ATI Proctored Exam Maternal Newborn

1. A nurse is providing discharge teaching to a client following tubal ligation (occlusion). Which of the following statement by the client indicates an understanding of the teaching? A. “premenstrual tension will no longer be present.” B. “Ovulation will remain the same.” C. “Hormone replacements will be needed following this procedure.” D. “My monthly menstrual period will be shorter.” ANS: B Ovulation (egg release from the ovaries) will remain the same. Tubal ligation also known as having your tubes tied or tubal sterilization is a type of permanent birth control. During tubal ligation, the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy. Tubal ligation prevents an egg from traveling from the ovaries through the fallopian tubes and blocks sperm from traveling up the fallopian tubes to the egg. The procedure doesn't affect your menstrual cycle it just prevents fertilization. 2. A nurse is assessing a newborn following forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method? A. Hypoglycemia B. Polycythemia C. Facial Palsy D. Bronchopulmonary dysplasia ANS: C Downloaded by Esemeje Stephen () lOMoARcPSD| Difficult delivery, with or without the use of an instrument called forceps, may lead to facial palsy. Facial paralysis 15 minutes after forceps birth or absence of movement on affected side is especially noticeable when infant cries. 3. A nurse is providing teaching about terbutaline to a client who is experiencing preterm labor. Which of the following statements by the client indicates understanding of the teaching? A. “This medication could cause me to experience heart palpitations.” B. “This medication could cause me to experience blurred vision.” C. “This medication could cause me to experience ringing in my ears.” D. “This medication could cause me to experience frequent urination.” ANS: A Beta-adrenergic agents such as terbutaline (Brethine) are associated with various side effects, including tachycardia, irregular pulse, myocardial ischemia, and pulmonary edema. Therefore, these medications should not be used in women with known or suspected heart disease 4. A nurse is caring for a client who is in labor and requests nonpharmacological pain management. Which of the following nursing actions promotes client comfort? A. Assisting the client into squatting position B. Having the client lie in a supine position C. Applying fundal pressure during contractions D. Encouraging the client to void every 6 hrs. ANS: C Downloaded by Esemeje Stephen () lOMoARcPSD| Applying fundal pressure by pushing on the mother's abdomen in the direction of the birth canal is often used to assist spontaneous vaginal birth, shorten the length of the second stage and reduce the need for instrumental birth (forceps- or vacuum-assisted) or caesarean section. 5. A nurse caring for a client who is at 20 weeks of gestation and has trichomoniasis. Which of the following findings should the nurse expect? A. Thick, White Vaginal Discharge B. Urinary Frequency C. Vulva Lesions D. Malodorous Discharge ANS: D Although trichomoniasis may be asymptomatic, women commonly experience characteristically yellowish-to-greenish, frothy, mucopurulent, copious, malodorous discharge. Inflammation of the vulva, vagina, or both may be present; and the woman may complain of irritation and pruritus. Dysuria and dyspareunia are often present. 6. A nurse is caring for a client who is at 14 weeks of gestation. At which of the following locations should the nurse place the doppler device when assessing the fetal heart rate? A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis B. Left Upper Abdomen C. Two fingerbreadths above the umbilicus D. Lateral at the Xiphoid Process ANS: A Toward the end of the first trimester, before the uterus is an abdominal organ, the fetal heart tones (FHTs) can be heard with an ultrasound fetoscope or an ultrasound stethoscope (Fig. 8- Downloaded by Esemeje Stephen () lOMoARcPSD| 8). To hear the FHTs, place the instrument in the midline just above the symphysis pubis and apply firm pressure. The woman and her family should be offered the opportunity to listen to the FHTs. The health status of the fetus is assessed at each visit for the remainder of the pregnancy. 7. A nurse is assessing a client who is at 27 weeks of gestation and has preeclampsia. Which of the following findings should the nurse report to the provider? A. Urine protein concentration 200 mg/24 hr. B. Creatinine 0.8 mg/ dL C. Hemoglobin 14.8 g/ dL D. Platelet Count 60,000/ mm3 ANS: D Platelets 100,000/mm3 (60,000/mm3 ) is below the expected reference range, which can indicate DIC. The nurse should report this result to the provider. In a 24-hour specimen proteinuria is defined as a concentration at or 300 mg/24 hours. 8. A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effect should the nurse include? A. Tinnitus B. Urinary Frequency C. Breast Tenderness D. Chills ANS: C Downloaded by Esemeje Stephen () lOMoARcPSD| The adverse effects of clomiphene citrate are stomach upset, bloating, abdominal/pelvic fullness, flushing ("hot flashes"), breast tenderness, headache, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. 9. A nurse is assessing a newborn upon admission to the nursery. Which of the following should the nurse expect? A. Bulging Fontanels B. Nasal Flaring C. Length from head to heel of 40 cm (15.7 in) D. Chest circumference 2 cm (0.8 in) smaller than the head circumference ANS: D Measure at nipple line 2-3 cm (0.8-1.2 in) less than head circumference; average 30-33 cm (11.8-13 in) ≤ 30 cm. 10. A nurse is planning care for a newborn who has neonatal abstinence syndrome. Which of the following interventions should the nurse include in the plan of care? A. Increase the newborn’s visual stimulation B. Weigh the newborn every other day C. Discourage parental interaction until after a social evaluation D. Swaddle the newborn in a flexed position ANS: D Swaddling in a flexed position with hands midline against chest and legs loosely swaddled in lumbar flexion to decrease sensory stimulation. Minimize environmental and physical stimulation low lighting and noise level do not use TV or mobiles. Avoidance of abrupt changes in infant’s environment handle gently and close to the body to increase sense of