ATI LPN
Maternal Newborn ATI Proctored Exam Questions
Question 1 of 9
A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition?
Correct Answer: D
Rationale: The correct answer is D: Report of severe shoulder pain. In a ruptured ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tube. As the tube ruptures, there is internal bleeding which can irritate the diaphragm, causing referred pain to the shoulder. This phenomenon is known as Kehr's sign. The other choices are incorrect because with a ruptured ectopic pregnancy, there would typically be altered menses due to the pregnancy disruption, a transvaginal ultrasound would not show a fetus in the uterus, and blood progesterone levels would not be elevated.
Question 2 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: All of the above. Cholecystitis, hypertension, and migraine headaches are all contraindications to oral contraceptives. Cholecystitis can be exacerbated by oral contraceptives. Hypertension increases the risk of cardiovascular events with oral contraceptives. Migraine headaches, especially with aura, are associated with an increased risk of stroke when combined with oral contraceptives. Therefore, considering these risks, it is crucial to recognize these findings as contraindications to prescribing oral contraceptives.
Question 3 of 9
When a client states, 'My water just broke,' what is the nurse's priority intervention?
Correct Answer: D
Rationale: The correct answer is D: Begin FHR monitoring. This is the priority intervention because assessing the fetal heart rate (FHR) helps determine the well-being of the baby after the water breaking. Monitoring the FHR can indicate if the baby is in distress and prompt further actions if needed. Performing Nitrazine testing (choice A) is used to confirm if the fluid is amniotic fluid, but FHR monitoring takes precedence. Assessing the fluid (choice B) is important but not as urgent as monitoring the FHR. Checking cervical dilation (choice C) is not the priority as ensuring the baby's well-being through FHR monitoring is crucial in this situation.
Question 4 of 9
During preterm labor, a client is scheduled for an amniocentesis. The nurse should review which of the following tests to assess fetal lung maturity?
Correct Answer: B
Rationale: The correct answer is B: Lecithin/sphingomyelin (L/S) ratio. This test is used to assess fetal lung maturity by determining the ratio of two substances present in amniotic fluid. An L/S ratio of 2:1 or higher indicates mature fetal lungs, reducing the risk of respiratory distress syndrome in preterm infants. A: Alpha-fetoprotein (AFP) is used to screen for neural tube defects, not fetal lung maturity. C: Kleihauer-Betke test is used to detect fetal-maternal hemorrhage. D: Indirect Coombs' test is used to detect antibodies in maternal blood that may attack fetal red blood cells, not assess fetal lung maturity. In summary, the L/S ratio test is the most appropriate choice to assess fetal lung maturity during preterm labor, as it directly correlates with the development of the fetal lungs.
Question 5 of 9
A parent is receiving discharge teaching from a nurse regarding caring for their newborn after a circumcision. Which instruction should the nurse include?
Correct Answer: A
Rationale: The correct answer is A: Apply slight pressure with a sterile gauze pad for mild bleeding. This instruction is crucial because it addresses the immediate post-circumcision care to control bleeding. Applying slight pressure with a sterile gauze pad helps to promote clotting and prevent excessive bleeding. This step is essential to ensure the newborn's safety and prevent complications. Summary of other choices: B: Inspecting the circumcision site every 6 to 8 hours is important, but not as critical as addressing bleeding promptly. C: Avoiding baby wipes containing alcohol is a good practice to prevent irritation, but it is not the most urgent instruction for immediate care. D: Cleaning the circumcision site daily using a warm, wet washcloth is generally recommended for routine care, but in the immediate post-circumcision period, controlling bleeding takes precedence.
Question 6 of 9
A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states, 'I missed one menstrual cycle and cannot be pregnant because I have an intrauterine device.' The nurse should suspect which of the following?
Correct Answer: B
Rationale: The correct answer is B: Ectopic pregnancy. Given the client's symptoms of right-sided lower quadrant abdominal pain, vaginal bleeding, missed menstrual cycle, and presence of an intrauterine device, these are classic signs of an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube, leading to abdominal pain and vaginal bleeding. The other choices are incorrect because: A: Missed abortion would typically present with cramping, bleeding, and passage of tissue. C: Severe preeclampsia is characterized by high blood pressure and proteinuria, not the symptoms described. D: Hydatidiform mole would typically present with vaginal bleeding and uterine enlargement, but not the sharp abdominal pain described.
Question 7 of 9
A client in active labor is irritable, reports the urge to have a bowel movement, vomits, and states, 'I've had enough. I can't do this anymore.' Which of the following stages of labor is the client experiencing?
Correct Answer: C
Rationale: The client is experiencing the transition phase of labor. This stage occurs between the first and second stages, characterized by intense contractions, rapid cervical dilation, and strong emotions like irritability and feeling overwhelmed. The urge to have a bowel movement and vomiting are common signs indicating the baby is descending. The statement 'I can't do this anymore' is typical of transition as it signifies the peak of discomfort before the urge to push in the second stage. Other options are incorrect as the symptoms described align with the transition phase.
Question 8 of 9
During a weekly prenatal visit, a nurse is assessing a client at 38 weeks of gestation. Which of the following findings should the nurse report to the provider?
Correct Answer: C
Rationale: The correct answer is C: Weight gain of 2.2 kg (4.8 lb). This finding should be reported to the provider because sudden excessive weight gain in late pregnancy can be a sign of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. This could indicate a potential complication that needs immediate medical attention. Explanation: A: Blood pressure 136/88 mm Hg - This blood pressure reading is slightly elevated but not concerning for preeclampsia at this level. B: Report of insomnia - Insomnia is a common issue during pregnancy and not typically a cause for immediate concern. D: Report of Braxton-Hicks contractions - Braxton-Hicks contractions are common in the third trimester and are considered normal as long as they are not regular or increasing in intensity.
Question 9 of 9
A healthcare professional is assessing a late preterm newborn. Which of the following clinical manifestations is an indication of hypoglycemia?
Correct Answer: D
Rationale: The correct answer is D: Respiratory distress. Hypoglycemia in a late preterm newborn can lead to respiratory distress due to inadequate energy supply to respiratory muscles. Hypertonia (choice A) may indicate other issues such as hypocalcemia. Increased feeding (choice B) is not a typical clinical manifestation of hypoglycemia, as the newborn may have poor feeding due to low energy levels. Hyperthermia (choice C) is not directly related to hypoglycemia but may occur in response to infection or other causes. Thus, respiratory distress is the most indicative of hypoglycemia in this scenario.