ATI MATERNAL NEWBORN PROCTORED EXAM 2019 GRADED A
1. A charge nurse is teaching a group of staff nurses about fetal monitoring during
labor. Which of the following findings should the charge nurse instruct the staff
nurses to report to the provider?
A. Contraction durations of 95 to 100 seconds
B. Fetal heart rate is 140/min
C. Absent early deceleration of fetal heart rate
D. Contraction frequency of 2 to 2 min apart
A fetal heart rate is higher than the normal adult people and can lie between 110 to 160 beats
per minute. The fetus might not show signs of early decelerations, or late or variable
decelerations. A normal contraction should lie in between the 45-60 seconds, any contraction
that lasts longer than the 60 seconds or more than 90 seconds puts excess stress on the fetus
and is considered abnormal. The nurses should report if the duration of contraction is 95 to 100
seconds.
2. A nurse is assisting the provider to administer a dinoprostone insert labor for a
client. Which of the following actions should the nurse take?
A. Place the client in semi-lower position for 1hr after administration
B. Verify that informed consent is obtained prior to administration
C. Allow the medication to reach room temperature prior to administration
D. Instruct the client to avoid urinary elimination until after administration
Dinoprostone is administered several hours before administrating oxytocin to induce labor.
It is administered either through a syringe or direct insertion into the vagina of the person.
The patient is asked to remain in the supine or semi-lower position for 1-2 hours after
administration of the drug.
3. A nurse is planning to teach a group of clients who are pregnant about
breastfeeding after returning to work. Which of the following information should the
nurse include in the teaching?
A. "Thawed breast milk can be refrigerated for up to 72 hours."
B. "Breast milk can be stored in a deep freezer for 12 months."
C. "Breast milk can be stored at room temperature for up to 12 hours."
D. "Thawed breast milk that is unused can be refrozen."
Breast milk is pumped and collected in a milk bottle using a breast pump. A freshly pumped
breast milk is fit to store at room temperature for only up to 4 hours, and up to 12 months in the
deep freezer. Breastmilk once thawed after freezing is not fit for consumption and is to be
discarded.
4. A nurse is caring for a 2-day-old newborn who was born at 35 weeks of gestation.
Which of the following actions should the nurse take?
A. Measure the abdominal circumference at the level for the newborn's umbilicus ever 12
hr.
, B. Administer nitric oxide inhalation therapy to the newborn
C. Provide the newborn with an iron-rich formula containing vitamin B12 every 2 hr
D. Inset an orogastric decompression tube with low wall suction
A baby born at 35 weeks of gestation is considered preterm and might be unable to
consume food through the mouth and requires feeding through orogastric intubation. They
require feeding tube for consumption of food.
5. A nurse is providing teaching about terbutaline to a client who is experiencing
preterm labor. Which of the following statements by the client indicates an
understanding of the teaching?
A. "This medication could cause me to experience ringing in my ears."
B. "This medication could cause me to experience frequent urination."
C. "This medication could cause me to experience blurred vision."
D. "This medication could cause me to experience heart palpitations."
Terbutaline is generally recommended for asthma or bronchoconstriction and is also used
for preventing the occurrence of preterm labor. Some of the serious adverse reactions that
can occur in pregnant women include heart palpitations, high blood sugar, and pulmonary
edema.
6. A nurse is caring for a newborn who is 6 hr old and has a bedside glucometer
reading of 65 mg/dL. The newborn's mother has type 2 diabetes mellitus. Which of
the following actions should the nurse take?
A. Obtain a blood sample for a serum glucose level
B. Reassess the blood glucose level prior to the next feeding
C. Administer 50 mL of dextrose solution IV
D. Feed the newborn immediately
A baby at the time of birth has a low blood glucose level as low as 30 mg/dl and gradually
increases to 54 to 72 mg/dl. As the mother is also diabetic, there might be a possibility of a
baby's blood sugar to rise more than the normal range, so it is necessary to assess the
blood sugar level before administrating the next feeding.
7. A nurse is teaching a prenatal class regarding false labor. Which of the following
information should the nurse include?
A. "You will have bloody show."
B. "You will have dilation and effacement of the cervix."
C. "Your contractions will become more intense when walking."
D. "Your contractions will become temporarily regular."
False labor is a feeling of occurrence of labor in the patient but the contractions do not lead
to the actual delivery of the baby. False labor includes contractions occurring in a sporadic
and irregular pattern, and there is no fixed duration of the contractions. The contractions in
the false labor changes with activity and might cease even without any changes in the
activity, while in true labor the contractions intensify during activities.
