LPN LPN
Maternal Newborn ATI Proctored Exam 2023
1. A client who is at 15 weeks of gestation, is Rh-negative, and has just had an amniocentesis. Which of the following interventions is the nurse's priority following the procedure?
- A. Check the client's temperature.
- B. Observe for uterine contractions.
- C. Administer Rho(D) immune globulin.
- D. Monitor the fetal heart rate (FHR).
Correct answer: D
Rationale: After an amniocentesis, the priority nursing intervention is to monitor the fetal heart rate (FHR) as the greatest risk to the client and fetus is fetal death. This monitoring helps in early identification of any fetal distress or compromise, allowing prompt intervention to ensure fetal well-being. Checking the client's temperature (Choice A) is not the priority as monitoring the fetus is crucial for immediate assessment. Observing for uterine contractions (Choice B) is important but not the priority after an amniocentesis. Administering Rho(D) immune globulin (Choice C) is typically done to Rh-negative clients after procedures that may lead to fetal-maternal hemorrhage, not immediately after an amniocentesis.
2. During an assessment, a client at 26 weeks of gestation presents with which of the following clinical manifestations that should be reported to the provider?
- A. Leukorrhea
- B. Supine hypotension
- C. Periodic numbness of the fingers
- D. Decreased urine output
Correct answer: D
Rationale: During pregnancy, decreased urine output can be indicative of decreased renal perfusion and impaired fetal well-being. It can also be a sign of preeclampsia when associated with symptoms like increased blood pressure, proteinuria, and decreased fetal activity. Therefore, the nurse should promptly report this finding to the healthcare provider for further evaluation and management. Leukorrhea is a common finding in pregnancy and not typically concerning. Supine hypotension and periodic numbness of the fingers can be managed by changing positions or adjusting posture and are not as urgent as decreased urine output in this context.
3. A client who is at 24 weeks of gestation and reports daily mild headaches is being cared for by a nurse. Which of the following instructions should the nurse include in the plan of care?
- A. Administer ibuprofen 400 mg twice daily.
- B. Recommend that the client perform conscious relaxation techniques daily.
- C. Give the client ginseng tea with each meal.
- D. Instruct the client to soak in a bath with a water temperature of 105°F for 15 minutes daily.
Correct answer: B
Rationale: Mild headaches during pregnancy can be common and are often related to stress and tension. Recommending conscious relaxation techniques daily can help to relieve tension, reduce stress, and alleviate headaches without the need for medication, which is safer during pregnancy. Choice A is incorrect as ibuprofen is not recommended during pregnancy due to potential risks to the fetus. Choice C is incorrect because ginseng tea is not recommended during pregnancy as it may have adverse effects. Choice D is incorrect as soaking in a hot bath with a water temperature of 105°F can raise the body temperature, which is not safe during pregnancy.
4. A client who is postpartum is receiving discharge teaching from a nurse. For which of the following clinical manifestations should the client be instructed to monitor and report to the provider?
- A. Persistent abdominal striae
- B. Temperature 37.8° C (100.2° F)
- C. Unilateral breast pain
- D. Brownish-red discharge on day 5
Correct answer: C
Rationale: Unilateral breast pain can be a sign of mastitis, an infection of the breast tissue, which requires prompt evaluation and treatment. The nurse should instruct the client to report this clinical manifestation to the provider to prevent complications and promote recovery.
5. A caregiver is learning about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching?
- A. I will dress my baby in flame-retardant clothing.
- B. I will ensure a bib on my baby at night to keep her clothing dry.
- C. I will warm my baby's formula using the lowest setting in the microwave.
- D. I will cover the crib mattress with plastic to prevent staining.
Correct answer: A
Rationale: The correct answer is A. Dressing a baby in flame-retardant clothing is crucial to prevent injuries, especially in case of accidental exposure to fire sources. This safety measure can provide an added layer of protection for the newborn. The other options do not directly address newborn safety concerns or best practices. Option B focuses on keeping clothing dry, which is not a primary safety concern. Option C poses a risk of overheating the formula, which can be dangerous for the baby. Option D, covering the crib mattress with plastic, may pose a suffocation hazard to the baby.
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