ATI MATERNAL NEWBORN DYNAMIC
QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES LATEST 2024-2025
UPDATED
A nurse is assessing a client who is at 35 weeks of gestation and has preeclampsia
without severe features. Which of the following findings should the nurse identify
as the priority?
A. 480 mL urine output in 24 hr.
B. Blood pressure 144/92 mm Hg
C. +2 edema of the feet
D. 1+ protein in the urine - ANSWER- A. because, when using the urgent vs. non
urgent approach to client care, the nurse should determine that the priority finding
is 480 mL or urine in 24 hr. because the minimum acceptable urine output in an
adult client is 30 mL/hr. This can indicate progression of preeclampsia to
preeclampsia with severe features, which requires immediate intervention.
Therefore, this is the priority finding.
A nurse is reviewing the medical record of a client who is at 33 weeks of gestation
and has placenta previa and bleeding. Which if the following prescriptions should
the nurse clarify with the provider?
A. Perform a vaginal examination
B. Perform continuous external fetal monitoring
,C. Insert a large-bore IV catheter
D. Obtain a blood sample for laboratory testing - ANSWER- A. because, what a
client has a placenta previa, the placenta implants in the lower part of the uterus
and obstructs the cervical os (the opening to the vagina). The nurse should clarify
this prescription because any manipulation can cause tearing of the placenta and
increased bleeding.
A nurse is assessing a client who is at 35 weeks of gestation and is receiving
magnesium sulfate via continuous IV infusion for severe pre-eclampsia. Which of
the following findings should the nurse report to the provider?
A. Deep tendon reflexes 2+
B. Blood pressure 150/96 mm Hg
C. Urinary output 20 mL/hr.
D. Respiratory rate 16/min - ANSWER- C. because, the nurse should report a
urinary output of 20 mL/hr because this can indicate inadequate renal perfusion,
increasing the risk of magnesium sulfate toxicity. A decrease in urinary output can
also indicate a decrease in renal perfusion secondary to a worsening of the client's
pre-eclampsia.
A nurse is assessing a client who is at 12 weeks of gestation and has a
hydatidiform mole. Which of the following findings should the nurse expect?
A. Hypothermia
B. Dark brown vaginal discharge
C. Decreased urinary output
D. Fetal heart tones - ANSWER- B. because, a hydatidiform mole, or a molar
pregnancy, is a benign proliferative growth of the chorionic villi, which gives rise
to multiple cysts. The products of conception transform into a large number of
,edematous fluid-filled vesicles. As cells slough off the uterine wall, vaginal
discharge is usually dark brown and can contain grape like clusters.
A nurse is caring for a client who is at 37 weeks of gestation and is undergoing a
non-stress test. The fetal heart rate (FHR) is 130/min without accelerations for the
past 10 min. Which of the following actions should the nurse take?
A. Use vibroacoustic stimulation on the client's abdomen for 3 seconds
B. Report the nonreactive test result to the provider immediately.
C. Request a prescription for an internal fetal scalp electrode
D. Auscultate the FHR with a Doppler transducer - ANSWER- A. because, the
nurse should use a vibroacoustic stimulator on the client's abdomen to elicit fetal
activity because the fetus us most likely sleeping. Fetal movement should cause
accelerations in the FHR.
A nurse is caring for a client who is at 26 weeks of gestation and reports
constipation. Which of the following responses by the nurse is appropriate?
A. "You should drink 1 ounce of mineral oil every morning."
B. "You should walk for at least 30 minutes every day."
C. "You should eat at least 3 ounces of red meat per day."
D. "You should stop taking your prenatal vitamin." - ANSWER- B. because, the
nurse should encourage the client to participate in moderate physical activity, such
as walking or swimming, every day. This activity increases intestinal peristalsis,
which will help alleviate constipation.
A nurse is teaching a client who is at 12 weeks of gestation about manifestations of
potential complications that she should report to her provider. Which of the
following information should the nurse include in the teaching?
, A. Swelling of the face
B. Urinary frequency
C. White vaginal discharge
D. Intermittent nausea - ANSWER- A. because, the nurse should instruct the client
to report swelling of the face because this can indicate hypertensive disorder or
preeclampsia.
A nurse is caring for a client who is at 35 weeks of gestation and has severe pre-
eclampsia, which of the following assessments provides the most accurate
information regarding the client's fluid and electrolyte status?
A. Blood pressure
B. Intake and output
C. Daily weight
D. Severity of edema - ANSWER- C. because, evidence-based practice indicates
that daily weight is the most accurate assessment to determine a client's fluid and
electrolyte status.
A nurse is providing teaching to a client who is at 8 weeks of gestation about
manifestations to report to the provider during pregnancy. Which of the following
should the nurse include in the teaching?
A. Nausea upon awakening
B. Leg cramps when sleeping
C. Increase in white vaginal discharge
D. Blurred or double vision - ANSWER- D. because, a client who is pregnant
should report experiencing blurred or double vision as these could be a
manifestation of gestation hypertension or pre-eclampsia.
QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES LATEST 2024-2025
UPDATED
A nurse is assessing a client who is at 35 weeks of gestation and has preeclampsia
without severe features. Which of the following findings should the nurse identify
as the priority?
A. 480 mL urine output in 24 hr.
B. Blood pressure 144/92 mm Hg
C. +2 edema of the feet
D. 1+ protein in the urine - ANSWER- A. because, when using the urgent vs. non
urgent approach to client care, the nurse should determine that the priority finding
is 480 mL or urine in 24 hr. because the minimum acceptable urine output in an
adult client is 30 mL/hr. This can indicate progression of preeclampsia to
preeclampsia with severe features, which requires immediate intervention.
Therefore, this is the priority finding.
A nurse is reviewing the medical record of a client who is at 33 weeks of gestation
and has placenta previa and bleeding. Which if the following prescriptions should
the nurse clarify with the provider?
A. Perform a vaginal examination
B. Perform continuous external fetal monitoring
,C. Insert a large-bore IV catheter
D. Obtain a blood sample for laboratory testing - ANSWER- A. because, what a
client has a placenta previa, the placenta implants in the lower part of the uterus
and obstructs the cervical os (the opening to the vagina). The nurse should clarify
this prescription because any manipulation can cause tearing of the placenta and
increased bleeding.
A nurse is assessing a client who is at 35 weeks of gestation and is receiving
magnesium sulfate via continuous IV infusion for severe pre-eclampsia. Which of
the following findings should the nurse report to the provider?
A. Deep tendon reflexes 2+
B. Blood pressure 150/96 mm Hg
C. Urinary output 20 mL/hr.
D. Respiratory rate 16/min - ANSWER- C. because, the nurse should report a
urinary output of 20 mL/hr because this can indicate inadequate renal perfusion,
increasing the risk of magnesium sulfate toxicity. A decrease in urinary output can
also indicate a decrease in renal perfusion secondary to a worsening of the client's
pre-eclampsia.
A nurse is assessing a client who is at 12 weeks of gestation and has a
hydatidiform mole. Which of the following findings should the nurse expect?
A. Hypothermia
B. Dark brown vaginal discharge
C. Decreased urinary output
D. Fetal heart tones - ANSWER- B. because, a hydatidiform mole, or a molar
pregnancy, is a benign proliferative growth of the chorionic villi, which gives rise
to multiple cysts. The products of conception transform into a large number of
,edematous fluid-filled vesicles. As cells slough off the uterine wall, vaginal
discharge is usually dark brown and can contain grape like clusters.
A nurse is caring for a client who is at 37 weeks of gestation and is undergoing a
non-stress test. The fetal heart rate (FHR) is 130/min without accelerations for the
past 10 min. Which of the following actions should the nurse take?
A. Use vibroacoustic stimulation on the client's abdomen for 3 seconds
B. Report the nonreactive test result to the provider immediately.
C. Request a prescription for an internal fetal scalp electrode
D. Auscultate the FHR with a Doppler transducer - ANSWER- A. because, the
nurse should use a vibroacoustic stimulator on the client's abdomen to elicit fetal
activity because the fetus us most likely sleeping. Fetal movement should cause
accelerations in the FHR.
A nurse is caring for a client who is at 26 weeks of gestation and reports
constipation. Which of the following responses by the nurse is appropriate?
A. "You should drink 1 ounce of mineral oil every morning."
B. "You should walk for at least 30 minutes every day."
C. "You should eat at least 3 ounces of red meat per day."
D. "You should stop taking your prenatal vitamin." - ANSWER- B. because, the
nurse should encourage the client to participate in moderate physical activity, such
as walking or swimming, every day. This activity increases intestinal peristalsis,
which will help alleviate constipation.
A nurse is teaching a client who is at 12 weeks of gestation about manifestations of
potential complications that she should report to her provider. Which of the
following information should the nurse include in the teaching?
, A. Swelling of the face
B. Urinary frequency
C. White vaginal discharge
D. Intermittent nausea - ANSWER- A. because, the nurse should instruct the client
to report swelling of the face because this can indicate hypertensive disorder or
preeclampsia.
A nurse is caring for a client who is at 35 weeks of gestation and has severe pre-
eclampsia, which of the following assessments provides the most accurate
information regarding the client's fluid and electrolyte status?
A. Blood pressure
B. Intake and output
C. Daily weight
D. Severity of edema - ANSWER- C. because, evidence-based practice indicates
that daily weight is the most accurate assessment to determine a client's fluid and
electrolyte status.
A nurse is providing teaching to a client who is at 8 weeks of gestation about
manifestations to report to the provider during pregnancy. Which of the following
should the nurse include in the teaching?
A. Nausea upon awakening
B. Leg cramps when sleeping
C. Increase in white vaginal discharge
D. Blurred or double vision - ANSWER- D. because, a client who is pregnant
should report experiencing blurred or double vision as these could be a
manifestation of gestation hypertension or pre-eclampsia.
