ATI Skills Module 3.0: Maternal Newborn
Questions with Answers
A nurse is providing teaching about danger signs during pregnancy to a client who is at
20 weeks of gestation. The nurse should instruct the client to report headaches, blurred
vision, and epigastric pain because these are indications of which of the following
complications of pregnancy?
Gestational diabetes
Preeclampsia
Hyperemesis gravidarum
Abruptio placentae
Ans: Preeclampsia
Rationale: Manifestations of preeclampsia include: headache, vision changes, epigastric or
abdominal pain, and edema, especially of the face and hands. The nurse should instruct the
client to report these to the provider.
A nurse is caring for a patient who is in early labor and has a fetus in the
occipitoposterior presentation. The client reports pain in their lower back with
contractions. Which of the following pain management techniques is most likely to be
effective in relieving low back pain caused by this type of fetal presentation?
Counterpressure
Effleurage
Therapeutic touch
Breathing techniques
Ans: Counterpressure
Rationale: Counterpressure is steady pressure that a support person applies to the sacral
area of the client's back during contractions. The clients support person, or the nurse, uses
the heel of the hand, a tennis ball, or a fist to apply form pressure to the sacral area during
contractions. This pressure can lift the fetal head off of the nerves in the sacral area,
decreasing pain.
A nurse is assigning a 1-minute Apgar score to a newborn who is crying loudly. The
newborn has a heart rate of 140/min, has well flexed arms and legs, grimaces when the
nurse rubs the soles of their feet, and is pink with mild acrocynosis. What Apgar score
should the nurse assign to this newborn?
Q&A