ATI LPN
Maternal Newborn ATI Proctored Exam
1. When caring for a client suspected of having hyperemesis gravidarum, which finding is a manifestation of this condition?
- A. Hgb 12.2 g/dL
- B. Urine ketones present
- C. Alanine aminotransferase 20 IU/L
- D. Blood glucose 114 mg/dL
Correct answer: B
Rationale: The correct answer is B: Urine ketones present. The presence of urine ketones indicates dehydration, which is a common manifestation of hyperemesis gravidarum. Hyperemesis gravidarum is characterized by severe nausea, vomiting, weight loss, and electrolyte imbalances due to dehydration. Monitoring for ketonuria helps assess the degree of dehydration in clients with this condition. Choices A, C, and D are incorrect because hemoglobin level, alanine aminotransferase level, and blood glucose level are not specific manifestations of hyperemesis gravidarum. While these laboratory values may be abnormal in some cases, they are not typically used to diagnose or assess the condition.
2. In contrast to the contractions associated with true labor, Braxton-Hicks contractions:
- A. generally follow rupture of the amniotic sac and occur with regularity.
- B. may be intensified by activity and are accompanied by a pink discharge.
- C. do not increase in intensity and are alleviated by a change in position.
- D. consistently become stronger and are not alleviated by changing position.
Correct answer: C
Rationale: Braxton-Hicks contractions are irregular and usually do not increase in intensity. Unlike true labor contractions, they tend to alleviate with a change in position, making option C the correct choice. Choices A, B, and D are incorrect because Braxton-Hicks contractions do not follow rupture of the amniotic sac, are not intensified by activity or accompanied by a pink discharge, and do not consistently become stronger or are not alleviated by changing position.
3. A healthcare professional is assessing a client who has a new prescription for enalapril. Which of the following findings should the professional report to the provider?
- A. Frequent urination
- B. Dry cough
- C. Tremors
- D. Dizziness
Correct answer: B
Rationale: The correct answer is B: Dry cough. A dry cough is a common side effect of enalapril that can indicate the development of angioedema or potentially life-threatening angioedema. An onset of dry cough should be reported to the provider promptly as it may require discontinuation of the medication to prevent further complications. Frequent urination, tremors, and dizziness are not typically associated with enalapril use and are less likely to be of immediate concern compared to a dry cough in this context.
4. When providing teaching to a client with a new prescription for digoxin, which of the following instructions should the nurse include?
- A. Take your pulse before taking the medication.
- B. Take the medication with an antacid.
- C. Double the dose if you miss one.
- D. Take the medication with a high-fiber meal.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for digoxin is to take their pulse before taking the medication. Digoxin can lead to bradycardia as a side effect, and monitoring the pulse helps in assessing the heart rate prior to medication administration. This precaution allows for the identification of any significant changes in heart rate that may require medical attention.
5. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following findings indicates she is dehydrated?
- A. Urine specific gravity of 1.020
- B. Urine specific gravity of 1.035
- C. Decreased skin turgor
- D. Decreased heart rate
Correct answer: B
Rationale: The correct answer is B. A urine specific gravity greater than 1.030 is indicative of dehydration as it reflects concentrated urine. Choice A is incorrect as a specific gravity of 1.020 is within the normal range. Choice C, decreased skin turgor, can be a sign of dehydration but is not as specific as urine specific gravity. Choice D, decreased heart rate, is not typically a direct indicator of dehydration.
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