NUR 210: ATI B - OB Exam and solution guide_updated 2025.

ATI B practice OB Q 1. A nurse is caring for a client who is 3 days postpartum. Medical History Gravida 1, Para 1 38 weeks of gestation Forceps-assisted birth following failed vacuum-assisted attempt. 3rd degree laceration with a repair. Amniotic membranes ruptured for 18 hr prior to delivery. Pregnancy complicated by gestational diabetes and anemia. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress. Insert an indwelling urinary catheter. Obtain a culture of vaginal fluid using a sterile swab. Endometritis Bladder distention Diameter of edematous area PARTIALLY CORRECT My Answer The nurse should plan to obtain a culture of vaginal fluid and to administer IV antibiotics because the client is most likely experiencing endometritis as evidenced by increased pelvic pain, pressure and tenderness, fever, and foul-smelling vaginal discharge. The client had an increased risk of developing endometritis due to the history of anemia, gestational diabetes, operative vaginal birth, and prolonged rupture of membranes. The nurse should plan to monitor the client's temperature and the amount and odor of the lochia. Clients who have endometritis have an increased risk of hemorrhage. A decrease of foul-smelling lochia and fever indicate progression toward resolution of the infection. Q 2 A nurse is caring for a client who is pregnant. Medical History 0900: Gravida 2 Para 1 31 weeks of gestation Allergies: NKDA Which of the following findings should the nurse report to the provider? Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again.0900: Temperature 38.3° C (101° F) Pulse rate 89/min Respiratory rate 20/min Blood pressure 128/70 mm Hg Oxygen saturation 98% Nurse's Notes 0900: Client reports, “I've been cramping and have had low back pain since yesterday. It burns when I urinate.” Client is placed on electronic fetal monitor. Fundal height palpated above the umbilicus. PARTIALLY CORRECT My Answer When recognizing cues the nurse should report the client’s temperature, which is above the expected reference range, and the burning upon urination to the provider. These are manifestation of an infection. The nurse should also report the client’s statement of “cramping and lower back pain”, the frequency and duration of the uterine contractions, and cervical dilation and effacement. These findings in a client who is less than 37 weeks’ gestation are all manifestations of preterm labor. Q 3 History and Physical Day 1, 1000: Gravida 3, Para 2, Abortion 1 Asthma (managed with levalbuterol inhaler as needed) Pelvic inflammatory disease (PID) Spontaneous vaginal delivery X 2 (hypertension with first pregnancy at 20 years of age) Voluntary termination of pregnancy (3rd pregnancy) Select the 3 findings that require immediate follow-up. Heart rate Abdomen assessment Respiratory assessment Vaginal spottingBowel sounds Menstrual period Oxygen saturation Temperature PARTIALLY CORRECT My Answer Heart rate is incorrect. The client's heart rate is regular and within the expected reference range; therefore, this finding does not require immediate follow up. Abdomen assessment is correct. The client reports dull abdominal pain and rates it as 2 on 0 to 10 pain scale. The nurse noted right lower quadrant abdominal tenderness during their assessment, which is an unexpected finding that requires immediate follow up. Respiratory assessment is incorrect. The client has a history of asthma, which causes wheezing. The client's respirations are regular, non-labored, and their oxygen saturation level is within the expected reference range. There is no indication that the client is in acute distress; therefore, this finding does not require immediate follow up. Vaginal spotting is correct. Spotting is defined as a scant amount of vaginal bleeding. The client reports spotting along with a late menstrual period, which are unexpected findings that require immediate follow up. Bowel sounds are incorrect. The nurse noted hyperactive bowel sounds in all four quadrants, which could indicate increased gastrointestinal motility caused by the client's anxiety; however, these findings do not require immediate follow up. Menstrual period is correct. The client reports a usual regular menstrual period; however, it is currently late by 2 weeks. This is an unexpected finding that requires immediate follow up. Oxygen saturation is incorrect. The client's oxygen saturation level is within the expected reference range; therefore, this finding does not require immediate follow up. Temperature is incorrect. The client's temperature is within the expectedQ3. Q 4. A nurse is caring for a client who is experiencing preterm labor at 29 weeks of gestation and has a prescription for betamethasone. Which of the following statements should the nurse make about the indication for medication administration?  "This medication will stop your labor."  "This medication stimulates fetal lung maturity."  "This medication will decrease your risk for uterine infections."  "This medication will increase your baby's weight." Q 5 A nurse is caring for a client who is at 26 weeks of gestation and has epilepsy. The nurse enters the room and observes the client having a seizure. After turning the client's head to one side, which of the following actions should the nurse take immediately after the seizure?  Monitor the FHR.  Assess uterine activity.  Administer oxygen via a nonrebreather mask.  Start a bolus of IV fluids.Q 6 A nurse is creating a plan of care for a client who is postpartum and adheres to traditional Hispanic cultural beliefs. Which of the following cultural practices should the nurse include in the plan of care?  Protect the client's head and feet from cold air.  Bathe the client within 12 hr following birth.  Ambulate the client within 24 hr following birth.  Offer the client a glass of cold milk with their first meal. Q 7. A nurse is caring for a client who is at 36 weeks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound? To locate a pocket of fluid To determine multiparity  To estimate the fetal weight To prescreen for fetal anomalies Q 8. A nurse is assessing a newborn who is 12 hr old. Which of the following findings should the nurse report to the provider? Subconjunctival hemorrhages Petechia on the trunk and face Central cyanosis Respiratory rate of 40/min| Q 9. A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching? “Obtain informed consent prior to obtaining the specimen." "Collect at least 1 milliliter of urine for the test." "Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen." "Premature newborns may have false negative tests due to immature development of liver enzymes." Q 10. nurse is reviewing the medical record of a client who is postpartum and has preeclampsia. Which of the following findings indicate that the client has progressed to preeclampsia with severe features?  Blood pressure 152/98 mm Hg  Elevated liver enzymes  Epigastric pain relieved with medication.  Pulmonary edemaQ 11. A nurse is caring for a client who is pregnant and is at the end of their first trimester. The nurse should place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones (FHT)?  Just above the umbilicus.  Just above the symphysis pubis  The right lower quadrant  The left lower quadrant Q 12. nurse in a provider's office is reviewing the medical record of a client who is in the first trimester of pregnancy. Which of the following findings should the nurse identify as a risk factor for the development of preeclampsia?  Singleton pregnancy.  BMI of 20  Maternal age 32 years  Pregestational diabetes mellitus Q 13. l nurse is caring for a client who is at 24 weeks of gestation and has a suspected placental abruption. Which of the following laboratory tests should the nurse expect the provider to prescribe?  Kleihauer-Betke test  Progesterone serum level  Lecithin/sphingomyelin (L/S) ratio  Maternal alpha-fetoprotein (AFP) Q 14. A nurse is assessing a client who received carboprost for postpartum hemorrhage. Which of the following findings is an adverse effect of this medication?  Hypertension  Hypothermia  Constipation  Muscle weakness Q 15. A nurse is assessing a newborn who is 12 hr old. Which of the following manifestations requires intervention by the nurse.  Acrocyanosis of the extremities  Murmur at the left sternal border  Substernal chest retractions while sleeping  Positive Babinski reflexQ 16. A nurse is providing discharge teaching to the guardian of a newborn about car seat safety. Which of the following instructions should the nurse include?  Place the shoulder harness in the slots above the newborn's shoulders.  Place the retainer clip at the level of the newborn's armpits.  Place the newborn at a 60° angle in the car seat.  Place the newborn in a blanket before securing them in the car seat. Q 17. A nurse is assessing a client who has preeclampsia with severe features. Which of the following manifestations should the nurse expect?  Blurred vision  Polyuria  Hypotension  2+ deep tendon reflexes Q 18. A nurse is providing teaching to a client about the physiological changes that occur during pregnancy. The client is at 10 weeks of gestation and has a BMI within the expected reference range. Which of the following client statements indicates an understanding of the teaching?  "I will not gain more than 15 to 20 pounds during my pregnancy."  "I will likely need to use alternative positions for sexual intercourse."  "I'm glad I had a breast reduction years ago, so they will not enlarge with my pregnancy." "I'm glad I have a light complexion and will not get any stretch marks." . Q 19. A nurse is teaching a client who is at 24 weeks of gestation regarding a 1-hr glucose tolerance test. Which of the following statements should the nurse include in the teaching?  "You will need to drink the glucose solution 2 hours prior to the test."  "Limit your carbohydrate intake for 3 days prior to the test."  "If this test is positive, you will be scheduled for a 3-hr glucose tolerance test."  "You will need to fast for 12 hours prior to the test." Q 20. A nurse is providing teaching about nonpharmacological pain management to a client who is breastfeeding and has engorgement. The nurse should recommend the application of which of the following items?  Cold cabbage leaves  Purified lanolin cream  A snug-fitting support bra  Breast shellsQ 21. A nurse is caring for a client who is pregnant. Medical History Gravida 1, Para 0 41 weeks of gestation Induction of labor due to postdates Which of the following actions are the nurse's priorities? Select the 4 actions that the nurse should take immediately. Assess cervical dilation. Administer a bolus of IV fluids. Insert an indwelling urinary catheter. Reposition the client to their side. Apply oxygen at 10 to 12 L/min by nonrebreather mask. Elevate the client's legs. Evaluate the client's pain level. Q 23. A nurse is admitting who is in labor the clients admit to recent cocaine use. For which complications the nurse assesses?  Abruptio placenta  Placenta previa  Preeclampsia  Maternal bradycardia Q 24. Diagnostic Results Lecithin/sphingomyelin (L/S) ratio 1.4:1 (greater than 2:1) Phosphatidylglycerol (PG) negative (positive) ABO-Rh B-negative A nurse is reviewing the medical record at 1800 for a client who is at 34 weeks of gestation. Based on the chart findings and documentation, the nursing plan of care should include which of the following actions? (Click on the exhibit button for additional information about the client. There are three tabs that contain separate categories of data.) Administer terbutaline. Discuss possible genetic anomalies with the client.Administer nalbuphine. Discontinue external fetal monitoring. 25. nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain?  Apply a cool pack for 10 min to the heel prior to the puncture.  Place the newborn skin to skin on the caregiver's chest.  Request a prescription for IM analgesic.  Use a manual lance blade to pierce the skin. .26. nurse is assessing a newborn who was born 12 hours ago. Which of the following findings requires an intervention by the nurse?  Acrocyanosis  Audible Murmur over base  Substernal retractions  Positive Babinski reflex Substernal Retractions are a sign of respiratory distress in the newborn and require a nursing intervention. 27. Nurse is caring for a client who is in labor. Medical History G1 P0 38 weeks’ gestation Preeclampsia with severe features Plan: Induction of labor A nurse reviews the most recent assessment findings. What actions should the nurse take? Select all that apply. Infuse a 500 mL bolus of lactated Ringer’s. Collect a specimen for a fetal fibronectin test. Administer calcium gluconate. Decrease the rate of the oxytocin infusion. Discontinue the magnesium infusion. Request a prescription for an amnioinfusion. Apply oxygen at 10 L by nonrebreather mask. PARTIALLY CORRECT My AnswerWhen taking action the nurse should discontinue the magnesium infusion, administer calcium gluconate, and apply oxygen at 10L by nonrebreather mask. The client is exhibiting signs of magnesium toxicity. The client's urine output is less than 25 to 30 mL/hr. Decreased renal function can lead to inadequate clearance of the magnesium. Other manifestations of magnesium toxicity the client is experiencing include decreased level of consciousness, decreased respiratory rate and absent deep tendon reflexes. Calcium gluconate is the antidote for magnesium sulfate toxicity and should be administered to prevent a cardiac arrest. The client's pulse oximeter reading is < 95%. Low circulating levels of maternal oxygen can lead to fetal distress. Q 28 Q Assessment Findings Clavicle fracture Erb-Duchenne paralysis Arm movement Palmar grasp reflex Wrist flexion Moro reflex Crepitus Birth history Note: Each category must have at least 1 response option selected. PARTIALLY CORRECT My Answer When analyzing cues the nurse should identify that clavicle fracture is associated with the birth of a large for gestational age newborn who had a vacuum assisted birth. Manifestations of a clavicle fracture include the presence of crepitus over the fractured bone with decreased movement and an absent moro reflex in the affected arm. The newborn retains the presence of a palmar grasp reflex. When analyzing cues the nurse should identify that Erb-Duchenne paralysis is the result of mechanical trauma to the spinal cord during a difficult birth. This complication is more likely to occur during the birth of a large for gestational age newborn and during a forceps or vacuum assisted birth. Manifestations of Erb-Duchenne paralysis include a limp arm withabsent spontaneous movement and absent moro reflex. The affected shoulder and arm are adducted and internally rotated with the wrist and fingers flexed. This results in a characteristic upwards positioning of the palm towards the back. The palmar grasp reflex is present because the paralysis is limited to the muscles in the upper arm. Q 29. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. Potential Order Anticipat ed Contraindica ted Transvaginal ultrasound Meperidine IM Repeat quantitative β-hCG level Methotrexate IM Blood typing PARTIALLY CORRECT My Answer Transvaginal ultrasound is indicated. The nurse should anticipate a prescription for a transvaginal ultrasound. A transvaginal ultrasound is useful in determining the location of the ectopic pregnancy. Meperidine IM is contraindicated. Clients who receive methotrexate for an ectopic pregnancy should not take analgesics stronger than acetaminophen, because these medications can mask the manifestations of tubal rupture. Repeat quantitative β-hCG level is anticipated. The quantitative β-hCG level should be repeated within 48 hr to see if the level has changed from last recording. If increased levels are identified with no intrauterine pregnancy on ultrasound, this is indicative of ectopic pregnancy. Methotrexate IM is anticipated. The nurse should anticipate a prescription for methotrexate IM administration to prevent further embryonic cell reproduction.Blood typing is anticipated. The nurse should also anticipate potential surgical intervention for the client; therefore, blood typing is indicated. Q 30. Ensure the client is NPO prior to surgery. Administer Rho(D) immune globulin prior to surgery. Prepare to administer AB positive blood products if needed. Insert an 18-gauge peripheral IV prior to surgery. Explain the surgical procedure to the client. Obtain a complete blood count. Verify a consent form is signed by the client. My Answer Inform the client to be NPO prior to surgery is correct. The nurse should inform the client to be NPO prior to surgery. This will prevent aspiration during surgery. Administer Rho(D) immune globulin prior to surgery is incorrect. The nurse should administer Rho D immune globulin after surgery. The client is Rh negative and could develop antibody formation if exposed to Rh positive blood. Prepare to administer AB positive blood products if needed is incorrect. The nurse should only administer O or B negative blood products if the client requires a blood transfusion. Any other blood types are incompatible and can cause a reaction. Insert an 18-gauge peripheral IV prior to surgery is correct. The nurse should provide IV access prior to surgery by inserting a larger bore IV such as an 18- or 20-gauge. An IV is used to administer IV fluids or blood products during surgery. Explain the surgical procedure to the client is incorrect. The provider is responsible for explaining the procedure to the client. The nurse is responsible for ensuring that the client is fully informed about the surgery. Obtain a complete blood count is correct. The nurse should obtain a complete blood count to establish baseline data prior to surgery. Verify a consent form is signed by the client is correct. The nurse should verify that the client has signed a consent form for surgery. This is mandatory prior to any surgical procedure. Q 31. Complete the following sentence by using the list of options. The nurse should first address the client's lung sounds followed by the client'svaginal spotting. My Answer Dropdown 1 Heart rate is correct. The nurse should first address the client's heart rate, which is above the expected reference range, to establish a baseline for continued monitoring. Lung sounds and bowel sounds are incorrect. The nurse should address these unexpected findings because they require further assessment by the nurse; however, there is another finding the nurse should address first. Dropdown 2 Vaginal spotting is correct. The nurse should next address the amount and characteristics of the client's vaginal spotting to establish a baseline for continued monitoring. Hemoglobin level and anxiety are incorrect. The nurse should address these unexpected findings because they require further assessment by the nurse; however, there is another finding the nurse should address first. Q PARTIALLY CORRECT My Answer The nurse should plan to obtain a culture of vaginal fluid and to administer IV antibiotics because the client is most likely experiencing endometritis as evidenced by increased pelvic pain, pressure and tenderness, fever, and foul-smelling vaginal discharge. The client had an increased risk of developing endometritis due to the history of anemia, gestational diabetes, operative vaginal birth, and prolonged rupture of membranes. The nurse should plan to monitor the client's temperature and the amount and odor of the lochia. Clients who have endometritis have an increased risk of hemorrhage. A decrease of foul-smelling lochia and fever indicate progression toward resolution of the infection.