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Maternal Newborn ATI Proctored Exam 2023
1. A nurse is teaching clients in a prenatal class about the importance of taking folic acid during pregnancy. The nurse should instruct the clients to consume an adequate amount of folic acid from various sources to prevent which of the following fetal abnormalities?
- A. Neural tube defect
- B. Trisomy 21
- C. Cleft lip
- D. Atrial septal defect
Correct answer: A
Rationale: The nurse should educate clients that inadequate folic acid intake is associated with an increased risk of neural tube defects in newborns. Consuming an adequate amount of folic acid from sources like fortified cereals, oranges, artichokes, liver, broccoli, and asparagus can help prevent this serious fetal abnormality. Trisomy 21 (Choice B) is caused by an extra chromosome 21 and is not preventable by folic acid intake. Cleft lip (Choice C) and atrial septal defect (Choice D) are not directly linked to folic acid intake during pregnancy.
2. 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.
3. An adolescent is being taught about levonorgestrel contraception by a school nurse. What information should the nurse include in the teaching?
- A. You should take the medication within 72 hours following unprotected sexual intercourse.
- B. Do not take this medication if you are on an oral contraceptive.
- C. If you do not start your period within 5 days of taking this medication, you will need a pregnancy test.
- D. One dose of this medication will prevent pregnancy for 14 days after taking it.
Correct answer: A
Rationale: Levonorgestrel is an emergency contraceptive that works by inhibiting ovulation to prevent conception. It is most effective when taken as soon as possible within 72 hours following unprotected sexual intercourse. Therefore, the nurse should instruct the adolescent to take the medication promptly to maximize its effectiveness. Choice B is incorrect because levonorgestrel can be used even if the individual is on oral contraceptives. Choice C is incorrect as the efficacy of levonorgestrel is not determined by the onset of menstruation. Choice D is incorrect because levonorgestrel is a single-dose emergency contraceptive and does not provide protection for 14 days after ingestion.
4. 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.
5. A client is postpartum and has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect?
- A. Decreased platelet count
- B. Increased erythrocyte sedimentation rate (ESR)
- C. Decreased megakaryocytes
- D. Increased WBC
Correct answer: A
Rationale: Idiopathic thrombocytopenic purpura (ITP) is characterized by an autoimmune response that leads to a decreased platelet count. This condition increases the risk of bleeding due to the low platelet levels. Monitoring the platelet count is crucial in managing ITP, as it helps determine the risk of bleeding and guides treatment decisions. Therefore, the correct finding to expect in a client with ITP is a decreased platelet count. Choice B, an increased erythrocyte sedimentation rate (ESR), is not typically associated with ITP. Choice C, decreased megakaryocytes, may be seen in conditions like aplastic anemia but are not a typical finding in ITP. Choice D, an increased white blood cell count (WBC), is not a characteristic feature of ITP.
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