2023-2024 ATI RN Maternal Newborn Proctored 2019 NGN

2023-2024 ATI RN MATERNAL NEWBORN PROCTORED 2019 NGN (REVISED FULL EXAM) A GRADED A nurse is caring for a client who is pregnant and states that her last menstrual period was April 1st. Which of the following is the client's estimated date of delivery? A. Jan 8 B. Jan 15 C. Feb 8 D. Feb 15 - ANSWER>>A. April 1st minus 3 months plus 7 days and 1 year A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy . The client's health records includes G3 T1 P0 A1 L1. How should the nurse interpret this? SATA A client has delivered one newborn at term B client has experienced no preterm labor C client has had 2 pregnancies D client has one living child E client has been through active labor - ANSWER>>a: delivered one newborn at term c: had 2 pregnancies d: has one living child a nurse is reviweing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following findings should the nurse expect? SATA a Montgomery glands b Goodell's Signs c ballottement d Chadwick's sign e quickening - ANSWER>>b: Goodell's sign c: ballottement d: chadwick's sign a nurse in a prenatal clinic caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make? a this is due to an increase in blood volume b this is due to pressure from the uterus on the diaphragm c this is due to the weight of the uterus on the vena cava d this is due to increase cardiac output - ANSWER>>c: due to the weight of the uterus on the vena cava A nurse in a clinic receives a phone call from a client who believes she is pregnant and would like to be tested in the clinic to confirm her pregnancy. Which of the following information should the nurse provide to the client? A) "You should wait until 4 weeks after conception to be tested" B) "You should be off any medications for 24 hours prior to the test" C) "You should be NPO for at least 8 hours prior to the test" D) "You should collect urine from the first morning void" - ANSWER>>d "You should collect urine from the first morning void" a nurse is teaching a group of women who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include in the teaching? SATA a avoid lifting b perform kegel exercises twice a day c perform the pelvic rock exercises every day d use proper body mechanics e avoid constrictive clothing - ANSWER>>c: perform the pelvic rock exercises every day d: use proper body mechanics a nurse is caring for a client who is pregnant and reviewing signs of complications the client should report to the provider. Which of the following complications should the nurse include in the teaching? a vaginal bleeding b swelling of the ankles c heartburn after eating d lightheartedness when lying on back - ANSWER>>a. vaginal bleeding a client who is at 7 weeks of gstation is experiencing n/v in the morning. Which of the following info should the nurse include in the teaching? a eat crackers or plain toast before getting out of bed b awaken during the night to eat a snack c skip breakfast and eat lunch after nausea has subsided d eat a large evening meal - ANSWER>>a: eat crackers or plain toast before getting out of bed a nurse is teaching a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include in the teaching? SATA a breast tenderness b urinary frequency c expistaxis d dysuria e epigastric pain - ANSWER>>a breast tenderness b urinary frequency c expistaxis A client who is at 8 weeks of gestation tells the RN that she isn't sure she is happy about being pregnant. which of the following responses should the nurse make? a: i will inform the provider that you are having these feelings b: it is normal to have these feelings during the first few months of pregnancy c: you should be happy that you are going to bring new life into the world d: i am going to make an appointment with the counselor for you to discuss these thoughts - ANSWER>>b: it is normal to have these feelings during the first few months of pregnancy a nurse in a prenatal clinic is providing education to a client who is in the 8th of gestation. The client states that she does not like milk. which of the following foods should the nurse recommend as a good source of Ca? a dark green leafy veggies b deep red or orange veggies c white breads and rice d meat, poultry and fish - ANSWER>>a dark green leafy veggies a nurse in a prenatal clinic is caring for four clients. which of the following client's weight gain should the nurse report to the provider? a 1.8 kg (4lb) weight gain and is in her first trimester b 3.6 kg (8lbs) weight gain and is in her first trimester c 6.8 kg (15 lbs) weight gain and is in her second trimester d 