LPN LPN
Maternal Newborn ATI Proctored Exam 2023
1. During a weekly prenatal visit, a nurse is assessing a client at 38 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Blood pressure 136/88 mm Hg
- B. Report of insomnia
- C. Weight gain of 2.2 kg (4.8 lb)
- D. Report of Braxton-Hicks contractions
Correct answer: C
Rationale: A weight gain of 2.2 kg (4.8 lb) in a week is above the expected reference range for a client at 38 weeks of gestation and could indicate complications such as preeclampsia or gestational hypertension. Rapid weight gain at this stage requires immediate attention and should be reported to the provider for further evaluation and management. Choices A, B, and D are not the priority findings to report to the provider at this stage of gestation. Blood pressure of 136/88 mm Hg is within normal limits in pregnancy, insomnia is common in the third trimester, and Braxton-Hicks contractions are expected in the third trimester as the body prepares for labor.
2. 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.
3. A client in active labor at 39 weeks of gestation is receiving continuous IV oxytocin and has early decelerations in the FHR on the monitor tracing. What action should the nurse take?
- A. Discontinue the oxytocin infusion.
- B. Continue monitoring the client.
- C. Request that the provider assess the client.
- D. Increase the infusion rate of the maintenance IV fluid.
Correct answer: B
Rationale: Early decelerations in the FHR are benign and are typically caused by fetal head compression during contractions. In this case, with the client at 39 weeks of gestation and on oxytocin, it is important for the nurse to continue monitoring the client. Early decelerations do not require intervention as they are a normal response to certain stimuli and do not indicate fetal distress. Discontinuing the oxytocin infusion (Choice A) is not necessary as early decelerations are not related to oxytocin administration. Requesting the provider to assess the client (Choice C) is not needed for early decelerations as they are a normal finding. Increasing the infusion rate of the maintenance IV fluid (Choice D) is not indicated and would not address the early decelerations. Therefore, the appropriate action is to continue monitoring the client and reassess as needed.
4. 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.
5. A charge nurse on the postpartum unit is observing a newly licensed nurse who is preparing to administer pain medication to a client. The charge nurse should intervene when the newly licensed nurse uses which of the following secondary identifiers to identify the client?
- A. The client's room number
- B. The client's telephone number
- C. The client's birth date
- D. The client's medical record number
Correct answer: A
Rationale: The correct answer is A. Using the client's room number as a secondary identifier is not an appropriate method for client identification in healthcare settings. It can lead to confusion and potential errors, especially in a busy environment like a postpartum unit. Room numbers are not unique to individual patients and can change frequently. Instead, healthcare providers should use more reliable and specific identifiers like the client's name, medical record number, or date of birth to ensure accurate identification and safe administration of medications. Choices B, C, and D are more appropriate secondary identifiers for client identification as they are more specific and less prone to errors than room numbers.
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