ATI RN
RN Maternal Newborn Online Practice 2019 A Questions
Question 1 of 5
A client at 36 weeks' gestation reports decreased fetal movement. What is the nurse's priority action?
Correct Answer: A
Rationale: In this scenario, the nurse's priority action should be to perform a nonstress test (Option A). This test is used to assess fetal well-being by monitoring the fetal heart rate in response to fetal movement. It helps determine if the fetus is receiving an adequate oxygen supply. Performing a nonstress test is crucial because decreased fetal movement could indicate fetal distress or compromise, which requires immediate attention to prevent adverse outcomes. This test provides real-time information on fetal status, guiding further interventions or decisions. Encouraging the client to drink orange juice (Option B) is not the priority action in this situation. While maternal hydration or consuming something sweet may sometimes encourage fetal movement, in cases of decreased fetal movement at 36 weeks, a more formal assessment like a nonstress test is needed to evaluate fetal well-being accurately. Scheduling an ultrasound (Option C) can provide detailed information about fetal status but may not be as immediate or readily available as a nonstress test in determining the current fetal response to stimuli. In cases of decreased fetal movement, time is critical, and the nonstress test offers a quicker assessment of fetal well-being. Notifying the healthcare provider (Option D) is important but should come after initiating the nonstress test. The provider should be informed of the situation and the test results, but the priority is to first assess the fetal well-being through the nonstress test. In the context of maternal newborn care, understanding the significance of fetal movement assessment and the appropriate interventions is vital for ensuring the health and safety of both the mother and the baby. Nurses need to prioritize prompt and accurate assessments to provide timely interventions and prevent potential complications during pregnancy.
Question 2 of 5
A client at 20 weeks' gestation asks about the purpose of an anatomy ultrasound. What is the nurse's best response?
Correct Answer: B
Rationale: The correct answer is B) To assess the baby’s growth and development. An anatomy ultrasound at 20 weeks' gestation is typically performed to evaluate the baby's growth, development, and overall anatomy. This detailed scan allows healthcare providers to assess the baby's organs, limbs, spine, brain, and other structures to ensure they are developing properly. It also helps in detecting any potential abnormalities that may require further evaluation or intervention. Option A) To confirm the baby’s sex is incorrect because while an ultrasound may reveal the baby's sex, its primary purpose at 20 weeks is to assess development, not determine gender. Option C) To detect early signs of labor is incorrect as an anatomy ultrasound does not typically provide information about the onset of labor. Signs of labor are usually monitored through other assessments closer to the due date. Option D) To evaluate amniotic fluid levels is incorrect because amniotic fluid levels are typically assessed through a separate ultrasound called an amniotic fluid index, which is not the primary purpose of an anatomy ultrasound at 20 weeks. In an educational context, it is important for nurses to understand the various types of ultrasounds performed during pregnancy and their specific purposes. This knowledge allows nurses to effectively educate and support pregnant clients in understanding the importance of these screenings for the health and well-being of both the mother and the baby.
Question 3 of 5
The nurse is assessing a client with suspected gestational hypertension. What finding supports this diagnosis?
Correct Answer: A
Rationale: In the assessment of a client with suspected gestational hypertension, a blood pressure reading of 150/90 mmHg supports this diagnosis. Gestational hypertension is characterized by elevated blood pressure that occurs after 20 weeks of gestation without the presence of proteinuria or end-organ damage. Option A is correct because a blood pressure reading of 150/90 mmHg indicates hypertension in pregnancy, which can lead to adverse outcomes for both the mother and the fetus if not managed appropriately. Option B, proteinuria of +2, is more indicative of preeclampsia rather than gestational hypertension. Preeclampsia is characterized by hypertension and proteinuria, while gestational hypertension is defined by elevated blood pressure alone. Option C, fetal heart rate of 140 beats/minute, is not directly related to the diagnosis of gestational hypertension. Fetal heart rate monitoring is important for assessing fetal well-being but does not confirm the diagnosis of gestational hypertension. Option D, mild edema in the lower extremities, is a common finding in pregnancy and is not specific to gestational hypertension. Edema alone is not a reliable indicator of this condition. Educationally, understanding the differences between gestational hypertension and preeclampsia is crucial for nurses caring for pregnant clients. Recognizing the key signs and symptoms of each condition is essential for early detection, appropriate management, and optimal outcomes for both the mother and the baby. Regular monitoring of blood pressure and other clinical signs is vital in the antenatal care of women at risk for hypertensive disorders of pregnancy.
Question 4 of 5
A patient who uses a diaphragm as contraception asks if they need to use a backup method. What should the nurse respond?
Correct Answer: B
Rationale: The diaphragm should be used with spermicide for maximum effectiveness. Choice A is incorrect because while the diaphragm is effective, spermicide enhances its performance and ensures greater protection. Choice C is unnecessary, as the diaphragm alone with spermicide is sufficient. Choice D is incorrect because while regular replacement is recommended, it does not require a backup method.
Question 5 of 5
The nurse assesses a patient for medical eligibility for contraceptive use. What is the meaning of an MEC score of 2?
Correct Answer: B
Rationale: An MEC score of 2 indicates that there is an unacceptable health risk if the contraceptive method is used. This means that the potential health risks associated with using this particular contraceptive method outweigh the benefits. Therefore, the nurse should advise against using this method for contraception due to the elevated health risks involved. It is essential for healthcare providers to meticulously assess the medical eligibility of a patient before recommending any contraceptive method to ensure the safety and well-being of the individual.