11.3 kg (25 lbs) weight gain and is in her third trimester - ANSWER>>b 3.6 kg (8lbs) weight gain and is in her first trimester a nurse in a clinic is teaching a client of childbearing age about recommended folic acid supplements. which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency? a iron deficiency anemia b poor bone formation c macrosomic fetus d neural tube defects - ANSWER>>d neural tube defects A nurse is reviewing a new prescription for iron supplement with a client who is in the 8th week of gestation and has iron deficiency anemia. which of the following beverages should the nurse instruct the client to take the iron supplement with? a ice water b low fat or whole milk c tea or coffee d orange juice - ANSWER>>d orange juice a nurse is reviewing postpartum nutrition needs with a group of new mothers who are breastfeeding their newborns. which of the following statements by a member of the group indicates an understanding of the teaching? a "i am glad i can have my morning coffee" b " i should take folic acid to increase my milk supply" c " i will continue adding 330 cal per day to my diet" d " i will continue my Ca supplements because i dont like milk" ANSWER>>d " i will continue my Ca supplements because i dont like milk" a nurse is reviewing findings of a client's biophysical profile. the nurse should expect which of the following variables to be included in the test? SATA a fetal weight b fetal breathing movement c fetal tone d fetal position e amniotic fluid volume - ANSWER>>b fetal breathing movement c fetal tone e amniotic fluid volume a nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. the nurse should evaluate which of the following tests to assess fetal lung maturity? a alphafetoprotein b L/S ratio c Kleihauer-Bertke test d Indirect-Coombs' test - ANSWER>>b L/S ratio A nursing is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. which of the following responses should the nurse make? a "it is used to stimulate uterine contractions" b "it will decrease the incidence of uterine contractions" c "it lulls the fetus to sleep" d "it awakens a sleeping fetus" - ANSWER>>d "it awakens a sleeping fetus" a nurse is teaching a client who is pregnant about amniocentesis procedure. which of the following statements should the nurse include in the teaching? a "you will lay on your right side during the procedure" b "you should not eat anything for 24 hours prior to the procedure" c "you should empty your bladder prior to the procedure" d "the test is done to determine gestational age" - ANSWER>>c "you should empty your bladder prior to the procedure" A nursing is caring for a client who is pregnant and is to undergo a CST. which of the following findings are indication for this procedure? SATA a decreased fetal movement b IUGR c postmaturity d placenta previa e amniotic fluid emboli - ANSWER>>a decreased fetal movement b IUGR c postmaturity a nurse in the ER is caring for a client who reports abrupt, sharp, rightsided lower quadrant abdominal pain and bright red vaginal bleeding. the client states she missed one menstrual cycle and cannot be pregnant b/c she has an intrauterine device. the nurse should suspect which of the following? a missed abortion b ectopic pregnancy c severe preeclampsia d hydatidiform mole - ANSWER>> a nurse is providing care for a client who is diagnosed with a marginal abruptio placentae. the nurse is aware that which of the following findings are risk factors for developing the condition? SATA a fetal position b blunt abdominal trauma c cocaine use d maternal age e smoking - ANSWER>>b blunt abdominal trauma c cocaine use e smoking a nurse is providing care for a client who is at 32 weeks of gestation and who has a placenta previa. the nurse notes that the client is actively bleeding. which of the following types of medications should the nurse anticipate the provider will prescribe? c betamethasone b indomethacin c nifedipine d methylergonovine - ANSWER>>c betamethasone A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea and vomiting and scant, prune-colored discharge. She has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect? A. Hyperemesis gravidarum B. Threatened abortion C. Hydatidiform mole D. Preterm labor - ANSWER>>C. Hydatidiform mole a nurse is caring for a client who has a diagnosis of ruptured ectopic pregnancy. which of the following findings is seen with this condition? a no alteration in menses b trans vaginal ultrasound indicating a fetus in the uterus c serum progesterone greater than the expected reference range d report of severe shoulder pain - ANSWER>>d report of severe shoulder pain A nurse is admitting a client who is in labor and has HIV. which of the following interventions should the nurse identify as contraindicated for this client? SATA a episotomy b oxytocin infusion c forceps d c-section e internal fetal monitoring - ANSWER>>a episotomy c forceps e internal fetal monitoring a nurse in an antepartum clinic is assessing a client who has a TORCH infection. which of the following findings should the nurse expect? SATA a joint pain b malaise c rash d urinary frequency e tender lymph nodes - ANSWER>>a joint pain b malaise c rash e tender lymph nodes a nurse is caring for a client who has gonorrhea. which of the following meds should the nurse anticipate the provider will give? a Ceftriaxone b Fluconazole c Metronidazole d Zidovudine - ANSWER>>a Ceftriaxone A nursing is caring for a client who is in labor. the nurse should identify that which of the following infections can be treated during labor or immediately following birth? SATA a gonorrhea b chlamydia c HIV d GBS e TOCRH - ANSWER>>a gonorrhea b chlamydia c HIV d GBS a nurse manager is reviewing ways to prevent a TORCH infection during pregnancy with a group of new nurses. which of the following statements by a nurse indicates understanding? a " obtain an immunization against rubella early in pregnancy" b "seek prophylactic treatment if cytomegalovirus is detected during pregnancy" c "a woman should avoid crowded places during pregnancy" d "a woman should avoid consuming undercooked meat while pregnant" ANSWER>>d "a woman should avoid consuming undercooked meat while pregnant" a nurse is caring for a client who is at 14 weeks and has hyperemesis gravidarum. the nurse should identify which of the following are risk factors for the client? SATA a obesity b multiferal pregnancy c maternal age greater than 40 d migraine HA e oligo - ANSWER>>a obesity b multiferal pregnancy d migraine HA a nurse is caring for a client who has suspected hyperemesis gravidarum and is reviewing the client's lab reports. which of the following findings is a s/s of this condition? a Hgb 12.2 g/dL b urine ketones present c alanine aminotransferase 20 IU/L d serum glucose of 114 mg/dL - ANSWER>>b urine ketones present a nurse is administering Mag to a client who has severe preeclampsia for seizure prophylaxis. which of the following indicates mag toxicity? SATA a respiration less than 12/min b urinary output less than 30 ml/hr c hyperreflexic deep tendon reflexes d decreased level of consciousness e flushing and sweating - ANSWER>>a respiration less than 12/min b urinary output less than 30 ml/hr d decreased level of consciousness a nurse is caring for a client who is receiving iv mag. which of the following meds should the nurse anticipate giving if mag toxicity is suspected? a nifedipine b pyridoxine c ferrous sulfate d Ca gluconate - ANSWER>>d Ca gluconate a nurse is reviewing a new prescription for ferrous sulfate with a client who is at 12 weeks of gestation. which of the following statements by the client indicates understanding of the teaching? a "i will take this pills with my breakfast" b "i will take this med with a glass milk" c "i plan to drink more orange juice while taking this pill" d "i plan to add more ca-rich foods to my diet while taking this medication" - ANSWER>>c "i plan to drink more orange juice while taking this pill" a nurse is caring for a client who reports indications of preterm labor. which of the following findings are risk factors of this condition? SATA a UTI b multifetal pregnancy c oligo d DM e uterine abnormalities ANSWER>>a UTI b multifetal pregnancy d DM e uterine abnormalities A nurse in L&D is providing care for a client who is in preterm labor at 32 wks of gestation. Which of the following medications should the nurse anticipate the provider will prescribe to hasten fetal lung maturity? A) calcium gluconate B) indomethacin (indocin) C) nifedipine (procardia) D) betamehtasone (celestrone) - ANSWER>>D) betamehtasone (celestrone) a nurse is caring for a client who is receiving nifedipine for prevention of preterm labor. the nurse should monitor for which of the following s/s? a blood-tinged sputum b dizziness c pallor d somnolence - ANSWER>>b dizziness a nurse is caring for a client who has a prescription of mag. the nurse should recognize that which of the following are contraindications for this med? SATA a fetal distress b preterm labor c vaginal bleeding d cervical dilation greater than 6cm e severe gestational HTN - ANSWER>>a fetal distress c vaginal bleeding d cervical dilation greater than 6cm