepare the client for induction of labor. b. Encourage the client to walk around without the monitoring unit for 10min, then resume monitoring. c. Offer the client a snack of orange juice and crackers. i. A nonstress test depends upon fetal movement, and this fetus is most likely asleep. Most fetuses are more active after meals due to the increase in the mother's blood sugar. Giving the mother a snack will promote fetal movement. d. Turn the client onto her left side. 21. A nurse in a prenatal clinic is caring for a client who is at 38 weeks gestation and undergoing a contraction stress test. The test results are negative. Which of the following interpretations of this finding should the nurse make? a. There is no evidence of cervical incompetence. b. There is no evidence of two or more accelerations in fetal heart rate in 20 min. c. There is no evidence of uteroplacental insufficiency. i. A contraction stress test determines how well the fetus tolerates the stress of uterine contractions. A test is negative when there are at least 3 uterine contractions in a 10-min period with no late or significant variable decelerations during electronic fetal monitoring. Uteroplacental insufficiency produces late decelerations. d. There are less than 3 uterine contractions in a 10 min period. 22. A nurse in a prenatal clinic is instructing a client about an amniocentesis, which is scheduled at 15 weeks of gestation. Which of the following should be included in the teaching? a. "The test will be performed if your baby's heartbeat is heard." b. "This test will determine if your baby's lungs are mature." c. "This test requires the presence of amniotic fluid." i. Amniocentesis requires adequate amniotic fluid for testing, which is not available until after 14 weeks of gestation. d. "After the test, you will be given Rh0 immune globulin since you are Rh positive." 23. A nurse is caring for a client who is scheduled for a maternal serum-alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client? a. This test assesses fetal lung maturity. b. It assesses various markers of fetal well-being. c. This test identifies an Rh incompatibility between the mother and fetus. d. It is a screening test for spinal defects in the fetus. i. The maternal serum alpha-fetoprotein (MSAFP) screening test is used to identify suspected neural tube defects (NTDs) and abdominal wall defects. These include spina bifida, microcephaly, and anencephaly. This tool is the basis for further testing, such as amniocentesis and specialized ultrasounds. 24. A nurse is caring for a client who is primigravida, at term, and having contractions but is statins that she is "not really sure if she is in labor or not." Which of the following should the nurse recognize as a sign of true labor? a. Rupture of the membranes b. Changes in the cervix i. Assessment of progressive changes in the effacement and dilation of the cervix is the most accurate indication of true labor. c. Station of the presenting part d. Pattern of contractions 25. A nurse is caring for a client who is in active labor with 7cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client's amniotic membranes are intact. The client suddenly states that she needs to push. Which of the following actions should the nurse take? a. Assist the client into a comfortable position. b. Observe the perineum for signs of crowning. c. Have the client pant during the next contractions. i. Panting is rapid, continuous, shallow breathing. It helps a client in labor refrain from pushing before her cervix reaches full dilation. Observe for hyperventilation and have the client exhale slowly through pursed lips. d. Help the client to the bathroom to void. 26. A nurse is caring for a client who is in the first stage of labor and is using pattern-paced breathing. The client says she feels light-headed, and her fingers are tingling. Which of the following actions should the nurse take? a. Administer oxygen via nasal cannula. b. Assist the client to breathe into a paper bag. i. This client is experiencing respiratory alkalosis due to hyperventilation. The client should be assisted to breathe into a paper bag or to cup her hands over her mouth to increase the carbon dioxide level, which replaces the bicarbonate ion. c. Have the client tuck her chin to her chest. d. Instruct the client to increase her respiratory rate to more than 42 breaths per min. 27. A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during this test. Which of the following should the nurse include? (SATA) a. Fetal breathing b. Fetal motion c. Fetal neck translucency d. Amniotic fluid volume i. A biophysical profile is an assessment of fetal well-being and includes ultrasound evaluation of fetal breathing movements, gross fetal movements, and amniotic fluid volume. A biophysical profile is an assessment of fetal well-being and includes ultrasound evaluation of fetal breathing movements, gross fetal movements, and amniotic fluid volume. A biophysical profile is an assessment of fetal well-being and includes ultrasound evaluation of fetal breathing movements, gross fetal movements, and amniotic fluid volume e. Fetal gender 28. A nurse admits a woman who is at 38 weeks of gestation and in early labor with ruptured membranes. The nurse determines that the client's oral temperature is 38.9C/102F. Besides notifying the provider, which of the following is the appropriate nursing action? a. Recheck the client's temperature in 4 hr. b. Administer glucocorticoids intramuscularly. c. Assess the odor of the amniotic fluid. i. Chorioamnionitis is an infection of the amniotic cavity that presents with maternal fever, tachycardia, increased uterine tenderness, and foul-smelling amniotic fluid. d. Prepare the client for emergency cesarean section. 29. A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha-fetoprotein (MSAFP) screening for which of the following clients? a. A client who has mitral valve prolapse b. A client who has been exposed to AIDS c. All of the clients i. MSAFP is a screening tool to detect open spinal and abdominal wall defects in the fetus. This maternal blood test is recommended for all pregnant woman d. A client who has a history of preterm labor. 30. A nurse in a clinic is caring for a client who is at 39 weeks of gestation and who asks about the signs that precede the onset of labor. Which of the following should the nurse identify as a sign that precedes labor? a. Decreased vaginal discharge b. A surge of energy i. Prior to the onset of labor, the pregnant client experiences a surge of energy. c. Urinary retention d. Weight gain of 0.5 to 1.5 kg 31. A nurse is caring for a client who is in labor and has an epidural anesthesia block. The client's blood pressure is 80/40 mm Hg, and the fetal heart rate is 140/min. Which of the following is the priority nursing action? a. Elevate the client's legs. b. Monitor vital signs every 5 min. c. Notify the provider. d. Place the client in a lateral position. CONTINUED................DOWNLOAD FOR BEST SCORES