ATI MATERNAL NEWBORN FINAL EXAM | QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | ALREADY
GRADED A+ | LATEST EXAM UPDATE
nurse is planning care for a requires phototherapy for hyperbilirubinemia.
Which of the following actions should the nurse include inthe plan of care -
CORRECT ANSWER - Ensure the newborns eyes are closed before applying
the eye shield - Overexposure to the lights during treatment can cause damage
to the newborn's corneas. Therefore, the nurse should gently close the newborn's
eyes prior to applying the eye shield.
A nurse is caring for a client at 34 weeks gestation and has a prescription for
terbutaline for preterm labor. Which of the following statements by the patient is
the priority? - CORRECT ANSWER - "My heart feels as if it is racing." - the
nurse should assess the client's heart rate. The primary action of terbutaline is to
cause bronchodilation and relax smooth muscles. However, an adverse effect is
tachycardia. If the pulse is greater than 130/min, the terbutaline needs to be held
until the provider is notified. The nurse might also need to use Maslow's
hierarchy of needs, the ABC priority-setting framework, or nursing knowledge
to identify which finding is the most urgent.
A nurse is planning care for a client who is pregnant and is Rh-negative. In
which of the following situations should the nurse administer Rh(D) Immune
Globulin? - CORRECT ANSWER - At 28 weeks of gestation - The nurse
should administer Rh(D) Immune Globulin to a client who is pregnant and has
Rh-negative blood at 28 weeks of gestation. Rh(D) Immune Globulin consists
of passive antibodies against the Rh factor, which will destroy any fetal RBCs in
the maternal circulation and block maternal antibody production.
A nurse is caring for a client who is at 39 weeks of gestation and is in active
labor. Which of the following actions should the nurse include in the plan of
care? - CORRECT ANSWER - Check the cervix prior to analgesic
administration. - Prior to administering an analgesic during active labor, the
,nurse must know how many centimeters the cervix is dilated. If administered
too close to the time of delivery, the analgesic could cause respiratory
depression in the newborn.
A nurse is planning care for a client who is at 35 weeks of gestation. Which of
the following lab tests should the nurse obtain? - CORRECT ANSWER -
Group B streptococcus Beta-hemolytic (GBS) - The nurse should obtain a
vaginal/anal group B streptococcus ß-hemolytic (GBS) culture at 35 to 37
weeks of gestation to screen for infection. Prophylactic antibiotics should be
given during labor to the client who is positive for GBS.
A nurse is caring for a newborn whose mother received magnesium sulfate to
treat preterm labor. Which of the following clinical manifestations is the
newborn indicates toxicity due to the magnesium sulfate therapy? - CORRECT
ANSWER - Respiratory depression - Magnesium sulfate can cause respiratory
and neuromuscular depression in the newborn. The nurse should monitor the
newborn for clinical manifestations of respiratory depression.
A nurse is caring for a client who is in labor and has an epidural for pain relief.
Which of the following is a complication from the epidural block? -
CORRECT ANSWER - hypotension - Maternal hypotension is an adverse
effect of epidural anesthesia. The nurse should administer an IV fluid bolus
prior to the placement of epidural anesthesia in order to decrease the likelihood
of this complication.
A nurse is caring for a client who has trichomoniasis and a prescription for
metronidazole. Which of the following instructions should the nurse provide to
the client about the treatment plan? - CORRECT ANSWER - "You and your
partner need to take the medication and use a condom during intercourse until
cultures are negative." - Trichomonas vaginalis is the organism that causes the
sexually transmitted infection trichomoniasis. Both men and women can be
infected with trichomoniasis. Clinical findings include yellowish to greenish,
frothy, mucopurulent, copious discharge with an unpleasant odor, as well as
itching, burning, or redness of the vulva and vagina. Trichomoniasis can be
treated easily with metronidazole. However, for the treatment to work, it is
important to make sure both sexual partners receive treatment to prevent
,reinfection. Instruct the client to use condoms during sexual intercourse while
being treated.
A nurse in a prenatal clinic is caring for a client who is within the recommended
guideline for weight. The client asks the nurse how much weight is safe for her
to gain during her pregnancy. Which of the following responses should the
nurse make? - CORRECT ANSWER - A weight gain of 25 - 35 lbs is good - A
weight gain of 25 to 35 lb is associated with good fetal outcome. A gain of 4 lb
in the first trimester and 12 lb each for the second and third trimester is
recommended.
A nurse is caring for a client who has a prescription for naloxone. Which of the
following is the intended action of the med in relation to the CNS? -
CORRECT ANSWER - Block effects of narcotics on the CNS- By blocking
the effects of narcotics on the CNS, naloxone prevents CNS and respiratory
depression in the newborn following delivery.
A nurse is discussing diaphragm use with a client. Which of the following
statements by client indicates an understanding of the teaching? - CORRECT
ANSWER - I should replace my diaphragm every 2 years - The diaphragm is a
flexible rubber cup that is filled with spermicide and is inserted over the cervix
prior to intercourse. The diaphragm is a prescribed device fitted by the provider.
