Maternal Newborn ATI Proctored Exam

Maternal Newborn ATI Proctored Exam Related

Review Maternal Newborn ATI Proctored Exam related questions and content

A healthcare professional is preparing to administer magnesium sulfate 2 g/hr IV to a client who is in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5% in water (D5W). How many mL/hr should the IV infusion pump be set to administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

  • A. 60
  • B. 30
  • C. 50
  • D. 80
Correct Answer: C

Rationale: To calculate the mL/hr for the IV infusion pump, we need to use the formula: (Desired dose in mg/hr * Volume of solution in mL) / Concentration of solution in mg/mL.
Given:
Desired dose = 2 g/hr = 2000 mg/hr
Volume of solution = 500 mL
Concentration of solution = 20 g in 500 mL = 20,000 mg in 500 mL = 40 mg/mL

Now, plug these values into the formula:
(2000 mg/hr * 500 mL) / 40 mg/mL = 25,000 mL/hr

Round this to the nearest whole number, which is 25,000 mL/hr ≈ 50 mL/hr. Therefore, the IV infusion pump should be set to administer 50 mL/hr, making choice C the correct answer.
Option A (60 mL/hr) and Option D (80 mL/hr) are incorrect as they do not match the calculated value. Option

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A client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?

  • A. Betamethasone
  • B. Indomethacin
  • C. Nifedipine
  • D. Methylergonovine
Correct Answer: A

Rationale: The correct answer is A: Betamethasone. Betamethasone is a corticosteroid used to promote fetal lung maturity in preterm labor. In this scenario, at 32 weeks of gestation with placenta previa and active bleeding, the priority is to promote fetal lung maturity in case of premature delivery due to the risk of maternal hemorrhage. Indomethacin (B) is a nonsteroidal anti-inflammatory drug and not indicated in this situation. Nifedipine (C) is a calcium channel blocker used for preterm labor to delay contractions, not for placenta previa and active bleeding. Methylergonovine (D) is used for postpartum hemorrhage and not indicated in this scenario.

A newborn was transferred to the nursery 30 min after delivery. What should the nurse do first?

  • A. Confirm the newborn's identification.
  • B. Verify the newborn's identification.
  • C. Administer vitamin K to the newborn.
  • D. Determine obstetrical risk factors.
Correct Answer: B

Rationale: The correct answer is B because verifying the newborn's identification ensures the right baby is in the nursery. It is crucial for patient safety and prevents mix-ups. Confirming identification (choice A) is important but comes after verification. Administering vitamin K (choice C) is a necessary procedure but not the first priority. Determining obstetrical risk factors (choice D) is important but not as immediate as verifying identification. Thus, verifying the newborn's identification should be done first to prevent errors and ensure proper care.

A client who is 12 hours postpartum has a fundus located two fingerbreadths above the umbilicus, deviated to the right of the midline, and less firm than previously noted. Which of the following actions should the nurse take?

  • A. Place the client in a side-lying position.
  • B. Assist the client to the bathroom to void.
  • C. Obtain a prescription for IV oxytocin.
  • D. Administer methylergonovine.
Correct Answer: B

Rationale: The correct answer is B: Assist the client to the bathroom to void. This action can help promote uterine contractions by relieving bladder distention, which can cause the fundus to be displaced. Voiding can help the uterus return to its normal position and firmness. Placing the client in a side-lying position (A) may be helpful for fundal massage but addressing bladder distention is the priority. Obtaining a prescription for IV oxytocin (C) or administering methylergonovine (D) are not indicated as first-line interventions for a fundus located above the umbilicus postpartum.

When a client states, 'My water just broke,' what is the nurse's priority intervention?

  • A. Perform Nitrazine testing.
  • B. Assess the fluid.
  • C. Check cervical dilation.
  • D. Begin FHR monitoring.
Correct Answer: D

Rationale: The correct answer is D: Begin FHR monitoring. This is the priority intervention because assessing the fetal heart rate (FHR) helps determine the well-being of the baby after the water breaking. Monitoring the FHR can indicate if the baby is in distress and prompt further actions if needed. Performing Nitrazine testing (choice A) is used to confirm if the fluid is amniotic fluid, but FHR monitoring takes precedence. Assessing the fluid (choice B) is important but not as urgent as monitoring the FHR. Checking cervical dilation (choice C) is not the priority as ensuring the baby's well-being through FHR monitoring is crucial in this situation.

A client at 40 weeks of gestation is experiencing contractions every 3 to 5 minutes, becoming stronger. A vaginal exam by the registered nurse reveals the client's cervix is 3 cm dilated, 80% effaced, and -1 station. The client requests pain medication. Which of the following actions should the nurse prepare to take? (Select all that apply)

  • A. Provide ice chips.
  • B. Insert an indwelling urinary catheter.
  • C. Administer opioid analgesic medication.
  • D. Provide ice chips.
Correct Answer: C

Rationale: The correct action is to administer opioid analgesic medication (Choice C). At 40 weeks gestation with contractions every 3-5 minutes, 3 cm dilated, 80% effaced, and -1 station, the client is in active labor. Pain medication is appropriate to manage discomfort during labor. Opioid analgesics can help reduce pain intensity while still allowing the client to remain alert and participate in labor. Ice chips (Choice A and D) are not directly related to pain management in labor. Inserting a urinary catheter (Choice B) is not indicated unless there are specific concerns about bladder distention.

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