RN ATI MATERNAL NEWBORN PROCTORED EXAM (VERSION 22)

1. A nurse is caring for a client who is at 15 weeks gestation, is Rh- negative, and has just had an amniocentesis. Which of the following interventions is the nurse priority following the procedure? a. Check the clients temp b. Observe for uterine contractions c. Administer Rh immunoglobulin d. Monitor fetal HR All are important, but FHR is most important after an amniocentesis/c greatest risk is fetal death 2. A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching? A. Obtain a informed consent prior to obtaining the specimen B. Collect at least 1 milliliter of urine for the test C. Ensure that the NB has been receiving feedings for 24 hours piror to obtaining the specimen D. Premature NB may have false negative tests due to immature development of liver enzymes -mandated by law so no consent is needed -collect a capillary blood sample via heel stick, not urine -immature development of liver enzymes = false positive 3. 32 weeks of gestation – report: A. fundal height 34 B. report of decreased fetal movement C. report of occasional ankle swelling D. BP 110/80 -fundal height can be the same or plus or minus 2 -occasional ankle edema is a common discomfort -in pregnancy, BP can be slightly decreased 4. For magnesium toxicity: administer..A. calcium gluconate B. hydralazine C. medroxyprogesterone acetate D. methylergonovine -hydralazine is an antihypertensive med -medroxyprogesterone acetate is an injectable contraceptive hormone -methylergonovine is used to treat postpartum hemorrhage 5. A nurse is assessing a client who is day 1 postpartum and has a vaginal hematoma. Which of the following manifestations should the nurse expect? A. lochia serosa B. vaginal pressure C. intermittent vaginal pain D. yellow exudate vaginal discharge -lochia serosa is 4-10 days postpartum -vaginal pressure is present due to blood leaked into the tissues -persistent vaginal/rectal pain, not intermittent -1 day postpartum = lochia rubra, not yellow exudate 6. 35 weeks, NST revels variable deceleration in the FHR. Which of the following actions should the nurse take? A. give the client orange juice B. elevate the legs C.have the client change position D. establish IV acess Orange juice and IV access are not appropriate. Elevate the clients legs for late decelerations associated w/ maternal hypotension7. education for oral contraceptives. Which of the following findings should the nurse include as an adverse effect of the medication? A. depression B. polyuria C. hypotension D. urticaria -Depression, fluid retention, and HTN are common adverse effects 8. 24 weeks gestation and suspected placental abruption – which of the following lab tests should the nurse expect the provider to prescribe? A. kleihauer- bertke test B. progesterone serum level C. lecithin/sphingomyelin L/S ratio D. Maternal/ alpha fetoprotein AFP -Kleihauer Bertke test – for a client who has a suspected placental abruption; determines if fetal blood is in the maternal circulation; useful to determine if Rh immune globulin therapy should be administered - progesterone level = determine if a client is pregnant and if the pregnancy is ectopic -L/S ratio – amniocentesis to evaluate lung maturity - Maternal Alpha Fetoprotein AFP = lab test used to assess for NTD or chromosome disorders 9. A nurse is creating a plan of care for a client who is postpartum and adheres to traditional Hispanic culture beliefs. Which of the following cultural practices shpuld the nurse include in the plan of care? A. protect the client’s head and feet from cold air B. bathe the client within 12 hours following birth C. ambulate the client within 254 hours following birth D. Offer the client cold milk with her first meal -Hispanics delay bathing for 14 days following birth-Hispanics bed rest for 3 days following birth - warm drinks, not cold 10. a nurse is teaching a client who is at 10 weeks of gestation about nutrition during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? A. I should increase my protein to 60 grams each day B. I should drink 2 L of water each day C. I should increase my overall daily caloric intake by 300 calories D. I should take 600 micrograms of folic acid each day -increase protein to 71g each day during 2nd and 3rd trimester 3rd -drink 3 L of water each day -increase overall daily caloric intake by 340 furing the 2nd trimester and 452 during the