It should be replaced every 2 years.
A nurse is teaching a client about a nonstress test. Which of the following
statements by the client indicates an understanding of the teaching? -
CORRECT ANSWER - I should press the button on the handheld marker
when my baby moves - The purpose of the test is to assess fetal well-being. The
client should press the button on the handheld marker when she feels fetal
movement.
A nurse is caring for a client who is 2 hr postpartum. The nurse notes the client's
perineal pad has a large amount of lochia rubra with several clots. Which of the
following actions should the nurse take first? - CORRECT ANSWER -
Massage the fundus - The primary cause of early postpartum bleeding is uterine
, atony manifested by a relaxed, boggy uterus. Thus, the greatest risk for the
client is hemorrhage. The nurse should massage the client's fundus first.
A nurse is caring for a preterm newborn who is receiving oxygen therapy.
Which of the following findings should the nurse identify as a potential
complication from the oxygen therapy? - CORRECT ANSWER - retinopathy -
Oxygen therapy can cause retinopathy of prematurity, especially in preterm
newborns. It is a disorder of retinal blood vessel development in the premature
newborn. In newborns who develop retinopathy of prematurity, the vessels grow
abnormally from the retina into the clear gel that fills the back of the eye. It can
reduce vision or result in complete blindness.
A nurse is caring for a client who is receiving oxytocin for induction of labor.
Which of the following actions should the nurse take? - CORRECT ANSWER
- Perform continuous fetal heart rate monitoring - When oxytocin is
administered to an antepartum client, the fetal monitor must be used to
continuously monitor the fetal heart rate and maternal contractions.
A nurse is assessing a client on the first postpartum day. Findings include
fundus firm and 1 fingerbreadth above and to the right of the umbilicus,
moderate lochia rubra with small clots, temp 37.3 and pulse 52. Which of the
following actions should the nurse take? - CORRECT ANSWER - Ask the pt
when she last voided
A nurse is assessing a newborn who is 12 hr old and notes mild jaundice of face
and trunk. Which of the following actions should the nurse take? - CORRECT
ANSWER - obtain stat prescription for a bilirubin level - Jaundice in the first
24 hr of life is pathologic. The nurse should notify the provider and obtain a stat
prescription for a bilirubin level.
A nurse is speaking with an expectant father who says that he feels resentful of
the added attention others are giving to his wife since the pregnancy was
announced. Which of the following responses should the nurse make? -
CORRECT ANSWER - These feeling are common for expectant fathers in
early pregnancy
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | ALREADY
GRADED A+ | LATEST EXAM UPDATE
nurse is planning care for a requires phototherapy for hyperbilirubinemia.
Which of the following actions should the nurse include inthe plan of care -
CORRECT ANSWER - Ensure the newborns eyes are closed before applying
the eye shield - Overexposure to the lights during treatment can cause damage
to the newborn's corneas. Therefore, the nurse should gently close the newborn's
eyes prior to applying the eye shield.
A nurse is caring for a client at 34 weeks gestation and has a prescription for
terbutaline for preterm labor. Which of the following statements by the patient is
the priority? - CORRECT ANSWER - "My heart feels as if it is racing." - the
nurse should assess the client's heart rate. The primary action of terbutaline is to
cause bronchodilation and relax smooth muscles. However, an adverse effect is
tachycardia. If the pulse is greater than 130/min, the terbutaline needs to be held
until the provider is notified. The nurse might also need to use Maslow's
hierarchy of needs, the ABC priority-setting framework, or nursing knowledge
to identify which finding is the most urgent.
A nurse is planning care for a client who is pregnant and is Rh-negative. In
which of the following situations should the nurse administer Rh(D) Immune
Globulin? - CORRECT ANSWER - At 28 weeks of gestation - The nurse
should administer Rh(D) Immune Globulin to a client who is pregnant and has
Rh-negative blood at 28 weeks of gestation. Rh(D) Immune Globulin consists
of passive antibodies against the Rh factor, which will destroy any fetal RBCs in
the maternal circulation and block maternal antibody production.
A nurse is caring for a client who is at 39 weeks of gestation and is in active
labor. Which of the following actions should the nurse include in the plan of
care? - CORRECT ANSWER - Check the cervix prior to analgesic
administration. - Prior to administering an analgesic during active labor, the
,nurse must know how many centimeters the cervix is dilated. If administered
too close to the time of delivery, the analgesic could cause respiratory
depression in the newborn.
A nurse is planning care for a client who is at 35 weeks of gestation. Which of
the following lab tests should the nurse obtain? - CORRECT ANSWER -
Group B streptococcus Beta-hemolytic (GBS) - The nurse should obtain a
vaginal/anal group B streptococcus ß-hemolytic (GBS) culture at 35 to 37
weeks of gestation to screen for infection. Prophylactic antibiotics should be
given during labor to the client who is positive for GBS.
