A client who is at 6 weeks of gestation with her first pregnancy asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make?

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ATI Maternal Newborn Proctored Questions

Question 1 of 5

A client who is at 6 weeks of gestation with her first pregnancy asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make?

Correct Answer: C

Rationale: The correct answer is C: This will occur between the fourth and fifth months of pregnancy. Quickening typically happens around 18-20 weeks, which falls between the fourth and fifth months of pregnancy. During this time, the fetus's movements become more pronounced and can be felt by the pregnant person. Choices A, B, and D are incorrect because quickening does not occur in the last trimester, end of the first trimester, or when the uterus rises out of the pelvis. These options do not align with the typical timing of quickening in pregnancy.

Question 2 of 5

A client is 1 hour postpartum and the nurse observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?

Correct Answer: D

Rationale: Rationale: 1. Lochia rubra and small clots are expected postpartum. 2. The firm, midline fundus indicates normal involution. 3. No signs of excessive bleeding or fundus displacement. 4. Documenting and monitoring is appropriate for normal postpartum assessment. Summary: A: Not necessary as no complications present. B: Unnecessary and could cause discomfort. C: Bladder emptying may help fundal position but not urgent. D: Correct option for normal postpartum assessment and monitoring.

Question 3 of 5

While caring for a newborn, a nurse auscultates an apical heart rate of 130/min. Which of the following actions should the nurse take?

Correct Answer: B

Rationale: The correct answer is B: Document this as an expected finding. A heart rate of 130/min in a newborn is within the normal range (120-160/min). The nurse should document this as an expected finding because it indicates a healthy heart rate for a newborn. There is no immediate need for intervention or further assessment as the heart rate falls within the normal range for a newborn. Asking another nurse to verify the heart rate (choice A) is unnecessary as it is within the normal range. Calling the provider to further assess the newborn (choice C) is not needed since the heart rate is normal. Preparing the newborn for transport to the NICU (choice D) is not indicated as the heart rate is within the normal range.

Question 4 of 5

A client with a BMI of 26.5 is seeking advice on weight gain during pregnancy at the first prenatal visit. Which of the following responses should the nurse provide?

Correct Answer: B

Rationale: The correct answer is B (15 to 25 pounds) because this recommendation aligns with the guidelines for weight gain during pregnancy for a client with a BMI of 26.5. The Institute of Medicine recommends this weight gain range for individuals in the overweight category. It is important to strike a balance between gaining enough weight to support the health of the fetus and not gaining excess weight that may lead to complications. Choice A (11 to 20 pounds) may not provide enough weight gain for optimal pregnancy outcomes, while choice C (25 to 35 pounds) may lead to excessive weight gain. Choice D (1 pound per week) is too specific and does not account for individual variations in weight gain patterns during pregnancy. It is crucial to tailor weight gain recommendations based on the client's BMI to ensure a healthy pregnancy.

Question 5 of 5

A client who is at 39 weeks of gestation and is in active labor has fetal heart tones located above the umbilicus at midline. The fetus is likely in which of the following positions?

Correct Answer: D

Rationale: The correct answer is D: Frank breech. In a frank breech position, the buttocks of the fetus are presenting first, which is why the fetal heart tones can be heard above the umbilicus at midline. In this position, the feet are near the head, causing the buttocks to be the presenting part. Choices A, B, and C are incorrect because in a cephalic position, the head would be presenting, in a transverse position, the baby would be lying sideways, and in a posterior position, the baby's back would be against the mother's back.

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