1. A charge nurse is teaching a group of staff nurses about fetal monitoring during
labor. Which of the following findings should the charge nurse instruct the staff
nurses to report to the provider?
A. Contraction durations of 95 to 100 seconds
B. Fetal heart rate is 140/min
C. Absent early deceleration of fetal heart rate
D. Contraction frequency of 2 to 2 min apart
A fetal heart rate is higher than the normal adult people and can lie between 110 to 160 beats
per minute. The fetus might not show signs of early decelerations, or late or variable
decelerations. A normal contraction should lie in between the 45-60 seconds, any contraction
that lasts longer than the 60 seconds or more than 90 seconds puts excess stress on the fetus
and is considered abnormal. The nurses should report if the duration of contraction is 95 to 100
seconds.
2. A nurse is assisting the provider to administer a dinoprostone insert labor for a
client. Which of the following actions should the nurse take?
A. Place the client in semi-lower position for 1hr after administration
B. Verify that informed consent is obtained prior to administration
C. Allow the medication to reach room temperature prior to administration
D. Instruct the client to avoid urinary elimination until after administration
Dinoprostone is administered several hours before administrating oxytocin to induce labor.
It is administered either through a syringe or direct insertion into the vagina of the person.
The patient is asked to remain in the supine or semi-lower position for 1-2 hours after
administration of the drug.
3. A nurse is planning to teach a group of clients who are pregnant about
breastfeeding after returning to work. Which of the following information should the
nurse include in the teaching?
A. "Thawed breast milk can be refrigerated for up to 72 hours."
B. "Breast milk can be stored in a deep freezer for 12 months."
C. "Breast milk can be stored at room temperature for up to 12 hours."
D. "Thawed breast milk that is unused can be refrozen."
Breast milk is pumped and collected in a milk bottle using a breast pump. A freshly pumped
breast milk is fit to store at room temperature for only up to 4 hours, and up to 12 months in the
deep freezer. Breastmilk once thawed after freezing is not fit for consumption and is to be
discarded.
4. A nurse is caring for a 2-day-old newborn who was born at 35 weeks of gestation.
Which of the following actions should the nurse take?
A. Measure the abdominal circumference at the level for the newborn's umbilicus ever 12
hr.
, B. Administer nitric oxide inhalation therapy to the newborn
C. Provide the newborn with an iron-rich formula containing vitamin B12 every 2 hr
D. Inset an orogastric decompression tube with low wall suction
A baby born at 35 weeks of gestation is considered preterm and might be unable to
consume food through the mouth and requires feeding through orogastric intubation. They
require feeding tube for consumption of food.
5. A nurse is providing teaching about terbutaline to a client who is experiencing
preterm labor. Which of the following statements by the client indicates an
understanding of the teaching?
A. "This medication could cause me to experience ringing in my ears."
B. "This medication could cause me to experience frequent urination."
C. "This medication could cause me to experience blurred vision."
D. "This medication could cause me to experience heart palpitations."
Terbutaline is generally recommended for asthma or bronchoconstriction and is also used
for preventing the occurrence of preterm labor. Some of the serious adverse reactions that
can occur in pregnant women include heart palpitations, high blood sugar, and pulmonary
edema.
6. A nurse is caring for a newborn who is 6 hr old and has a bedside glucometer
reading of 65 mg/dL. The newborn's mother has type 2 diabetes mellitus. Which of
the following actions should the nurse take?
A. Obtain a blood sample for a serum glucose level
B. Reassess the blood glucose level prior to the next feeding
C. Administer 50 mL of dextrose solution IV
D. Feed the newborn immediately
A baby at the time of birth has a low blood glucose level as low as 30 mg/dl and gradually
increases to 54 to 72 mg/dl. As the mother is also diabetic, there might be a possibility of a
baby's blood sugar to rise more than the normal range, so it is necessary to assess the
blood sugar level before administrating the next feeding.
7. A nurse is teaching a prenatal class regarding false labor. Which of the following
information should the nurse include?
A. "You will have bloody show."
B. "You will have dilation and effacement of the cervix."
C. "Your contractions will become more intense when walking."
D. "Your contractions will become temporarily regular."
False labor is a feeling of occurrence of labor in the patient but the contractions do not lead
to the actual delivery of the baby. False labor includes contractions occurring in a sporadic
and irregular pattern, and there is no fixed duration of the contractions. The contractions in
the false labor changes with activity and might cease even without any changes in the
activity, while in true labor the contractions intensify during activities.