a nurse is reviewing discharge teaching with a client who has PROM at 26 weeks gestation. which of the following instructions should the nurse include in the teaching? a use a condom with sex b avoid bubble bath solution when taking a bath c wipe from back to front d keep a daily record of fetal kick counts - ANSWER>>d keep a daily record of fetal kick counts a nurse in the L&D unit receives a phone call from a client who reports that her contractions started about 2 hours ago, did not go away when she had two glasses of water and rested, and became stronger since she started walking. her contractions occur every 10 mins and last about 30 seconds. she hasnt had any fluid leak from her vagina. however she saw some blood when she wiped after voiding. based on this report, which of the following clinical findings should the nurse recognize that the client is experiencing? a braxton hicks contractions b ROM c fetal descent d true contractions - ANSWER>>d true contractions a nurse in the L&D unit is caring for a client in labor and applies an external fetal monitor and toco. the FHR is around 140/min. contractions are occuring q 8 min and 30- 40 seconds in duration. the nurse performs a vaginal exam and finds the cervix is 2 cm dilated, 50% effaced and the fetus is at a -2 station. which of the following stages and phases of labor is this client experiencing? a first stage, latent phase b first stage, active phase c first stage, transition phase d second stage of labor - ANSWER>>a first stage, latent phase a client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. which of the following actions should the nurse take first? a check amniotic fluid for meconium b monitor FHR for distress c dry the client and make her comfortable d monitor UC - ANSWER>>b monitor FHR for distress a nurse in L&D unit is completing an admission assessment for a client who is at 39 weeks gestation. the client reports that she has been leaking fluid from her vagina for 2 days. which of the following conditions is the client at risk for developing? a cord prolaspe b infection c PPH d hydramnios - ANSWER>>b infection a nurse is caring for a client who is in active in labor and becomes nauseous and vomits. the client is irritable and feels the urge to have a bowel movement. she states "ive had enough, i cant do this anymore. i want to go home" which of the following stages of labor is the client experiencing? a second stage b fourth stage c transition phase d latent phase - ANSWER>>c transition phase a nurse is caring for a client who is at 40 weeks gestation and experiencing contractions q 3-5 mins and becoming stronger. a vaginal exam reveals that the client's cervix is 3cm dilated, 80% effaced, and -1 station. the client asks for pain meds. which of the following actions should the nurse take? SATA a encourage use of patterned breathing techniques b insert an indwelling cath c admin opioid analgesic med d suggest application of cold e provide ice chips - ANSWER>>a encourage use of patterned breathing techniques c admin opioid analgesic med d suggest application of cold a nurse is caring for a client who is in active labor. the client reports lower back pain. the nurse suspects that this pain is r/t a persistent occiput posterior fetal position. which of the following nonpharm NI should the nurse recommend to the client? a abd effleurage b sacral counterpressure c showering if not contraindicated d back rub and massage - ANSWER>>b sacral counterpressure a nurse is caring for a client following the admin of an epidural block and is preparing to admin an iv fluid bolus. the client's partner ask about the purpose of the iv fluid. which is an appropriate answer? a "its needed to promote increase urinary output" b "it is needed to counteract resp depression" c "it is needed to counteract hypotension" d "it is needed to prevent oligo" - ANSWER>>c "it is needed to counteract hypotension" a nurse is caring for a client who is in the second stage of labor . the client's labor has been progressing and she is expected to deliver vaginally in 20 min. the provider is preparing to admin for pain relief and perform an episiotomy. the nurse should know that which of the following types of regional anesthetic block is to be administered? a pudenal b epidural c spinal d paracervical - ANSWER>>a pudenal a nurse is caring for a client who is using patterned breathing during labor. the client reports numbness and tingling of the fingers. which of the following action should the nurse take? a admin O2 via nasal cannuli @ 2 min/L b apply a warm blanket c assit the client