ATI LPN
ATI Maternal Newborn Proctored Questions
Question 1 of 5
While observing the electronic fetal heart rate monitor tracing for a client at 40 weeks of gestation in labor, a nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?
Correct Answer: D
Rationale: The correct answer is D: Variable decelerations. Variable decelerations are abrupt decreases in the fetal heart rate that coincide with contractions, indicating umbilical cord compression. This pattern can lead to fetal hypoxia and distress. Early decelerations (
A) are gradual decreases in heart rate that mirror contractions and are considered benign. Accelerations (
B) are increases in heart rate and are a reassuring sign of fetal well-being. Late decelerations (
C) are gradual decreases in heart rate that occur after the peak of a contraction, indicating uteroplacental insufficiency.
Question 2 of 5
A client is scheduled for a cesarean birth based on fetal lung maturity. Which finding indicates that the fetal lungs are mature?
Correct Answer: C
Rationale: The correct answer is C: Lecithin/sphingomyelin (L/S) ratio of 2:1. This ratio indicates fetal lung maturity as it signifies adequate production of surfactant in the fetal lungs, essential for proper lung function after birth. Absence of Phosphatidylglycerol (PG) (
Choice
A) indicates immaturity, Biophysical profile score of 8 (
Choice
B) assesses overall fetal well-being, not lung maturity, and Reactive nonstress test (
Choice
D) evaluates fetal well-being, not lung maturity. The L/S ratio of 2:1 is the most reliable indicator of fetal lung maturity.
Question 3 of 5
When monitoring uterine contractions in a client in the active phase of the first stage of labor, which finding should the nurse report to the provider?
Correct Answer: A
Rationale:
Rationale: Contractions lasting longer than 90 seconds can indicate uterine hyperstimulation, which can lead to decreased oxygenation of the fetus. This finding should be reported to the provider for further assessment and intervention. Contractions occurring every 3 to 5 minutes (choice
B) are normal in the active phase of labor. Strong contractions (choice
C) are also expected during this phase. Feeling contractions in the lower back (choice
D) is common and not typically a cause for concern. Reporting contractions lasting longer than 90 seconds is crucial to ensure the safety of both the mother and the baby.
Question 4 of 5
A client is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The client asks the nurse about the purpose of this test. What explanation should the nurse provide?
Correct Answer: A
Rationale: The correct answer is A because the maternal serum alpha-fetoprotein test is specifically used to screen for neural tube defects and other developmental abnormalities in the fetus. Alpha-fetoprotein levels in the mother's blood can indicate the presence of such abnormalities. This test is typically done around 15-20 weeks of gestation.
Choice B is incorrect because the maternal serum alpha-fetoprotein test is not used to assess various markers of fetal well-being.
Choice C is incorrect because it does not identify Rh incompatibility, which is typically detected through other tests.
Choice D is incorrect because the test is not primarily for spinal defects, but rather for neural tube defects and other developmental abnormalities.
Question 5 of 5
When advising a woman considering pregnancy on nutritional needs to reduce the risk of giving birth to a newborn with a neural tube defect, what information should the nurse include?
Correct Answer: C
Rationale: The correct answer is C: Consume foods fortified with folic acid. Folic acid plays a crucial role in preventing neural tube defects in newborns. It is recommended that women of childbearing age consume 400 mcg of folic acid daily to reduce the risk. Foods fortified with folic acid include cereals, bread, and pasta.
A: Limit alcohol consumption - While important for overall health, alcohol consumption is not directly related to preventing neural tube defects.
B: Increase intake of iron-rich foods - Iron is essential during pregnancy, but it is not specifically linked to reducing the risk of neural tube defects.
D: Avoid foods containing aspartame - Aspartame is a sweetener and does not have a direct impact on neural tube defects prevention.