VIRTUAL ATI- maternal
newborn ASSESSMENT
updated version 2024/2025
A nurse is planning to administer phytonadione IM to a newborn shortly after birth. The
nurse should identify that this medication is administered to prevent which of the
following complications?
1. Ophthalmia neonatorum
2. Hemorrhagic disease
3. Hypoglycemia
4. Hypothermia - CORRECT ANSWER 2. Hemorrhagic disease
A nurse is assisting with the care of a client who is in active labor and noted late
deceleration in the fetal heart rate. Which of the following actions should the nurse take
first?
1. Palpate the client's uterus to check for tachysystole
2. Place the client in a side-lying position
3. Administer oxygen at 10 L/min via nonrebreather face mask
4. Increase the rate of the clients IV fluids - CORRECT ANSWER 2. Place the client in a
side-lying position
A nurse is an antepartum clinic is collecting data from a client who is 28 weeks’
gestation. Which of the following findings should the nurse identify as an indication of a
potential complication?
1. Fetal heart rate 120/min
2. Dysuria
3. Leucorrhea
4. Fasting blood glucose 80 mg/dL - CORRECT ANSWER 2. Dysuria
-unexpected finding that can indicate a UTI
A nurse is assisting with the care of a client who is in active stage of labor. For which of
the following findings should the nurse notify the provider?
1. Spontaneous rupture of membranes
2. prolapsed umbilical cord
3. Pink to blood mucus discharge
4. Contraction duration of 60 seconds - CORRECT ANSWER 2. prolapsed umbilical
cord
, A nurse on a postpartum unit is reinforcing teaching with an AP about preventing
newborn abduction. Which of the following information should the nurse include?
1. The AP should use the identification card on the crib to confirm the newborn's identity
2. The AP should allow the newborn to remain in the mother’s room while showering
3. The AP should carry the newborn to the nursery
4. The AP should have their photo identification badge displayed - CORRECT
ANSWER 4. The AP should have their photo identification badge displayed
A nurse is reinforcing discharge teaching about car seat safety with the guardian of a
newborn. Which of the following statements by the guardian demonstrates an
understanding of the teaching?
1. "I will place my baby at a 45-degree angle in the car seat"
2. "I will position the harness retainer clip across my baby’s stomach"
3. "I will keep my baby’s car seat rear facing until she weighs 20lb and is 1 year"
4. "I will place padding under my baby’s back until she reaches 10 lbs." - CORRECT
ANSWER 1. "I will place my baby at a 45-degree angle in the car seat"
A nurse is collecting data from a client who has hyperemesis gravid arum. Which of the
following findings indicates that the client is at risk for dehydration?
1. Hematuria
2. Sodium 140 mEq/L
3. Potassium 3.5 mEq/L
4. Ketonuria - CORRECT ANSWER 4. Ketonuria
A nurse is caring for a postpartum client who has an episiotomy. Which of the following
actions should the nurse take?
1. Apply an anesthetic spray to the client's perineal area as needed for pain
2. Place a donut pillow under the clients when sitting in a chair
3. Apply a moist heat pack to the client's perineal area for 20 min every hour for the first
24 hours
4. Assist the client with changing the perineal pad every 8 hr to expedite healing -
CORRECT ANSWER 1. Apply an anesthetic spray to the client's perineal area as
needed for pain
A nurse is caring for a client who is 16 weeks of gestation and is at risk for developing
hyperemesis gravid arum. Which of the following conditions places the client at an
increased risk of developing this condition?
1. Placenta Previa
2. Hypertension
3. Iron deficiency anemia
4. Diabetes mellitus - CORRECT ANSWER 4. Diabetes mellitus
A nurse is reinforcing teaching about home safety with a client who is postpartum.
Which of the following statements should the nurse include in the teaching?
1. "You should keep the water temp at 110 degrees Fahrenheit for your baby’s bath"
newborn ASSESSMENT
updated version 2024/2025
A nurse is planning to administer phytonadione IM to a newborn shortly after birth. The
nurse should identify that this medication is administered to prevent which of the
following complications?
1. Ophthalmia neonatorum
2. Hemorrhagic disease
3. Hypoglycemia
4. Hypothermia - CORRECT ANSWER 2. Hemorrhagic disease
A nurse is assisting with the care of a client who is in active labor and noted late
deceleration in the fetal heart rate. Which of the following actions should the nurse take
first?
1. Palpate the client's uterus to check for tachysystole
2. Place the client in a side-lying position
3. Administer oxygen at 10 L/min via nonrebreather face mask
4. Increase the rate of the clients IV fluids - CORRECT ANSWER 2. Place the client in a
side-lying position
A nurse is an antepartum clinic is collecting data from a client who is 28 weeks’
gestation. Which of the following findings should the nurse identify as an indication of a
potential complication?
1. Fetal heart rate 120/min
2. Dysuria
3. Leucorrhea
4. Fasting blood glucose 80 mg/dL - CORRECT ANSWER 2. Dysuria
-unexpected finding that can indicate a UTI
A nurse is assisting with the care of a client who is in active stage of labor. For which of
the following findings should the nurse notify the provider?
1. Spontaneous rupture of membranes
2. prolapsed umbilical cord
3. Pink to blood mucus discharge
4. Contraction duration of 60 seconds - CORRECT ANSWER 2. prolapsed umbilical
cord
, A nurse on a postpartum unit is reinforcing teaching with an AP about preventing
newborn abduction. Which of the following information should the nurse include?
1. The AP should use the identification card on the crib to confirm the newborn's identity
2. The AP should allow the newborn to remain in the mother’s room while showering
3. The AP should carry the newborn to the nursery
4. The AP should have their photo identification badge displayed - CORRECT
ANSWER 4. The AP should have their photo identification badge displayed
A nurse is reinforcing discharge teaching about car seat safety with the guardian of a
newborn. Which of the following statements by the guardian demonstrates an
understanding of the teaching?
1. "I will place my baby at a 45-degree angle in the car seat"
2. "I will position the harness retainer clip across my baby’s stomach"
3. "I will keep my baby’s car seat rear facing until she weighs 20lb and is 1 year"
4. "I will place padding under my baby’s back until she reaches 10 lbs." - CORRECT
ANSWER 1. "I will place my baby at a 45-degree angle in the car seat"
A nurse is collecting data from a client who has hyperemesis gravid arum. Which of the
following findings indicates that the client is at risk for dehydration?
1. Hematuria
2. Sodium 140 mEq/L
3. Potassium 3.5 mEq/L
4. Ketonuria - CORRECT ANSWER 4. Ketonuria
A nurse is caring for a postpartum client who has an episiotomy. Which of the following
actions should the nurse take?
1. Apply an anesthetic spray to the client's perineal area as needed for pain
2. Place a donut pillow under the clients when sitting in a chair
3. Apply a moist heat pack to the client's perineal area for 20 min every hour for the first
24 hours
4. Assist the client with changing the perineal pad every 8 hr to expedite healing -
CORRECT ANSWER 1. Apply an anesthetic spray to the client's perineal area as
needed for pain
A nurse is caring for a client who is 16 weeks of gestation and is at risk for developing
hyperemesis gravid arum. Which of the following conditions places the client at an
increased risk of developing this condition?
1. Placenta Previa
2. Hypertension
3. Iron deficiency anemia
4. Diabetes mellitus - CORRECT ANSWER 4. Diabetes mellitus
A nurse is reinforcing teaching about home safety with a client who is postpartum.
Which of the following statements should the nurse include in the teaching?
1. "You should keep the water temp at 110 degrees Fahrenheit for your baby’s bath"
