ATI Maternal Newborn Practice Questions

ATI Maternal Newborn Practice Questions Related

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A client in labor at 40 weeks of gestation has saturated two perineal pads in the past 30 min. The nurse suspects placenta previa. Which of the following is an appropriate nursing action?

  • A. Examination to determine cervical status
  • B. A magnesium sulfate infusion
  • C. Initiation of pushing
  • D. Preparation for cesarean birth
Correct Answer: D

Rationale: In the scenario described, the client is experiencing heavy vaginal bleeding, which is concerning for placenta previa. The appropriate nursing action in this situation is to prepare for a cesarean birth. Placenta previa is a condition where the placenta partially or completely covers the cervix, which can lead to life-threatening bleeding during labor. It is crucial to avoid vaginal examinations or initiation of pushing as these actions can exacerbate bleeding. A magnesium sulfate infusion is not indicated in the management of placenta previa. Therefore, the priority intervention is to prepare for a cesarean birth to ensure the safety of the mother and the baby.

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A healthcare provider is preparing to administer an injection of Rho (D) immunoglobulin. The provider should understand that the purpose of this injection is to prevent which of the following newborn complications?

  • A. Hydrops fetalis
  • B. Hypobilirubinemia
  • C. Biliary atresia
  • D. Transient clotting difficulties
Correct Answer: B

Rationale: Rho (D) immunoglobulin is given to Rh-negative individuals to prevent hemolytic disease of the newborn (HDN) caused by Rh incompatibility between the mother and the fetus. If an Rh-negative mother carries an Rh-positive fetus, there is a risk of sensitization during pregnancy or childbirth. Sensitization can lead to the production of antibodies that may attack Rh-positive red blood cells in future pregnancies, potentially causing severe hemolytic disease in the newborn, including complications like hydrops fetalis. Hydrops fetalis is a condition characterized by severe edema and fetal organ enlargement due to severe anemia and heart failure in the fetus.

A client with preterm labor is being admitted. The nurse anticipates a prescription by the provider for which of the following medications?

  • A. Prostaglandin E2
  • B. Indomethacin
  • C. Methylergonovine
  • D. Oxytocin
Correct Answer: B

Rationale: Indomethacin is used to delay premature labor by inhibiting uterine contractions. Prostaglandin E2, Methylergonovine, and Oxytocin are not typically used to manage preterm labor. Prostaglandin E2 can be used for cervical ripening and labor induction. Methylergonovine is used to prevent or control postpartum hemorrhage. Oxytocin is used for labor induction and augmentation of labor in term pregnancies.

A client with severe preeclampsia is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe to continue the infusion?

  • A. Diminished deep-tendon reflexes
  • B. Respiratory rate of 16/min
  • C. Urine output of 50 mL in 4 hours
  • D. Heart rate of 56/min
Correct Answer: B

Rationale: A respiratory rate of 16/min within the normal range is an essential parameter to monitor when administering magnesium sulfate, as respiratory depression is a potential adverse effect. Diminished deep-tendon reflexes may indicate magnesium toxicity, warranting immediate intervention. A urine output of 50 mL in 4 hours is below the expected amount, suggesting decreased kidney perfusion, which can be exacerbated by magnesium sulfate. A heart rate of 56/min is bradycardic and may indicate magnesium toxicity, requiring assessment and possible discontinuation of the infusion.

A nurse in the antepartum unit is caring for a client who is at 36 weeks of gestation and has pregnancy-induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following comp

  • A. Placenta previa
  • B. Prolapsed cord
  • C. Incompetent cervix
  • D. Abruptio placentae
Correct Answer: D

Rationale:

When caring for a newborn with macrosomia born to a mother with diabetes mellitus, which newborn complication should the nurse prioritize care for?

  • A. Hypoglycemia
  • B. Hypomagnesemia
  • C. Hyperbilirubinemia
  • D. Hypocalcemia
Correct Answer: A

Rationale: In newborns of diabetic mothers with macrosomia, hypoglycemia is the priority focus of care due to the risk of developing low blood sugar levels after birth. Infants born to diabetic mothers are at risk of hypoglycemia because they have been exposed to high glucose levels in utero and produce high levels of insulin. Hypoglycemia can lead to serious complications if not promptly identified and managed, making it crucial for nurses to closely monitor blood glucose levels and provide necessary interventions to prevent adverse outcomes.

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