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Maternal Newborn ATI Proctored Exam 2023
1. A client is being educated by a healthcare provider about the physiological changes that occur during pregnancy. The client is at 10 weeks of gestation and has a BMI within the expected reference range. Which of the following client statements indicates an understanding of the teaching?
- A. I should gain more than 15 to 20 pounds during my pregnancy.
- B. I will likely need to use alternative positions for sexual intercourse.
- C. I'm glad I had a breast reduction years ago so they will not enlarge with my pregnancy.
- D. I'm glad I have a light complexion and will not get any stretch marks.
Correct answer: B
Rationale: During pregnancy, weight gain is expected. The client's understanding is demonstrated by acknowledging the need for alternative sexual positions due to the physiological changes, such as weight gain and a growing abdomen. This statement reflects comprehension of the teaching provided by the healthcare provider.
2. A healthcare professional is preparing to administer magnesium sulfate 2 g/hr IV to a client who is in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5% in water (D5W). How many mL/hr should the IV infusion pump be set to administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 60
- B. 30
- C. 50
- D. 80
Correct answer: C
Rationale: To administer magnesium sulfate 2 g/hr IV, the healthcare professional should set the IV infusion pump to administer 50 mL/hr. The calculation is as follows: 20 g / 500 mL = 2 g / X mL, X = 50 mL/hr. Choice A (60 mL/hr) is incorrect as it does not match the calculated rate. Choice B (30 mL/hr) is incorrect as it is half of the calculated rate. Choice D (80 mL/hr) is incorrect as it is higher than the calculated rate.
3. A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow.
- A. Palpate the fundus to identify the fetal part.
- B. Determine the location of the fetal back.
- C. Palpate for the fetal part presenting at the inlet.
- D. All of the Above
Correct answer: D
Rationale: The correct sequence for the nurse to follow when performing Leopold maneuvers is as follows: first, palpate the client's fundus to identify the fetal part, second, determine the location of the fetal back, third, palpate for the fetal part presenting at the inlet, and finally, palpate the cephalic prominence to identify the attitude of the head. Therefore, option D, 'All of the Above,' is the correct answer as it includes all the steps in the correct sequence. Choices A, B, and C are incorrect as they do not represent the complete sequence required for performing Leopold maneuvers.
4. A nurse is developing a plan of care for a client who has preeclampsia and is receiving magnesium sulfate via a continuous IV infusion. Which of the following interventions should the nurse include in the plan?
- A. Monitor the client's blood pressure every hour.
- B. Restrict the total hourly intake to 200 mL.
- C. Monitor the FHR continuously.
- D. Administer protamine sulfate for manifestations of toxicity.
Correct answer: C
Rationale: The correct answer is C. When a client with preeclampsia is receiving magnesium sulfate via continuous IV infusion, it is crucial to monitor the fetal heart rate (FHR) continuously. Magnesium sulfate is given to prevent seizures and is considered a high-alert medication that requires close monitoring, especially of FHR and uterine contractions. Monitoring the client's blood pressure every hour, as in choice A, is important but not as crucial as continuous FHR monitoring. Restricting the total hourly intake to 200 mL, as in choice B, is not a relevant intervention for a client receiving magnesium sulfate. Administering protamine sulfate for manifestations of toxicity, as in choice D, is incorrect as protamine sulfate is not the antidote for magnesium sulfate toxicity.
5. A parent is receiving discharge teaching from a nurse regarding caring for their newborn after a circumcision. Which instruction should the nurse include?
- A. Apply slight pressure with a sterile gauze pad for mild bleeding.
- B. Inspect the circumcision site every 6 to 8 hours.
- C. Avoid using baby wipes containing alcohol to cleanse the penis with each diaper change.
- D. Clean the circumcision site daily using a warm, wet washcloth.
Correct answer: A
Rationale: The correct answer is to apply slight pressure with a sterile gauze pad for mild bleeding. This helps to stop bleeding. If the bleeding persists, the parent should contact the healthcare provider for further guidance. While inspecting the circumcision site is important, checking every 6 to 8 hours might be too frequent and could disrupt healing. Using baby wipes containing alcohol can irritate the sensitive skin, so it is advised to avoid them. Cleaning the circumcision site daily is crucial, but excessive cleaning by removing yellow exudate daily is not necessary unless advised by the healthcare provider.
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