ATI RN
RN Maternal Newborn Online Practice 2019 A Questions
Question 1 of 5
A nurse is admitting a client who has a diagnosis of preterm labor. The nurse anticipates a prescription by the provider for which of the following medications? (Select all that apply.)
Correct Answer: A
Rationale: In the management of preterm labor, the correct medication anticipated by the nurse is Prostaglandin E2 (Option A). Prostaglandin E2 is a medication commonly used to induce labor or ripen the cervix in preparation for labor in obstetric care. In the context of preterm labor, it can be used to promote uterine contractions to progress labor and potentially prevent further complications associated with preterm birth. Indomethacin (Option B) is a nonsteroidal anti-inflammatory drug that can be used to delay preterm labor by inhibiting prostaglandin synthesis. However, it is not the first-line medication choice for actively managing preterm labor. Magnesium sulfate (Option C) is often used to prevent seizures in preeclampsia/eclampsia and is not typically used to manage preterm labor directly. Methylergonovine (Option D) is a medication used to prevent or control postpartum hemorrhage by promoting uterine contractions after delivery, and it is not indicated for managing preterm labor. Understanding the appropriate pharmacological interventions in managing preterm labor is crucial for nurses working in maternal newborn care to ensure safe and effective patient outcomes. Prostaglandin E2 is selected in this scenario due to its role in promoting uterine contractions and advancing labor in the context of preterm birth.
Question 2 of 5
What is the primary purpose of administering vitamin K to a newborn?
Correct Answer: C
Rationale: Administering vitamin K to a newborn is crucial to prevent bleeding disorders, specifically hemorrhagic disease of the newborn. Newborns have low levels of vitamin K at birth, which puts them at risk for hemorrhagic disease, a condition that can lead to severe bleeding, including intracranial hemorrhage. Vitamin K is essential for the production of clotting factors in the liver, which help the blood to clot effectively. By giving newborns a dose of vitamin K at birth, healthcare providers can prevent potential bleeding complications and ensure the baby's health and safety. Option A, preventing anemia, is incorrect because vitamin K does not play a significant role in preventing anemia in newborns. Anemia is usually related to iron deficiency or other factors, not vitamin K. Option B, enhancing immune function, is incorrect because while vitamin K is important for overall health, its primary role in newborns is related to blood clotting and preventing bleeding disorders, not directly related to immune function. Option D, promoting growth and development, is incorrect because although vitamin K is essential for overall growth and development, its immediate priority in newborns is to prevent bleeding disorders, as deficiencies can have serious consequences. Understanding the specific role of vitamin K in newborns' health is essential for healthcare providers working in maternal newborn care to ensure the best possible outcomes for their patients.
Question 3 of 5
Which finding in a 36-week pregnant client is most concerning?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Proteinuria of +2 is the most concerning finding in a 36-week pregnant client. Proteinuria is the presence of abnormal levels of protein in the urine, which can indicate underlying issues like preeclampsia, a serious condition characterized by high blood pressure and organ damage. In a pregnant woman, particularly at 36 weeks, proteinuria can be a sign of preeclampsia, which requires immediate medical attention to prevent complications for both the mother and the baby. Now, let's discuss why the other options are not as concerning: A) Braxton Hicks contractions are common and considered normal in pregnancy, especially in the third trimester. They are usually irregular, mild, and do not indicate labor. B) Frequent urination is a common symptom in pregnancy due to hormonal changes and the growing uterus putting pressure on the bladder. While it can be uncomfortable, it is not typically a cause for concern. D) Weight gain of 2 pounds in a week is within the normal range for pregnancy, especially towards the end of the third trimester when the baby is growing rapidly. Sudden excessive weight gain or swelling, however, could be a sign of preeclampsia and should be monitored. Educationally, this question highlights the importance of recognizing concerning signs and symptoms in pregnant clients, especially those that could indicate severe conditions like preeclampsia. Understanding the significance of proteinuria in this context is crucial for nurses and healthcare providers to provide timely and appropriate care to ensure the well-being of both the pregnant individual and the unborn child.
Question 4 of 5
What is the recommended response for a pregnant client reporting decreased fetal movements?
Correct Answer: C
Rationale: In the context of pharmacology and maternal newborn care, the recommended response for a pregnant client reporting decreased fetal movements is to advise monitoring for fetal heart rate decelerations (Option C). This is the correct choice because decreased fetal movements can be an early sign of fetal distress. Monitoring the fetal heart rate can provide crucial information about the well-being of the baby, helping healthcare providers assess the situation promptly and take necessary actions to ensure the safety of both the mother and the baby. Option A, encouraging the client to lie on her left side, is a common recommendation to improve blood flow to the fetus and can be helpful in certain situations. However, in the case of decreased fetal movements, monitoring the fetal heart rate is a more direct and immediate way to assess the baby's well-being. Option B, scheduling an immediate ultrasound, may be necessary in some cases of decreased fetal movements to visualize the baby and assess its condition. However, monitoring the fetal heart rate is a quicker and more accessible initial step to take in response to this situation. Option D, instructing the client to monitor movements over the next 48 hours, is not advisable when a pregnant client reports decreased fetal movements. Time is of the essence in such situations, and waiting for 48 hours without immediate assessment could pose risks to the baby's well-being. In an educational context, understanding the importance of monitoring fetal well-being and responding promptly to changes in fetal movements is crucial for healthcare providers caring for pregnant clients. This knowledge can help prevent adverse outcomes and ensure the best possible care for both the mother and the baby.
Question 5 of 5
What teaching is most important for a mother with a newborn receiving phototherapy?
Correct Answer: A
Rationale: In the context of a newborn receiving phototherapy for jaundice, the most important teaching for the mother is Option A) Ensure the newborn wears protective eyewear. Phototherapy involves exposing the baby's skin to light to help break down excess bilirubin. Without eye protection, the baby's eyes can be harmed by the bright lights used in phototherapy. Therefore, ensuring that the newborn wears protective eyewear is crucial to prevent eye damage. Option B) Increase the newborn's fluid intake is not the most important teaching in this scenario. While adequate hydration is important for newborns, it is not directly related to the safety and effectiveness of phototherapy. Option C) Turn the newborn frequently to prevent pressure sores is not the priority teaching here. While repositioning is essential for preventing pressure sores in hospitalized patients, it is not the primary concern for a newborn undergoing phototherapy. Option D) Monitor bilirubin levels every 8 hours is important for healthcare providers to do, but it is not a teaching that would directly involve the mother of the newborn. Teaching the mother about the importance of protective eyewear during phototherapy is more relevant and crucial for her active participation in the care of her newborn. In an educational context, this question highlights the importance of patient safety and family education in newborn care, emphasizing the specific considerations involved in managing newborns undergoing phototherapy for jaundice. It underscores the significance of providing clear and concise instructions to parents to ensure the well-being of their newborns during medical interventions.