LPN LPN
Maternal Newborn ATI Proctored Exam
1. When caring for a client suspected of having hyperemesis gravidarum, which finding is a manifestation of this condition?
- A. Hgb 12.2 g/dL
- B. Urine ketones present
- C. Alanine aminotransferase 20 IU/L
- D. Blood glucose 114 mg/dL
Correct answer: B
Rationale: The correct answer is B: Urine ketones present. The presence of urine ketones indicates dehydration, which is a common manifestation of hyperemesis gravidarum. Hyperemesis gravidarum is characterized by severe nausea, vomiting, weight loss, and electrolyte imbalances due to dehydration. Monitoring for ketonuria helps assess the degree of dehydration in clients with this condition. Choices A, C, and D are incorrect because hemoglobin level, alanine aminotransferase level, and blood glucose level are not specific manifestations of hyperemesis gravidarum. While these laboratory values may be abnormal in some cases, they are not typically used to diagnose or assess the condition.
2. When caring for clients in a prenatal clinic, a nurse should report which client's weight gain to the provider?
- A. 1.8 kg (4 lb) weight gain in the first trimester
- B. 3.6 kg (8 lb) weight gain in the first trimester
- C. 6.8 kg (15 lb) weight gain in the second trimester
- D. 11.3 kg (25 lb) weight gain in the third trimester
Correct answer: B
Rationale: A weight gain of 3.6 kg (8 lb) in the first trimester is excessive and should be reported to the provider for further evaluation. Excessive weight gain in the first trimester can be a sign of potential issues that need monitoring and intervention to ensure the well-being of both the mother and the baby. Choices A, C, and D represent weight gains that are within normal ranges for the respective trimesters and do not raise immediate concerns for reporting to the provider.
3. A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition?
- A. No alteration in menses
- B. Transvaginal ultrasound indicating a fetus in the uterus
- C. Blood progesterone greater than the expected reference range
- D. Report of severe shoulder pain
Correct answer: D
Rationale: Severe shoulder pain is a common finding in clients with a ruptured ectopic pregnancy due to referred pain from diaphragmatic irritation caused by blood in the abdominal cavity. This pain is known as Kehr's sign and is often experienced in the shoulder due to irritation of the phrenic nerve. Choices A, B, and C are incorrect. A ruptured ectopic pregnancy typically presents with symptoms such as abdominal pain, vaginal bleeding, and signs of shock, rather than no alteration in menses, a fetus in the uterus, or elevated blood progesterone levels.
4. A client who is at 6 weeks of gestation is being educated about common discomforts of pregnancy. Which of the following findings should the individual include? (Select all that apply)
- A. Breast tenderness
- B. Urinary frequency
- C. Epistaxis
- D. All of the above
Correct answer: D
Rationale: During early pregnancy, common discomforts include breast tenderness due to hormonal changes, urinary frequency caused by increased blood flow to the kidneys, and epistaxis (nosebleeds) due to increased blood volume and hormonal changes. Educating the client about these discomforts helps them understand what to expect during this stage. Choice D, 'All of the above,' is the correct answer because all the listed findings are common discomforts experienced during early pregnancy. Choices A, B, and C are individually correct as well, as breast tenderness, urinary frequency, and epistaxis are all common discomforts that pregnant individuals may encounter.
5. A client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?
- A. Betamethasone
- B. Indomethacin
- C. Nifedipine
- D. Methylergonovine
Correct answer: A
Rationale: In cases of placenta previa with active bleeding at 32 weeks of gestation, Betamethasone is prescribed to accelerate fetal lung maturity in anticipation of potential preterm delivery. This medication helps in reducing the risk of respiratory distress syndrome in the newborn, which is crucial in managing such high-risk pregnancies. Indomethacin is a nonsteroidal anti-inflammatory drug not indicated in this scenario and may be contraindicated due to its effects on platelet function and potential risk of bleeding. Nifedipine is a calcium channel blocker used for conditions like preterm labor or hypertension, not specifically for placenta previa with active bleeding. Methylergonovine is a uterotonic drug used to prevent or control postpartum hemorrhage, not indicated for placenta previa with active bleeding.
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