ATI Maternal Newborn 2019 Practice B with Solutions

A nurse is preparing to perform Leopold's Manoeuvres for a client identify the sequence the nurse should follow A. Identify the altitude of the head B. Determine the location of the fetal back C. Palpate for the fetal part presenting at the inlet D. Palpate the funds to identify the fetal part DBCA Palpate the funds to identify the fetal part Determine the location of the fetal back Palpate for the fetal part presenting at the inlet Identify the altitude of the head The first step the nurse should take when performing Leopold maneuvers is to palpate the client's fundus to identify the fetal part. Second, the nurse should determine the location of the fetal back. Third, the nurse should palpate for the fetal part presenting at the inlet. Finally, the nurse should palpate the cephalic prominence to identify the attitude of the head. A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina after calling for assistance which of the following actions should the nurse take next A. Place a rolled towel beneath one of the client's hips. B. Apply internal upward pressure to the presenting part using two gloved fingers. C. Administer oxygen to the client via a nonrebreather mask at 10 L/min. D. Increase the IV infusion rate. B. Apply internal upward pressure to the presenting part using two gloved fingers Using evidence-based practice, the first action the nurse should take is to apply internal upward pressure to the presenting part. Prolapse of the umbilical cord during labor can result in decreased perfusion to the fetus, which can lead to hypoxia. After calling for assistance, the nurse should relieve the compression on the umbilical cord by applying upward internal pressure on the presenting part with two gloved fingers. The nurse should not move their hand.A nurse is planning care for a client who is two hours postpartum which of the following intervention should the nurse plan to implement during the taking hold phase of postpartum behavioral adjustment A. Discuss contraceptive options with the client and her partner. B. Repeat information to ensure client understanding. C. Listen to the client and her partner as they reflect upon the birth experience. D. Demonstrate to the client how to perform a newborn bath. D. Demonstrate to the client how to perform a newborn bath Demonstrating to the client how to perform a newborn bath occurs during the taking-hold phase. The new parent moves from being passively dependent to taking a stronger interest in her new role as a mother. She is now focusing on the care her newborn and acquiring parenting skills. The nurse should provide positive reinforcement during this phase to give the new parent confidence and promote maternal adjustment. A nurse is teaching a client who is at 36 weeks of gestation and has a prescription for a nonstress test which of the following statements should the nurse include in the teaching A. "You will receive IV fluids prior to this test." B. "The procedure will take approximately 10 to 15 minutes." C. "You will be offered orange juice to drink during the test." D. "You will need to sign an informed consent form each time you have this test." C. You will be offered orange juice to drink during a test A nonstress test is performed to measure fetal activity. Having the client drink orange juice, or another beverage high in glucose, will stimulate fetal movements during the procedure, helping to obtain results. A nurse in a women's health clinic is providing teaching about nutritional intake to a client who is it eight weeks of gestation the nurse should instruct the client to increase her daily intake of which of the following nutrients: A. Calcium B. Vitamin E C. Iron D. Vitamin DC. Iron The recommendation for iron intake during pregnancy is higher than that for women who are not pregnant. For women who are pregnant, it is 27 mg/day. For women who are not pregnant, it is 15 mg/day for women younger than 19 years old and 18 mg/day for women between the ages of 19 and 50 years old. A nurse is caring for a client who is at 35 weeks of gestation and has placenta previa which of the following actions should the nurse take A. Perform a vaginal exam to determine cervical dilation every 2 hr. B. Instruct the client to ambulate in the hallway once every 4 hr. C. Administer betamethasone to the client via IM injection. D. Initiate continuous external fetal monitoring. D. Initiate continuous external fetal monitoring The nurse should identify that a client who has a placenta previa and is actively bleeding is at an increased risk for preterm labor and hemorrhage. The nurse should initiate interventions such as bed rest, pelvic rest, and continuous fetal heart monitoring, which assesses fetal well-being and the presence of contractions. The nurse should obtain IV access and monitor laboratory values. Also, the nurse should implement interventions to prepare for an emergency birth. A nurse is assessing fetal heart tones for a client who is pregnant the nurse is determined the fetal position as left occipital anterior to which of the following areas of the clients abdomen sure the nurse apply the ultrasound transducer to assess the point of maximum intensity to the fetal heart A. Left upper quadrant B. Right upper quadrant C. Left lower quadrant D. Right lower quadrant C. Left lower quadrant The fetal heart tones of a fetus in the left occipital anterior position are best heard in the left lower quadrant. A nurse is preparing to administer azithromycin to a client who is at 16 weeks of gestation and has a positive chlamydia culture the prescription states administer is it from ice in 1 g orallly now available is 250 mg tablets how many tablets for thenurse administer round the answer to the nearest whole number using leading zero if it applies do not use a trailing zero 4 tablets A nurse is caring for a newborn who is undergoing photo therapy to treat hyperbilirubinemia which of the following actions should the nurse take A. Cover the newborn's eyes while under the phototherapy light. B. Keep the newborn in a shirt while under the phototherapy light. C. Apply a light moisturizing lotion to the newborn's skin. D. Turn and reposition the newborn every 4 hr while undergoing phototherapy. A. Cover the newborns eyes while under the photo therapy light Applying an opaque eye mask prevents damage to the newborn's retinas and corneas from the phototherapy light. A school nurse is providing teaching to an adolescent about levonorgestrel contraception which of the following information should the nurse include in the teaching A. "You should take the medication within 72 hours following unprotected sexual intercourse." B. "You should avoid taking this medication if you are on an oral contraceptive." C. "If you don't start your period within 5 days of taking this medication, you will need a pregnancy test." D. "One dose of this medication will prevent you from becoming pregnant for 14 days after taking it." A. You should take the medication within 72 hours following unprotected sexual intercourse Levonorgestrel is an emergency contraceptive which inhibits ovulation to prevent conception. The nurse should instruct the adolescent to take this medication as soon as possible within 72 hr after unprotected sexual intercourse.