ATI LPN
Maternal Newborn ATI Proctored Exam
1. A client at 8 weeks of gestation with iron deficiency anemia is prescribed iron supplements. Which beverage should the nurse reinforce the client to take the supplements with for better absorption?
- A. Ice water
- B. Low-fat or whole milk
- C. Tea or coffee
- D. Orange juice
Correct answer: D
Rationale: The correct answer is 'Orange juice.' Orange juice is recommended to be taken with iron supplements because vitamin C present in orange juice enhances iron absorption, improving the effectiveness of the supplement. It is essential to take iron supplements with a source of vitamin C to optimize iron absorption and address iron deficiency anemia. Ice water (Choice A), low-fat or whole milk (Choice B), and tea or coffee (Choice C) are not ideal choices to take with iron supplements as they do not contain vitamin C, which is crucial for enhancing iron absorption.
2. A healthcare professional is assessing four newborns. Which of the following findings should the professional report to the provider?
- A. A newborn who is 26 hours old and has erythema toxicum on their face
- B. A newborn who is 32 hours old and has not passed meconium stool
- C. A newborn who is 12 hours old and has pink-tinged urine
- D. A newborn who is 18 hours old and has an axillary temperature of 37.7° C (99.9° F)
Correct answer: D
Rationale: An axillary temperature greater than 37.5° C (99.5° F) is above the expected reference range for a newborn and can be an indication of sepsis. Therefore, the healthcare professional should report this finding to the provider for further evaluation and management to rule out sepsis. Choices A, B, and C are within the expected range of normal findings for newborns. Erythema toxicum is a common and benign rash in newborns, not requiring immediate reporting. Not passing meconium stool within the first 24-48 hours can be normal, and pink-tinged urine can be due to uric acid crystals excretion, which is also common in newborns.
3. A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 minute and a frequency of 3 minutes. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?
- A. Notify the provider of the findings.
- B. Position the client with one hip elevated.
- C. Ask the client if she needs pain medication.
- D. Have the client void.
Correct answer: B
Rationale: The priority action for the nurse in this situation is to position the client with one hip elevated. This position can help improve blood flow to the placenta and stabilize blood pressure, which is crucial for both the client and the fetus during labor. It can also help optimize fetal oxygenation by improving circulation. Notifying the provider of the findings may be necessary, but ensuring proper positioning of the client takes precedence to address the immediate physiological needs. Asking the client about pain medication or having the client void are important interventions but are not the priority in this scenario where the client is experiencing painful contractions and has low blood pressure.
4. 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.
5. When should a provider order a maternal serum alpha-fetoprotein (MSAFP) screening for pregnant clients?
- A. A client who has mitral valve prolapse
- B. A client who has been exposed to AIDS
- C. All pregnant clients
- D. A client who has a history of preterm labor
Correct answer: C
Rationale: Maternal serum alpha-fetoprotein (MSAFP) screening is recommended for all pregnant clients to assess the risk of neural tube defects. It is a routine screening test used to detect increased levels of alpha-fetoprotein in maternal blood, which may indicate a higher risk for conditions such as neural tube defects in the developing fetus. Therefore, all pregnant clients, regardless of their medical history or risk factors, should undergo MSAFP screening as part of routine prenatal care. Choices A, B, and D are incorrect because the MSAFP screening is not specific to certain medical conditions or histories; it is a standard screening procedure for all pregnant individuals to evaluate neural tube defect risk in the fetus.
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