ATI LPN
Maternal Newborn ATI Proctored Exam
1. Which of the following medications should the provider prescribe for a client with gonorrhea?
- A. Ceftriaxone
- B. Fluconazole
- C. Metronidazole
- D. Zidovudine
Correct answer: A
Rationale: Ceftriaxone is the preferred medication to treat gonorrhea, a bacterial infection. It is essential to promptly treat gonorrhea to prevent complications such as pelvic inflammatory disease, infertility, and the spread of the infection to others. Fluconazole is used for fungal infections, Metronidazole treats certain bacterial and parasitic infections, and Zidovudine is an antiretroviral medication used in HIV treatment; none of these are appropriate for gonorrhea.
2. A healthcare professional is discussing risk factors for urinary tract infections with a newly licensed nurse. Which of the following conditions should the healthcare professional include in the teaching? (Select all that apply)
- A. Epidural anesthesia
- B. Urinary bladder catheterization
- C. Frequent pelvic examinations
- D. All of the Above
Correct answer: D
Rationale: Urinary tract infections can be influenced by various factors. Epidural anesthesia, urinary bladder catheterization, and frequent pelvic examinations are all associated with an increased risk of UTIs. Epidural anesthesia can introduce bacteria into the urinary tract, urinary bladder catheterization can serve as a pathway for bacteria to enter the bladder, and frequent pelvic examinations can disrupt the natural flora and introduce bacteria. Therefore, it is crucial for healthcare professionals to be aware of these risk factors to help prevent and manage UTIs effectively. Choice D, 'All of the Above,' is the correct answer as all the listed conditions are significant risk factors for urinary tract infections. Choices A, B, and C are incorrect because each of them, when present, can contribute to the development of UTIs. It is essential for healthcare professionals to educate patients and colleagues about these risk factors to minimize the occurrence of UTIs.
3. During active labor, a nurse notes tachycardia on the external fetal monitor tracing. Which of the following conditions should the nurse identify as a potential cause of the heart rate?
- A. Maternal fever
- B. Fetal heart failure
- C. Maternal hypoglycemia
- D. Fetal head compression
Correct answer: A
Rationale: Maternal fever can lead to fetal tachycardia due to the transmission of maternal fever to the fetus. This can result in an increased fetal heart rate, making it the correct potential cause in this scenario. Fetal heart failure (choice B) would typically present with bradycardia rather than tachycardia, making it an incorrect choice. Maternal hypoglycemia (choice C) is more likely to cause fetal distress rather than tachycardia. Fetal head compression (choice D) may lead to decelerations in the fetal heart rate pattern, but not necessarily tachycardia.
4. A woman at 38 weeks of gestation is admitted in early labor with ruptured membranes. The nurse determines that the client's oral temperature is 38.9°C (102°F). Besides notifying the provider, which of the following is an appropriate nursing action?
- A. Recheck the client's temperature in 4 hours.
- B. Administer glucocorticoids intramuscularly.
- C. Assess the odor of the amniotic fluid.
- D. Prepare the client for emergency cesarean section.
Correct answer: C
Rationale: An elevated temperature in a woman with ruptured membranes may indicate infection. Assessing the odor of the amniotic fluid can help determine if chorioamnionitis (an infection of the amniotic fluid) is present. This assessment is crucial to guide further interventions and management of the client's condition. Options A, B, and D are incorrect. Rechecking the client's temperature in 4 hours does not address the immediate concern of potential infection. Administering glucocorticoids intramuscularly is not indicated based solely on an elevated temperature. Preparing the client for an emergency cesarean section is premature and not supported by the information provided.
5. During a vaginal exam on a client in labor who reports severe pressure and pain in the lower back, a nurse notes that the fetal head is in a posterior position. Which of the following is the best nonpharmacological intervention for the nurse to perform to relieve the client's discomfort?
- A. Back rub
- B. Counter-pressure
- C. Playing music
- D. Foot massage
Correct answer: B
Rationale: In cases where the fetus is in a posterior position causing severe pressure and pain in the lower back during labor, applying counter-pressure is the most effective nonpharmacological intervention. Counter-pressure helps lift the fetal head off the spinal nerve, offering relief to the client. This technique is evidence-based and recommended to alleviate discomfort associated with a posterior fetal position. Choices A, C, and D are not as effective in this situation. While a back rub or playing music may provide some comfort, they do not directly address the issue caused by the fetal head's position. Similarly, a foot massage may offer relaxation but may not significantly relieve the specific discomfort arising from the posterior fetal position and the associated lower back pain.
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