to a side-lying position d place an O2 mask over the client's nose and mask - ANSWER>> a nurse is providing care for a client who is in active labor. her cervix is dilated to 5 cm, and her membranes are intact. based on the use of external electronic fetal monitoring, the nurse notes a FHR of 115 to 125/min with occasional increases up to 150-155/min that last for 25 sec and have beatto-beat variability of 20/min. there is no slowing of FHR from the baseline. the nurse should recognize that this client is exhibiting signs of which of the following? SATA a moderate variability b FHR accel c FHR decel d normal baseline FHR e fetal tachy - ANSWER>>a moderate variability b FHR accel d normal baseline FHR a nurse is teaching a client about the benefits of internal fetal heart monitoring. which of the following should the nurse include in the teaching? SATA a "it is considered a noninvasive procedure" b "it can detect abnormal fetal heart tones early" c "it can determine the amount of amniotic fluid you have" d "it allows for accurate readings with maternal movement" e "it can measure uterine contraction activity" - ANSWER>>b "it can detect abnormal fetal heart tones early" d "it allows for accurate readings with maternal movement" e "it can measure uterine contraction activity" a nurse is reviewing the electronic monitor tracing of a client who is in active labor. the nurse should know that a fetus receives more O2 when which of the following appears on the tracing? a peak of UC b moderate variability c FHR accel d relaxation between UC - ANSWER>>d relaxation between UC a nurse is caring for a client who is in labor and observes late decel on the electronic fetal monitor. which of the following is the first action the nurse should take? a assist the client into left-lateral position b apply a FSE c insert an iv cath d perform a vaginal exam - ANSWER>>a assist the client into left-lateral position a nurse is performing Leopold maneuvers on a client who is in labor. which of the following techniques should the nurse use to identify the fetal lie? a apply palms of both hands to sides of the uterus b palpate the fundus of the uterus c grasp lower uterine segment between thumb and fingers d stand facing client's feet with fingertips outlining cephalic prominence ANSWER>>b palpate the fundus of the uterus a nurse is caring for a client and her partner during the second stage of labor. the client's partner asks the nurse to explain how he will know when crowning occurs. which of the following responses should the nurse make? a "the placenta will protrude from the vagina" b "your partner will report a decrease in the intensity of contractions" c "the vaginal area will bulge as the baby's head appears" d "your partner will report less rectal pressure" - ANSWER>>c "the vaginal area will bulge as the baby's head appears" a nursing is caring for a client who is in the transition phase of labor and reports that she needs to have a bowel movement with the peak of contractions. which of the following actions should the nurse make? a assist the client to the bathroom b prepare from an impending delivery c prepare to remove a fecal impaction d encourage the client to take deep, cleansing breaths - ANSWER>>b prepare from an impending delivery a nurse is caring for a client in the third stage of labor. which of the following findings indicate that placental separation? SATA a lengthening of the umbilical cord b swift gush of clear amniotic fluid c softening of the lower uterine segment d appearance of dark blood from the vagina e fundus firm upon palpation - ANSWER>>a lengthening of the umbilical cord d appearance of dark blood from the vagina e fundus firm upon palpation a nurse in labor and delivery is planning care for a newly admitted client who reports shes in labor and has been having vaginal bleeding for 2 weeks. which of the following should the nurse include in plan of care? a inspect the introitus for a prolapsed cord b perform a test to identify the ferning pattern c monitor station of the presenting part d defer vaginal exams - ANSWER>>d defer vaginal exams a nurse is caring for a client who is in the first stage of labor and is encouraging the client to void q2hrs. which of the following statements should the nurse make? a "a full bladder increases the risk for fetal trauma" b "a full bladder increases the risk for bladder infections" c "a distended bladder will be traumatized by frequent pelvic exams" d "a distended bladder reduces pelvic space needed for birth" - ANSWER>>d "a distended bladder reduces pelvic space needed for birth"