ATI RN
Ethical Issues in Maternity Care Questions
Question 1 of 5
A nurse is assessing a newborn who is 48 hr old and is experiencing opioid withdrawals. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Moderate tremors of the extremities. Newborns exposed to opioids in utero are at risk for neonatal abstinence syndrome (NAS), which can manifest as withdrawal symptoms after birth. Tremors of the extremities are a common sign of NAS due to the baby's central nervous system being affected by the opioid exposure. Option A) Hypotonicity is less likely in opioid-exposed newborns as they often exhibit increased muscle tone or hypertonicity. Option C) An axillary temperature of 36.1°C (96.9°F) is within the normal range for a newborn and not directly related to opioid withdrawal symptoms. Option D) Excessive sleeping is not a typical sign of opioid withdrawal in newborns; instead, they may exhibit increased irritability and difficulty with sleeping. Educationally, understanding the signs and symptoms of NAS is crucial for healthcare providers working in maternity care to provide appropriate care and support for newborns experiencing opioid withdrawals. By recognizing these symptoms early, healthcare professionals can implement interventions to help manage the newborn's withdrawal symptoms and promote their well-being.
Question 2 of 5
A nurse is caring for a client who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding. The client has a history of cocaine use. The nurse should identify that the client is likely experiencing which of the following complications?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Abruptio placentae. Abruptio placentae is a serious complication where the placenta detaches from the uterine wall before delivery. The symptoms of abdominal pain and vaginal bleeding in a pregnant woman with a history of cocaine use are indicative of this condition. Cocaine can cause vasoconstriction, leading to decreased blood flow to the placenta, increasing the risk of abruptio placentae. Option B) Hydatidiform mole is incorrect because this condition presents with symptoms such as vaginal bleeding, passage of vesicles, and elevated hCG levels, not continuous abdominal pain. Option C) Preterm labor is unlikely in this case as the symptoms described are more indicative of a placental complication rather than uterine contractions. Option D) Placenta previa typically presents with painless vaginal bleeding in the third trimester, not continuous abdominal pain. Educationally, this question highlights the importance of recognizing the signs and symptoms of various pregnancy complications, understanding how substance use can impact pregnancy outcomes, and the critical role of nurses in identifying and managing such high-risk situations in maternity care.
Question 3 of 5
A nurse is caring for a client who is receiving oxytocin to augment labor. The nurse notes recurrent variable decelerations of the FHR. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: In this scenario, the correct action for the nurse to take first is to place the client in a left lateral position (Option D). This is because placing the client in a left lateral position can help improve placental perfusion and oxygenation to the fetus by relieving pressure on the maternal vena cava, thus potentially improving fetal oxygenation and reducing the variable decelerations of the fetal heart rate (FHR). Option A, preparing for an amnioinfusion, is not the first priority because it is a more invasive intervention and should be considered after initial non-invasive measures have been taken. Administering oxygen via a nonrebreather face mask (Option B) is important in cases of fetal distress, but in this situation, addressing the maternal position to improve fetal oxygenation is the priority. Discontinuing the oxytocin infusion (Option C) may eventually be necessary if the variable decelerations persist, but changing the maternal position is the initial step to attempt to improve fetal well-being before considering discontinuing the oxytocin infusion. Educationally, understanding the rationale behind positioning interventions in obstetric care is crucial for nurses to effectively manage fetal distress during labor. It is essential for nurses to prioritize interventions based on their potential to improve fetal oxygenation and minimize risks during childbirth.
Question 4 of 5
A nurse is caring for a newborn who has a blood glucose level of 45 mg/dL. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: In this scenario, the correct action for the nurse to take is option A: Encourage the mother to breastfeed the newborn. This is the appropriate choice because breastfeeding is the most natural and effective way to increase the newborn's blood glucose level. Breast milk contains the necessary nutrients and sugars that can help regulate the baby's glucose levels. Option B, gavage feeding 60 mL of glucose water, is incorrect because it introduces an unnecessary intervention that may not align with the infant's actual needs. Providing glucose water may also disrupt the establishment of breastfeeding. Option C, administering 10 mL of D W via IV, is not the first-line intervention for a newborn with low blood glucose levels. Intravenous administration should be reserved for severe cases where oral intake is not feasible or effective. Option D, rechecking the glucose level in 2 hours, is not the most appropriate immediate action when dealing with a newborn with low blood glucose levels. Prompt intervention is crucial to prevent further complications associated with hypoglycemia in neonates. In an educational context, understanding the significance of promoting breastfeeding for newborns is crucial for healthcare professionals working in maternity care. Encouraging breastfeeding not only provides optimal nutrition but also helps establish bonding between the mother and the infant. It is essential for nurses to prioritize evidence-based practices that support the well-being of both the newborn and the mother in maternity care settings.
Question 5 of 5
A nurse is teaching the parent of a newborn about car seat safety. Which of the following statements should the nurse make?
Correct Answer: A
Rationale: In this scenario, option A, "You should keep the car seat rear-facing until your baby is at least 2 years old," is the correct statement for the nurse to make. This recommendation aligns with current safety guidelines from organizations like the American Academy of Pediatrics (AAP) and the National Highway Traffic Safety Administration (NHTSA). Rear-facing car seats provide the best protection for infants and young children in the event of a crash by supporting the child's head, neck, and spine. Options B, C, and D are incorrect statements. Positioning the retainer clip over the upper part of the baby's abdomen (Option B) can result in serious internal injuries in a crash. Placing the baby in the car seat at a 90-degree angle (Option C) is not necessary and may not be practical in all vehicles. Lastly, placing the shoulder harness straps in the slots above the baby's shoulders (Option D) can lead to improper fit and decreased safety in the event of a crash. Educationally, it is crucial for healthcare providers to provide evidence-based information on car seat safety to parents. By understanding and following the recommended guidelines, parents can significantly reduce the risk of injury to their child in a motor vehicle accident. Nurses play a vital role in educating families on best practices to ensure the safety and well-being of infants and children during car travel.