a nurse is caring for a term macrosomic newborn whose mother has poorly controlled type 2 diabetes the newborn has respiratory distress syndrome the n
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ATI RN

ATI Maternal Newborn Proctored Exam 2023

1. A newborn is born to a mother with poorly controlled type 2 diabetes. The newborn is macrosomic and presents with respiratory distress syndrome. The most likely cause of the respiratory distress is which of the following?

Correct answer: A

Rationale: The correct answer is hyperinsulinemia. In infants born to mothers with poorly controlled diabetes, the excess glucose crosses the placenta, leading to fetal hyperglycemia. This results in fetal hyperinsulinemia, which in turn can cause macrosomia (large birth weight), increasing the risk of respiratory distress syndrome due to the immature lungs' inability to handle the increased workload. Hyperinsulinemia, not increased deposits of fat, brachial plexus injury, or increased blood viscosity, is the most likely cause of respiratory distress in this scenario.

2. A newborn's mother is positive for the hepatitis B surface antigen. Which of the following should the infant receive?

Correct answer: C

Rationale: In the scenario where a newborn's mother is positive for hepatitis B surface antigen, the infant should receive both hepatitis B immune globulin and hepatitis B vaccine within 12 hours of birth. This is crucial to provide passive and active immunity against the Hepatitis B virus. Hepatitis B immune globulin provides immediate protection by giving passive immunity, while the vaccine stimulates active immunity in the infant. Administering both within 12 hours of birth is important to prevent vertical transmission of the virus.

3. A client at 37 weeks of gestation with severe gestational hypertension is being admitted by a nurse. Which of the following actions should the nurse NOT expect to implement?

Correct answer: C

Rationale: Assessing respiratory status every 4 hours is not a priority for a client with severe gestational hypertension. In this scenario, the focus should be on monitoring blood pressure, assessing for signs of preeclampsia, administering medications like magnesium sulfate for seizure prophylaxis, and ensuring that calcium gluconate is readily available in case of magnesium toxicity. Respiratory status assessment is important in other conditions but is not directly related to managing severe gestational hypertension.

4. A client at 22 weeks of gestation with uncontrolled gestational diabetes mellitus may require medication. Which of the following medications would the provider likely prescribe?

Correct answer: C

Rationale: Glyburide is commonly prescribed for gestational diabetes mellitus when diet and exercise are insufficient to control blood sugar levels. It is considered safe and effective during pregnancy, making it a suitable choice for managing diabetes in pregnant individuals. Acarbose, Repaglinide, and Glipizide are not typically recommended for use in pregnancy due to potential risks to the fetus.

5. A nurse in the antepartum unit is caring for a client who is at 36 weeks of gestation and has pregnancy-induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following comp

Correct answer: D

Rationale:

Similar Questions

A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?
A client at 11 weeks of gestation reports slight occasional vaginal bleeding over the past 2 weeks. Following an examination, the provider informs the client that the fetus has died, indicating a:
A client is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select one that doesn't apply.)
A nurse on the postpartum unit is caring for a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?
A client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios is found to have which of the following?

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