A nurse is caring for a newborn whose mother received magnesium sulfate to
treat preterm labor. Which of the following clinical manifestations is the
newborn indicates toxicity due to the magnesium sulfate therapy? - CORRECT
ANSWER - Respiratory depression - Magnesium sulfate can cause respiratory
and neuromuscular depression in the newborn. The nurse should monitor the
newborn for clinical manifestations of respiratory depression.
A nurse is caring for a client who is in labor and has an epidural for pain relief.
Which of the following is a complication from the epidural block? -
CORRECT ANSWER - hypotension - Maternal hypotension is an adverse
effect of epidural anesthesia. The nurse should administer an IV fluid bolus
prior to the placement of epidural anesthesia in order to decrease the likelihood
of this complication.
A nurse is caring for a client who has trichomoniasis and a prescription for
metronidazole. Which of the following instructions should the nurse provide to
the client about the treatment plan? - CORRECT ANSWER - "You and your
partner need to take the medication and use a condom during intercourse until
cultures are negative." - Trichomonas vaginalis is the organism that causes the
sexually transmitted infection trichomoniasis. Both men and women can be
infected with trichomoniasis. Clinical findings include yellowish to greenish,
frothy, mucopurulent, copious discharge with an unpleasant odor, as well as
itching, burning, or redness of the vulva and vagina. Trichomoniasis can be
treated easily with metronidazole. However, for the treatment to work, it is
important to make sure both sexual partners receive treatment to prevent
,reinfection. Instruct the client to use condoms during sexual intercourse while
being treated.
A nurse in a prenatal clinic is caring for a client who is within the recommended
guideline for weight. The client asks the nurse how much weight is safe for her
to gain during her pregnancy. Which of the following responses should the
nurse make? - CORRECT ANSWER - A weight gain of 25 - 35 lbs is good - A
weight gain of 25 to 35 lb is associated with good fetal outcome. A gain of 4 lb
in the first trimester and 12 lb each for the second and third trimester is
recommended.
A nurse is caring for a client who has a prescription for naloxone. Which of the
following is the intended action of the med in relation to the CNS? -
CORRECT ANSWER - Block effects of narcotics on the CNS- By blocking
the effects of narcotics on the CNS, naloxone prevents CNS and respiratory
depression in the newborn following delivery.
A nurse is discussing diaphragm use with a client. Which of the following
statements by client indicates an understanding of the teaching? - CORRECT
ANSWER - I should replace my diaphragm every 2 years - The diaphragm is a
flexible rubber cup that is filled with spermicide and is inserted over the cervix
prior to intercourse. The diaphragm is a prescribed device fitted by the provider.
It should be replaced every 2 years.
A nurse is teaching a client about a nonstress test. Which of the following
statements by the client indicates an understanding of the teaching? -
CORRECT ANSWER - I should press the button on the handheld marker
when my baby moves - The purpose of the test is to assess fetal well-being. The
client should press the button on the handheld marker when she feels fetal
movement.
A nurse is caring for a client who is 2 hr postpartum. The nurse notes the client's
perineal pad has a large amount of lochia rubra with several clots. Which of the
following actions should the nurse take first? - CORRECT ANSWER -
Massage the fundus - The primary cause of early postpartum bleeding is uterine
, atony manifested by a relaxed, boggy uterus. Thus, the greatest risk for the
client is hemorrhage. The nurse should massage the client's fundus first.
A nurse is caring for a preterm newborn who is receiving oxygen therapy.
Which of the following findings should the nurse identify as a potential
complication from the oxygen therapy? - CORRECT ANSWER - retinopathy -
Oxygen therapy can cause retinopathy of prematurity, especially in preterm
newborns. It is a disorder of retinal blood vessel development in the premature
newborn. In newborns who develop retinopathy of prematurity, the vessels grow
abnormally from the retina into the clear gel that fills the back of the eye. It can
reduce vision or result in complete blindness.
A nurse is caring for a client who is receiving oxytocin for induction of labor.
Which of the following actions should the nurse take? - CORRECT ANSWER
- Perform continuous fetal heart rate monitoring - When oxytocin is
administered to an antepartum client, the fetal monitor must be used to
continuously monitor the fetal heart rate and maternal contractions.
A nurse is assessing a client on the first postpartum day. Findings include
fundus firm and 1 fingerbreadth above and to the right of the umbilicus,
moderate lochia rubra with small clots, temp 37.3 and pulse 52. Which of the
following actions should the nurse take? - CORRECT ANSWER - Ask the pt
when she last voided
A nurse is assessing a newborn who is 12 hr old and notes mild jaundice of face
and trunk. Which of the following actions should the nurse take? - CORRECT
ANSWER - obtain stat prescription for a bilirubin level - Jaundice in the first
24 hr of life is pathologic. The nurse should notify the provider and obtain a stat
prescription for a bilirubin level.
A nurse is speaking with an expectant father who says that he feels resentful of
the added attention others are giving to his wife since the pregnancy was
announced. Which of the following responses should the nurse make? -
CORRECT ANSWER - These feeling are common for expectant fathers in
early pregnancy
