ATI Maternal Newborn Proctored Exam 2022 (Part II)

ATI Maternal Newborn Proctored Exam 2022 (Part II) part II @Nursehan (THE TECHANT) ATI MATERNAL NEWBORN PROCTORED EXAM 2022 1. A nurse is reviewing laboratory results for client who is pregnant. The Nurse should e ...

ATI Maternal Newborn Proctored Exam 2022 (Part II) part II @Nursehan (THE TECHANT) ATI MATERNAL NEWBORN PROCTORED EXAM 2022 1. A nurse is reviewing laboratory results for client who is pregnant. The Nurse should expect which of the following laboratory values to increase? A. RBC count B. Bilirubin C. Fasting blood glucose D. Bun ANS: A RBC count increases from million/mm3 4.2-5.4 to 5-6.25 million/mm3 during pregnancy. 2. A nurse is caring for a client who is experiencing preterm labor and has a prescription for 4 doses of dexamethasone 6 mg IM 12 hr. Available in dexamethasone 10 mg/mL. How many mL of dexamethasone should the nurse administer per dose? (Round the answer to he nearest tenth. Use a leading zero if it applies. Do not use trailing zero.) ANS: 0.6 m 3. A nurse is caring for four clients. For which of the following clients should the nurse auscultate the fetal heart rate during the prenatal visit? A. A client who has an ultrasound that confirms a molar pregnancy B. A client who has a crown-rump length of 7 weeks gestation C. A client who has a positive urine pregnancy test 1 week after missed menses D. A client who has felt quickening for the first time. ANS: D In pregnancy terms, quickening is the moment in pregnancy when the pregnant woman starts to feel or perceive fetal movements in the uterus. part II @Nursehan (THE TECHANT) 4. A nurse is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the nurse include in the plan of care? A. Dress the newborn in lightweight clothing. B. Avoid using lotion or ointment on the newborn skin. C. Keep the newborn supine throughout treatment D. Measure the newborn’s temperature every 8hr ANS: B Frequent skin care is important, but do not use lotions, creams, balms, or ointments on uncovered skin. These products react with the phototherapy lights and cause burns. 5. A nurse is receiving laboratory results for a term newborn who is 24 hrs. old. Which of the following results require intervention by the nurse? A. WBC count 10,000/mm3 B. Platelets 180,000/mm3 C. Hemoglobin 20g/dL D. Glucose 20 mg/dL ANS: D But at birth, it's common for a newborn to have a blood glucose level as low as 30 mg per dl, which will gradually increase to 54 to 72 mg/dl. According to guidelines from the American Academy of Pediatrics, the generally accepted blood glucose level for treating newborn hypoglycemia is 47 mg/dl. 6. A nurse is assessing a client following an amniocentesis. Which of the following findings should the nurse recognize as complications? (select all that apply). A. Amnionitis B. Urinary tract infection C. Polyhydramnios D. Leakage of amniotic fluid E. Preterm labor ANS: A, D, E Amniocentesis is a well-known procedure performed during pregnancy for diagnostic and therapeutic purposes. Typical complications of the procedure include infection of the amniotic sac, preterm labor, respiratory distress, fetal deformities, trauma, alloimmunization, and failure of the puncture wound to heal properly. part II @Nursehan (THE TECHANT) 7. A nurse on a labor and delivery unit is reviewing infection control standards with a newly licensed nurse. The nurse should instruct the newly licensed nurse to don gloves for which of the following procedures? A. Assisting a mother with breastfeeding B. Performing a newborn’s initial bath C. Administering the measles, mumps, rubella vaccine D. Performing umbilical cord care ANS: D Wear gloves when a reasonably anticipated possibility exists that contact with blood or other potentially infectious materials, mucous membranes, nonintact skin, or potentially contaminated intact skin (e.g., of a patient incontinent of stool or urine) might occur. Gloves should be worn during infant eye prophylaxis, care of the umbilical cord, circumcision site, parenteral procedures, diaper changes, contact with colostrum, and postpartum assessments. Wear gloves with fit and durability appropriate to the task. 8. A nurse is providing teaching to a client who has mild preeclampsia and will be caring for herself at home during the last 2 months of pregnancy. Which of the following statements by the client indicates an understanding of the teaching? A. “I will count baby’s kicks every other day.” B. “I will alternate the arm use to check my blood pressure.” C. “I will check my urine for protein daily.” D. “I will consume 50 grams of protein daily.” ANS: C This urine will be tested to see if you are passing more than 300 mg of protein in a day. Any amount of protein in your urine over 300 mg in one day may indicate preeclampsia. However, the amount of protein doesn't define how severe the preeclampsia is or may get. To test your urine protein at home on a daily basis, use a simple test kit containing a urine testing strip that you dip into a fresh sample of your urine. part II @Nursehan (THE TECHANT) 9. A nurse is caring for four newborns. Which of the following newborns should the nurse assess first? A. newborn who has nasal flaring B. newborn who has subconjunctival hemorrhage of the left eye C. A newborn who has overlapping suture lines D. A newborn who has not rust-stained urine ANS: A Based on the ABC rule, respiratory distress needs more attention. Nasal flaring occurs when the nostrils widen while breathing. It is often a sign of trouble breathing. Nasal flaring may be an indication of breathing difficulty, or even respiratory distress in infant. 