Maternal Newborn ATI Proctored Exam 2023

Maternal Newborn ATI Proctored Exam 2023 Related

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Which of the following should be implemented in is experiencing increased oral mucus should provide management of hypovolemic shock due to postpar- parent education on which of the following? tum hemorrhage? Select all that apply.

  • A. Correctly positioning the infant for feedings
  • B. IV fluid replacement with 5% dextrose
  • C. Initiating cardiopulmonary resuscitation
  • D. Administration of oxygen with a nonrebreather
Correct Answer: A

Rationale: The correct answer is A: Correctly positioning the infant for feedings. This is the most appropriate intervention as it addresses the specific issue of increased oral mucus in an infant, which can be a sign of difficulty feeding and potential aspiration. Positioning the infant correctly can help facilitate safe and effective feeding, reducing the risk of complications.

Summary of why other choices are incorrect:
B: IV fluid replacement with 5% dextrose - This choice does not directly address the issue of increased oral mucus and hypovolemic shock due to postpartum hemorrhage.
C: Initiating cardiopulmonary resuscitation - This choice is not indicated for the given scenario and is more appropriate for a life-threatening emergency situation.
D: Administration of oxygen with a nonrebreather - While oxygen may be necessary in certain cases, it does not address the specific issue of increased oral mucus and hypovolemic shock due to postpartum hemorrhage.

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A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding?

  • A. The fetal head is in the left occiput posterior position.
  • B. The largest fetal diameter has passed through the pelvic outlet.
  • C. The posterior fontanel is palpable.
  • D. The lowermost portion of the fetus is at the level of the ischial spines.
Correct Answer: D

Rationale: Correct Answer: D. The lowermost portion of the fetus is at the level of the ischial spines.

Rationale:
1. Station 0 indicates the presenting part of the fetus is at the level of the ischial spines.
2. This position is significant as it helps determine the progress of labor.
3. It means the fetus has not descended into the birth canal yet, indicating early labor stages.

Summary:
A: Incorrect. Left occiput posterior position is related to fetal head position, not station.
B: Incorrect. Passing through the pelvic outlet refers to engagement, not station.
C: Incorrect. The posterior fontanel being palpable is not directly related to station.

A nurse is teaching a prenatal class about immunizations that newborns receive following birth. Which of the following immunizations should the nurse include in the teaching?

  • A. Hepatitis B
  • B. Rotavirus
  • C. Pneumococcal
  • D. Varicella
Correct Answer: A

Rationale: The correct answer is A: Hepatitis B. Newborns typically receive the Hepatitis B vaccine shortly after birth to provide protection against the virus. This is important because newborns are at risk of contracting Hepatitis B from infected mothers during childbirth. The vaccine helps prevent chronic liver infections and liver cancer later in life.

Why other choices are incorrect:
B: Rotavirus - Rotavirus vaccine is typically given to infants starting at 2 months of age, not immediately after birth.
C: Pneumococcal - Pneumococcal vaccines are usually given later in infancy, not right after birth.
D: Varicella - Varicella vaccine is typically given around 12-15 months of age, not immediately after birth.

The nurse is caring for a client with suspected preterm labor. Which medication is most likely to be prescribed?

  • A. Magnesium sulfate.
  • B. Methyldopa.
  • C. Rho(D) immune globulin.
  • D. Oxytocin.
Correct Answer: A

Rationale: The correct answer is A: Magnesium sulfate. This medication is commonly prescribed for preterm labor to relax the uterine muscles and prevent contractions. It helps delay labor and reduce the risk of preterm birth. Methyldopa (B) is used for managing hypertension, not preterm labor. Rho(D) immune globulin (C) is given to Rh-negative mothers to prevent hemolytic disease in newborns. Oxytocin (D) is used to induce or augment labor, not for suspected preterm labor. Therefore, A is the most appropriate choice for managing preterm labor.

Probable signs of pregnancy

  • A. Ballottement (rebounding of the fetus against the examiner's fingers on palpation)
  • B. Chadwicks sign (violet coloration of mucous membranes of cervix, vagina, and vulva @4 wks)
  • C. Uterine enlargement
  • D. Hegar's sign (compressibility and softening of lower uterine segment @6 wks)
Correct Answer: A

Rationale: The correct answer is A: Ballottement. This is a probable sign of pregnancy because it involves the rebounding of the fetus against the examiner's fingers on palpation. This occurs when the examiner pushes against the uterus and feels a bouncing back, indicating the presence of a fetus.

Choice B, Chadwick's sign, is actually the violet coloration of mucous membranes of cervix, vagina, and vulva at around 6-8 weeks, not 4 weeks as stated.

Choice C, uterine enlargement, is a presumptive sign of pregnancy as it can be caused by factors other than pregnancy, such as fibroids.

Choice D, Hegar's sign, involves the compressibility and softening of the lower uterine segment at around 6 weeks, but it is a probable sign rather than a definitive one like Ballottement.

The nurse is caring for a client in the third trimester reporting severe right upper quadrant pain and nausea. What condition should the nurse suspect?

  • A. Placenta previa.
  • B. HELLP syndrome.
  • C. Hyperemesis gravidarum.
  • D. Abruptio placentae.
Correct Answer: B

Rationale: The correct answer is B: HELLP syndrome. In the third trimester, severe right upper quadrant pain and nausea can indicate HELLP syndrome, a serious pregnancy complication involving hemolysis, elevated liver enzymes, and low platelet count. The pain and nausea are due to liver and gallbladder involvement. Placenta previa typically presents with painless vaginal bleeding, not upper quadrant pain. Hyperemesis gravidarum causes severe nausea and vomiting but not specific upper quadrant pain. Abruptio placentae presents with sudden-onset abdominal pain and vaginal bleeding.

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