ATI LPN
Maternal Newborn ATI Proctored Exam
1. A healthcare provider is reinforcing teaching with a client about a new prescription for medroxyprogesterone. Which of the following information should the provider include in the teaching? (Select all that apply)
- A. Weight fluctuations can occur.
- B. Irregular vaginal spotting can occur.
- C. You should increase your intake of calcium.
- D. All of the above
Correct answer: D
Rationale: When educating a client about medroxyprogesterone, it is important to include information about potential side effects and recommendations. Weight fluctuations and irregular vaginal spotting are common side effects of medroxyprogesterone. Additionally, increasing calcium intake is often advised to counteract the potential bone density loss associated with this medication. Therefore, all the statements provided are correct, making option D the correct answer. Choices A, B, and C are all essential pieces of information that the healthcare provider should convey to the client regarding medroxyprogesterone.
2. After an amniotomy, what is the priority nursing action?
- A. Observe color and consistency of fluid
- B. Assess the fetal heart rate pattern
- C. Assess the client's temperature
- D. Evaluate the client for the presence of chills and increased uterine tenderness using palpation
Correct answer: B
Rationale: After an amniotomy, the priority nursing action is to assess the fetal heart rate pattern. This is crucial to monitor for any signs of fetal distress, as changes in the fetal heart rate could indicate potential complications related to the procedure. Observing the color and consistency of the fluid (Choice A) is important but not the priority over assessing fetal well-being. Assessing the client's temperature (Choice C) and evaluating the client for chills and increased uterine tenderness (Choice D) are not immediate priorities following an amniotomy.
3. A woman in a women's health clinic is receiving teaching about nutritional intake during her 8th week of gestation. The healthcare provider should advise the woman to increase her daily intake of which of the following nutrients?
- A. Calcium
- B. Vitamin E
- C. Iron
- D. Vitamin D
Correct answer: C
Rationale: During pregnancy, the recommended daily iron intake is higher compared to non-pregnant women. Pregnant women should aim for 27 mg/day of iron, while non-pregnant women require 15 mg/day if under 19 years old and 18 mg/day if between 19 and 50 years old. Iron is essential during pregnancy to support the increased blood volume and ensure the proper oxygen supply to the fetus. Calcium is important for bone health but does not need a significant increase during early pregnancy. Vitamin E and Vitamin D are important but do not have specific increases recommended during the 8th week of gestation.
4. A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea, vomiting, and scant, prune-colored discharge. The client has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect?
- A. Hyperemesis gravidarum
- B. Threatened abortion
- C. Hydatidiform mole
- D. Preterm labor
Correct answer: C
Rationale: In this scenario, the symptoms of continued nausea, vomiting, scant prune-colored discharge, and a fundal height larger than expected at 4 months of gestation suggest a possible hydatidiform mole. Hyperemesis gravidarum (choice A) typically presents with severe nausea, vomiting, weight loss, and electrolyte imbalances. Threatened abortion (choice B) is characterized by vaginal bleeding with or without cramping but does not typically present with prune-colored discharge. Preterm labor (choice D) manifests with regular uterine contractions leading to cervical changes and can occur later in pregnancy.
5. A nurse is admitting a term newborn following a cesarean birth. The nurse observes that the newborn's skin is slightly yellow. This finding indicates the newborn is experiencing a complication related to which of the following?
- A. Maternal/newborn blood group incompatibility
- B. Absence of vitamin K
- C. Physiologic jaundice
- D. Maternal cocaine abuse
Correct answer: A
Rationale: The yellow skin observed in the newborn suggests jaundice. Maternal/newborn blood group incompatibility is a common cause of jaundice in newborns. This occurs when the mother and baby have different blood types, leading to the baby's immune system attacking the red blood cells, causing jaundice. Physiologic jaundice, which is a normal process due to the breakdown of red blood cells in newborns, typically presents after the first 24 hours of life. Absence of vitamin K leads to bleeding issues, not jaundice. Maternal cocaine abuse does not directly cause jaundice in newborns.
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