ATI LPN
Maternal Newborn ATI Proctored Exam Questions
Question 1 of 5
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 2 of 5
A client who is at 22 weeks gestation is being educated by a nurse about the amniocentesis procedure. Which of the following statements should the nurse make?
Correct Answer: C
Rationale: The correct answer is C: You should empty your bladder before the procedure. This is important because a full bladder can obstruct the visualization of the fetus during amniocentesis. By emptying the bladder, the uterus is better positioned for the procedure, making it safer and more effective. Explanation: 1. A (You will lie on your right side during the procedure) is incorrect because the position during amniocentesis is typically on the back or slightly tilted to the left. 2. B (You should not eat anything for 24 hours before the procedure) is incorrect as fasting is not required for amniocentesis. 3. D (The test is performed to determine gestational age) is incorrect as amniocentesis is used to detect genetic abnormalities, not gestational age.
Question 3 of 5
A client who is pregnant is scheduled for a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply)
Correct Answer: D
Rationale: The correct answer is D, All of the Above. 1. Decreased fetal movement indicates fetal distress, necessitating CST. 2. IUGR implies potential placental insufficiency, requiring CST evaluation. 3. Postmaturity increases risk of placental insufficiency, warranting CST. Other choices are incorrect as they do not directly indicate the need for CST in a pregnant client.
Question 4 of 5
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 5 of 5
A client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?
Correct Answer: A
Rationale: The correct answer is A: Betamethasone. Betamethasone is a corticosteroid used to promote fetal lung maturity in preterm labor. In this scenario, at 32 weeks of gestation with placenta previa and active bleeding, the priority is to promote fetal lung maturity in case of premature delivery due to the risk of maternal hemorrhage. Indomethacin (B) is a nonsteroidal anti-inflammatory drug and not indicated in this situation. Nifedipine (C) is a calcium channel blocker used for preterm labor to delay contractions, not for placenta previa and active bleeding. Methylergonovine (D) is used for postpartum hemorrhage and not indicated in this scenario.