10. A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for infection. A. Meconium-stained fluid B. placenta previa C. Midline episiotomy D. Gestational hypertension ANS: C Midline episiotomy puts the client in risk for infection. 11. A nurse is caring for a client who is 4 hrs. postpartum and is experiencing hypovolemic shock. Which of the following actions should the nurse take? A. Administer indomethacin orally B. Insert a second IV using a 22-gauge IV catheter, C. Insert an indwelling urinary catheter. D. Administer oxygen at 2 L/min via nasal cannula. ANS: C Insert an indwelling urinary catheter to monitor perfusion of kidneys. Provide additional or maintain existing IV infusion of lactated Ringer's solution or normal saline solution to restore circulatory volume (woman should have two patent IV lines; insert second IV infusion using 16- to 18-gauge IV catheter). Give oxygen by nonrebreather face mask or nasal prongs at 8 to 10 L/min. part II @Nursehan (THE TECHANT) 12. A nurse is teaching a client who is 28 weeks of gestation and not up to date on current immunization. Which of the following immunizations should the nurse inform the client to anticipate receiving following birth? A. Pneumococcal B. Hepatitis B C. Human papillomavirus D. Rubella ANS: B Hepatitis B immunization is recommended at birth, 1 to 2 months, and between 6 to 18 months. It is injected intramuscularly soon after birth. 13. A nurse is caring for a newborn who is 24 hrs. old. Which of the following Laboratory findings should the nurse report to the provider? A. Hgb 20 g/dL B. Bilirubin 2mg/dL C. Platelets 200,000/mm3 D. WBC count 32,000/mm3 ANS: D An abnormal number of WBCs often indicates that the newborn baby's body is fighting some sort of infection. Results of the CBC can be obtained quite quickly. Blood culture: The blood culture will determine if any bacteria can be grown in the blood. 14. A nurse is caring for newborn who is 1 hr. old and has a respiratory rate of 50/min, a heart rate of 130/min, and an axillary temperature of 36.10C (97F). Which of the following actions should the nurse take? A. Give the newborn a warm bath. B. Apply a cap to the newborn head. C. Reposition the newborn. D. Obtain an oxygen saturation level ANS: B A cap may be worn to decrease heat loss from the infant's head. part II @Nursehan (THE TECHANT) 15. A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan? A. Apply a thin layer of lotion to the newborn skin every 8 hrs. B. Give the newborn 1oz of glucose water every 4 hrs. C. Ensure the newborn eyes are closed beneath the shield. D. Dress the newborn in a thin layer of clothing during therapy ANS: C Applying an opaque eye mask prevents damage to the newborn’s retinas and corneas from the phototherapy light 16. A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statement should the nurse make? A. “You can bathe and dress your baby if you’d like to.” B. “If you don’t hold the baby, it will make letting go much harder.” C. “You should name the baby so she can have an identity.” D. “I’m sure you will be able to have another baby when you’re ready.” ANS: B Offer the parents the choice of holding the infant in their arms. 17. A nurse is providing teaching to a client who is at 38 weeks of gestation and has a prescription to receive misoprostol intravaginally. Which of the following statement should the nurse make? A. “You will need to stay in a side-lying position for 30 minutes after each dose.” B. “You will receive an IV infusion of oxytocin 1 hour after your last dose.” C. “You will receive a magnesium supplement immediately following therapy.” D. “You will need to have a full bladder before the therapy begins.” ANS: A Assist the woman to maintain a supine position with a lateral tilt or a side-lying position for 30 to 40 minutes after insertion. Initiate oxytocin for induction of labor no sooner than 4 hours after the last dose of misoprostol was administered, following agency protocol, if ripening has occurred and labor has not begun. part II @Nursehan (THE TECHANT) 18. A nurse is assessing a newborn who was born post-term. Which of the following findings should the nurse expect? A. Nails extending over tips of fingers B. Large deposits of subcutaneous fat C. Pale, translucent skin D. Thin covering of fine hair on shoulders and back ANS: A Overgrown nails, abundant scalp hair, visible creases on palms and soles of feet, minimal fat deposits etc. 19. A nurse is planning to teach a group of clients who are pregnant about reastfeeding after returning to work. Which of the following information should the nurse nclude in the teaching? A. “Thawed (defrosted) breast milk can be refrigerated for up to 72 hours.” B. “Breast milk can be stored in a deep freezer for 12 months.” C. “Breast milk can be stored at room temperature for up to 12 hours.” D. “Thawed breast milk that is unused can be refrozen.” ANS: B Freshly expressed or pumped milk can be stored: At room temperature (77°F or colder) for up to 4 hours. In the refrigerator for up to 4 days. In the freezer for about 6 months is best; up to 12 months is acceptable. 20. A nurse on postpartum unit caring for four clients. Which of the following clients should receive Rh, (D) Immune globulin to prevent Rh- is immunization? A. A Rh-negative mother who has a Rh-positive infant B. A Rh-positive mother who has a Rh-negative infant C. A Rh-positive mother who has a Rh-positive infant D. A Rh-negative mother who has a Rh-negative infant ANS: A Rho(D) immune globulin is used to prevent antibodies from forming when a mother has Rhnegative blood and the baby is Rh-positive so that antibodies from the mother that crosses the placenta and attacks fetal blood cells causing hemolysis