ATI Maternal Newborn Proctored

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Review ATI Maternal Newborn Proctored related questions and content

A client who is 6 hours postpartum and Rh-negative has an Rh-positive newborn. The client asks why an indirect Coombs test was ordered. Which of the following is an appropriate response by the healthcare provider?

  • A. It determines if kernicterus will occur in the newborn.
  • B. It detects Rh-negative antibodies in the newborn's blood.
  • C. It detects Rh-positive antibodies in the mother's blood.
  • D. It determines the presence of maternal antibodies in the newborn's blood.
Correct Answer: C

Rationale: The correct answer is C because the indirect Coombs test is used to detect Rh-positive antibodies in the mother's blood. In this scenario, the mother is Rh-negative, so if she has been sensitized to Rh-positive blood during childbirth, her immune system may produce antibodies that could potentially harm future Rh-positive pregnancies. This test helps identify the presence of these antibodies early on so appropriate interventions can be initiated to prevent hemolytic disease of the newborn.

Choices A, B, and D are incorrect:
A: This test does not determine if kernicterus will occur in the newborn. Kernicterus is a severe complication of jaundice, which may result from hemolytic disease of the newborn if untreated.
B: The indirect Coombs test does not detect Rh-negative antibodies in the newborn's blood. It specifically looks for Rh-positive antibodies in the mother's blood.
D: The test does not determine the presence of maternal antibodies in the newborn's blood. It focuses on detecting antibodies in

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A client who underwent an amniotomy is now in the active phase of the first stage of labor. Which of the following actions should the nurse implement with this client?

  • A. Maintain the client in the lithotomy position.
  • B. Perform vaginal examinations frequently.
  • C. Remind the client to bear down with each contraction.
  • D. Encourage the client to empty her bladder every 2 hours.
Correct Answer: D

Rationale: The correct answer is D: Encourage the client to empty her bladder every 2 hours. This is important to prevent bladder distention, which can impede fetal descent and progression of labor. A: Maintaining the client in the lithotomy position is unnecessary and may be uncomfortable. B: Performing frequent vaginal examinations increases the risk of infection and should be minimized. C: Reminding the client to bear down with each contraction is not appropriate during the active phase of the first stage of labor as it can lead to exhaustion and prolonged labor.

A client with a BMI of 26.5 is seeking advice on weight gain during pregnancy at the first prenatal visit. Which of the following responses should the nurse provide?

  • A. It would be best if you gained about 11 to 20 pounds.
  • B. The recommendation for you is about 15 to 25 pounds.
  • C. A gain of about 25 to 35 pounds is recommended for you.
  • D. A gain of about 1 pound per week is the best pattern for you.
Correct Answer: B

Rationale: The correct answer is B (15 to 25 pounds) because this recommendation aligns with the guidelines for weight gain during pregnancy for a client with a BMI of 26.5. The Institute of Medicine recommends this weight gain range for individuals in the overweight category. It is important to strike a balance between gaining enough weight to support the health of the fetus and not gaining excess weight that may lead to complications.

Choice A (11 to 20 pounds) may not provide enough weight gain for optimal pregnancy outcomes, while choice C (25 to 35 pounds) may lead to excessive weight gain. Choice D (1 pound per week) is too specific and does not account for individual variations in weight gain patterns during pregnancy. It is crucial to tailor weight gain recommendations based on the client's BMI to ensure a healthy pregnancy.

A woman at 38 weeks of gestation is admitted in early labor with ruptured membranes. The nurse determines that the client's oral temperature is 38.9°C (102°F). Besides notifying the provider, which of the following is an appropriate nursing action?

  • A. Recheck the client's temperature in 4 hours.
  • B. Administer glucocorticoids intramuscularly.
  • C. Assess the odor of the amniotic fluid.
  • D. Prepare the client for emergency cesarean section.
Correct Answer: C

Rationale: The correct answer is C: Assess the odor of the amniotic fluid. This is the appropriate nursing action because the woman is at risk for chorioamnionitis due to the elevated temperature and ruptured membranes. Assessing the odor of the amniotic fluid can help in identifying signs of infection, as foul-smelling amniotic fluid may indicate chorioamnionitis. This can guide further interventions and management, such as initiating antibiotics.

Choice A is incorrect as waiting 4 hours to recheck the temperature can delay necessary interventions for potential infection. Choice B is also incorrect as administering glucocorticoids is not the immediate priority in this situation. Choice D is incorrect as preparing for an emergency cesarean section is not warranted solely based on the client's temperature and ruptured membranes without further assessment for infection.

During an assessment of a client in labor who received epidural anesthesia, which finding should the nurse identify as a complication of the epidural block?

  • A. Vomiting
  • B. Tachycardia
  • C. Respiratory depression
  • D. Hypotension
Correct Answer: D

Rationale: The correct answer is D: Hypotension. Epidural anesthesia can lead to hypotension due to vasodilation and sympathetic blockade, resulting in decreased blood pressure. This is a common complication that nurses should monitor for and manage promptly. Vomiting (A) is not a direct complication of epidural anesthesia. Tachycardia (B) is not typically associated with epidural anesthesia but may indicate other issues. Respiratory depression (C) is more commonly seen with opioids and not a typical complication of epidural anesthesia.

A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients?

  • A. A client who is experiencing fetal death at 32 weeks of gestation
  • B. A client who is experiencing preterm labor at 26 weeks of gestation
  • C. A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation
  • D. A client who has a post-term pregnancy at 42 weeks of gestation
Correct Answer: B

Rationale: Correct Answer: B

Rationale:
1. Tocolytic therapy is used to delay preterm labor and prevent premature birth.
2. Administering tocolytic therapy at 26 weeks of gestation allows time for corticosteroids to enhance fetal lung maturity.
3. Delaying labor at this stage can improve neonatal outcomes.
4. Other choices are incorrect because tocolytic therapy is not indicated for fetal death, Braxton-Hicks contractions, or post-term pregnancy.

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