NEXT GENERATION RN ATI FUNDAMENTALS OF NURSING PROCTORED EXAM 2024/25 WITH NGN GRADED A+ WITH VERIFIED QUESTIONS AND DETAILED RATIONALES EXAM 3

NEXT GENERATION RN ATI FUNDAMENTALS OF NURSING PROCTORED EXAM 2024/25 WITH NGN GRADED A+ WITH VERIFIED QUESTIONS AND DETAILED RATIONALES EXAM 3 Antepartum period 1. A client comes to the office for her first prenatal visit. She reports that October 5 was the first day of her last menstrual period. Which statements represent findings in the first trimester of pregnancy? Select all that apply. □ 1. Slow fetal cell differentiation is occurring. □ 2. The client’s estimated date of delivery is June 12. □ 3. The client may expect to have some nausea and increased urinary frequency. □ 4. The client will notice decreased vaginal secretions. □ 5. The client’s breasts may become swollen and tender. □ 6. Chadwick’s sign will be positive at 9 weeks. 2. A nurse is assisting with a prenatal assessment on a client who is 32 weeks pregnant. She performs Leopold’s maneuvers and determines that the fetus is in the cephalic position. Identify the area where the nurse should place the Doppler to auscultate fetal heart tones. Answer: 3, 5, 6 ANT EPAR TU M P E R IOD 2 Rationale: The client can expect to have nausea, possi- ble vomiting, urinary frequency, and swollen, tender breasts in the first trimester. Bluish discoloration of the mucous membranes of the vagina, cervix, and vulva (Chadwick’s sign) can be noticed beginning at 9 weeks. There’s rapid fetal cell differentiation occurring and the client may expect increased—not decreased—vaginal se- cretions. The estimated date of delivery is calculated us- ing Nägele’s rule; thus October 5 - 3 months = July 5; + 7 days makes the date July 12, not June 12. Nursing process step: Planning Client needs category: Health promotion and maintenance Client needs subcategory: None Cognitive level: Analysis Rationale: When the fetus is in the cephalic position, fetal heart tones are best auscultated midway be- tween the symphysis pubis and the umbilicus. When the fetus is in the breech position, fetal heart tones are best heard at or above the level of the umbilicus. Nursing process step: Data collection Client needs category: Health promotion and maintenance Client needs subcategory: None Cognitive level: Analysis Answer: ANT EPAR TU M P E R IOD 3 3. A client comes to the office for her first prenatal visit. She asks the nurse what physiological changes she can expect during pregnancy. The nurse knows that changes can be in three categories: presumptive, probable, and positive. The nurse prepares to start the discussion with the probable changes of pregnancy. Put the following probable changes in ascending chronological order. Use all the options. 1. The vagina changes color from pink to violet (Chadwick’s sign); cervix softens (Goodell’s sign). 2. Serum laboratory tests are positive for human chorionic gonadotropin. 3. Braxton Hicks contractions and fetal outline can be palpated through the abdomen. 4. Fetus can be felt to rise against the abdominal wall when lower uterine segment is tapped during a bimanual examination (Ballottement). 2. Serum laboratory tests are positive for human chorionic gonadotropin. 1. The vagina changes color from pink to violet (Chadwick’s sign); cervix softens (Goodell’s sign). 4. Fetus can be felt to rise against the abdominal wall when lower uterine segment is tapped during a bimanual examination (Ballottement). 3. Braxton Hicks contractions and fetal outline can be palpated through the abdomen. Rationale: Probable changes that strongly suggest pregnancy include laboratory tests, which are positive at about 1 week from implantation. Chadwick’s and Goodell’s signs occur at 6 weeks. Ballottement occurs at 16 weeks. Braxton Hicks contractions and palpation of the fetal outline can occur as early as 20 weeks. Nursing process step: Planning Client needs category: Health promotion and maintenance Client needs subcategory: None Cognitive level: Application 4. Which nutritional instructions should the nurse review with a 32-year-old primigravida? Select all that apply. □ 1. Caloric intake should be increased by 300 cal/day. □ 2. Protein intake should be increased to more than 30 g/day. □ 3. Vitamin intake should not increase from prepregnancy requirements. □ 4. Folic acid intake should be increased to 400 mg/day. □ 5. Intake of all minerals, especially iron, should be increased. Rationale: A pregnant woman should increase her caloric intake by 300 cal/day. The protein requirements (76 g/day) of a pregnant woman exceed those of a nonpregnant woman by 30 g/day. All mineral requirements, especially iron, are increased in a pregnant woman. The woman should increase her intake of all vitamins and a prenatal vitamin is usually recommended. Folic acid intake is particularly important to help prevent fetal anomalies such as neural tube defect. Intake should be increased from 400 to 800 mg/ day. Nursing process step: Planning Client needs category: Physiological integrity Client needs subcategory: Basic care and comfort Cognitive level: Comprehension Answer: Answer: 1, 2, 5 ANT EPAR TU M P E R IOD 4 5. During a prenatal screening of a client with diabetes, the nurse should keep in mind that the client is at increased risk for which complications? Select all that apply. □ 1. Still birth □ 2. Rh incompatibility □ 3. Gestational hypertension □ 4. Placenta previa □ 5. Spontaneous abortion Rationale: Clients with diabetes are at increased risk for intrauterine fetal death after 36 weeks’ gestation. Gestational diabetes is also associated with an increased risk of gestational hypertension and spontaneous abortion. The risk of Rh incompatibility and placenta previa isn’t increased in the client with diabetes. Nursing process step: Data collection Client needs category: Health promotion and maintenance Client needs subcategory: None Cognitive level: Comprehension 6. A 30-year-old client comes to the office for a routine prenatal visit. After reading the laboratory test results below, the nurse should prepare the client for which study? □ 1. Triple screen □ 2. Indirect Coombs’ test □ 3. 1-hour glucose tolerance test □ 4. Amniocentesis Rationale: Screening for gestational diabetes using a 1-hour glucose test is recommended for all pregnant women between 24 and 28 weeks. If the client has a history of previously unexplained fetal loss, family history of diabetes, previous large-for-gestational-age neonate, obesity, or glycosuria, the test should be performed toward the end of the first trimester. The triple screen is a blood study routinely offered between the 15th and 20th week and looks for chromosomal abnormalities. The indirect Coombs’ test screens maternal blood for red blood cell antibodies. Amniocentesis is a needle aspiration of fluid from the amniotic sac to detect fetal abnormalities and is usually done between 16 and 18 weeks and after 35 weeks to assess lung maturity. Nursing process step: Planning Client needs category: Physiological integrity Client needs subcategory: Reduction of risk potential Cognitive level: Application