ATI LPN
Maternal Newborn ATI Proctored Exam 2023 Questions
Question 1 of 9
A client in a family planning clinic requests oral contraceptives. Which of the following findings in the client's history should be recognized as contraindications to oral contraceptives? (Select all that apply.)
Correct Answer: D
Rationale: The correct answer is D. Cholecystitis, hypertension, and migraine headaches are contraindications to oral contraceptives due to increased risks of complications. Cholecystitis can worsen with oral contraceptives, hypertension increases cardiovascular risks, and migraines with aura can increase stroke risk. Other choices are incorrect because they do not pose significant risks with oral contraceptives.
Question 2 of 9
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?
Correct Answer: B
Rationale: The correct answer is B: Assist the client to the bathroom to void. This action helps the uterus to contract and promotes fundal height descent. Voiding eliminates the full bladder, which can impede fundal firmness. Placing the client in a side-lying position may alleviate discomfort but does not address the fundal position. IV oxytocin is not indicated unless fundal massage and other non-pharmacological interventions fail. Methylergonovine is contraindicated postpartum due to the risk of severe hypertension and other adverse effects.
Question 3 of 9
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.)
Correct Answer: C
Rationale: To calculate the mL/hr for the IV pump infusion rate, first determine the total volume of magnesium sulfate to be administered per hour (2 g/hr). Next, calculate the volume of the solution that contains the 2 g of magnesium sulfate (20 g in 500 mL). Divide the total volume by the concentration of magnesium sulfate in the solution to find the mL/hr rate. In this case, (2 g/hr / 20 g) * 500 mL = 50 mL/hr. Therefore, the correct answer is C (50 mL/hr). Choice A (60 mL/hr) is incorrect as it does not accurately calculate the mL/hr rate based on the provided information. Choice B (30 mL/hr) is incorrect as it is too low of a rate based on the concentration of magnesium sulfate in the solution. Choice D (80 mL/hr) is incorrect as it is too high of a rate based on the concentration of magnesium sulfate in the solution.
Question 4 of 9
A client in active labor reports back pain while being examined by a nurse who finds her to be 8 cm dilated, 100% effaced, -2 station, and in the occiput posterior position. What action should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Assist the client to the hands and knees position. This position, also known as the all-fours position, can help rotate the baby from an occiput posterior position to an occiput anterior position, which is ideal for labor progress. It can alleviate back pain by reducing pressure on the spine and encouraging optimal fetal positioning. Effleurage (choice A) may provide comfort but won't address the underlying issue. Placing the client in lithotomy position (choice B) may not be helpful and can even worsen the occiput posterior position. Applying a scalp electrode to the fetus (choice D) is unnecessary at this point and does not address the client's back pain or fetal positioning.
Question 5 of 9
A healthcare provider is assessing fetal heart tones for a pregnant client. The provider has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the provider apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?
Correct Answer: C
Rationale: The correct answer is C: Left lower quadrant. When the fetal position is left occipital anterior, the provider should place the ultrasound transducer on the left lower quadrant. This is because the fetal heart is closest to this area, allowing for optimal detection of the fetal heart tones. Placing the transducer on other quadrants would not provide the best angle to capture the maximum intensity of the fetal heart tones. The left upper quadrant (choice A) and right upper quadrant (choice B) are not in line with the fetal position and may result in poor signal detection. The right lower quadrant (choice D) is farther away from the fetal heart and may not provide an accurate assessment of the fetal heart tones.
Question 6 of 9
A client who is postpartum is receiving discharge teaching from a nurse. For which of the following clinical manifestations should the client be instructed to monitor and report to the provider?
Correct Answer: C
Rationale: The correct answer is C: Unilateral breast pain. This is important to monitor and report because it can be a sign of mastitis, which is an infection of the breast tissue common in postpartum clients. Mastitis can lead to complications if not treated promptly. A: Persistent abdominal striae are common after pregnancy and do not typically require immediate medical attention. B: A temperature of 37.8°C (100.2°F) is slightly elevated but not necessarily concerning unless accompanied by other symptoms. D: Brownish-red discharge on day 5 postpartum is normal lochia and is expected during this time frame.
Question 7 of 9
A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow.
Correct Answer: D
Rationale: The correct sequence for performing Leopold maneuvers is as follows: 1. Palpate the fundus to identify the fetal part (A) 2. Determine the location of the fetal back (B) 3. Palpate for the fetal part presenting at the inlet (C) By following these steps, the nurse can assess the position of the fetus and determine the best approach for delivery. Choosing option D (All of the Above) is correct because each step is essential in conducting a thorough assessment. Options A, B, and C are incorrect individually because they represent isolated steps of the process, whereas performing all three steps in sequence provides a comprehensive evaluation of fetal position.
Question 8 of 9
A client is to receive oxytocin to augment labor. Which finding contraindicates the initiation of the oxytocin infusion and should be reported to the provider?
Correct Answer: A
Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, which can lead to fetal hypoxia. Administering oxytocin in this scenario can further compromise fetal oxygenation due to increased uterine contractions. It is crucial to report this finding to the provider immediately to prevent harm to the fetus. Incorrect Choices: B: Moderate variability of the FHR is a normal finding indicating fetal well-being. C: Cessation of uterine dilation does not directly contraindicate oxytocin infusion. D: Prolonged active phase of labor may necessitate oxytocin augmentation but does not contraindicate its initiation.
Question 9 of 9
A client with hyperemesis gravidarum is receiving dietary teaching. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: A
Rationale: Correct Answer: A Rationale: A client with hyperemesis gravidarum may have aversions to certain foods due to nausea and vomiting. Choosing foods that appeal to their taste can help them consume enough nutrients. By prioritizing taste over balance, the client is more likely to eat and maintain adequate nutrition. This approach supports the client's individual needs during this challenging time. Summary: - Choice B is incorrect as having a snack at bedtime can help manage nausea by keeping blood sugar levels stable. - Choice C is incorrect as hot tea may exacerbate nausea in some individuals with hyperemesis gravidarum. - Choice D is incorrect as pairing sweets with starches may not address the client's specific food aversions and may not be well tolerated.