ATI RN
Maternal Newborn Nursing Questions
Question 1 of 5
Screening at 24 weeks gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning the woman9s care. The nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus due to the GDM. The nurse identifies that the fetus is at risk for which of the following? Congenital anomalies of the central nervous system Macrosomia Preterm birth Low birth weight Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for:
Correct Answer: A
Rationale: Gestational diabetes mellitus (GDM) is a condition where high blood sugar levels develop during pregnancy in women who didn't have diabetes before pregnancy. One of the primary risks associated with GDM is fetal overgrowth, also known as macrosomia. This means the baby is larger than normal. Macrosomia can lead to complications during delivery, such as shoulder dystocia (when the baby's shoulders get stuck during delivery) and an increased risk of birth injuries for both the baby and the mother. It can also increase the likelihood of a cesarean section delivery. Therefore, preventing macrosomia is an important goal in managing GDM to ensure the safety and well-being of both the mother and the baby.
Question 2 of 5
A nurse on the labor and delivery unit is caring for a client who is having a difficult, prolonged labor with severe backache. Which of the following contributing causes should the nurse identify
Correct Answer: D
Rationale: In a labor where the fetal position is persistent occiput posterior, the baby is positioned face up, which can lead to a longer and more difficult labor. In this position, the baby's head is pressing against the mother's spine, causing severe backache for the mother. This malposition can slow down the progress of labor, making it more prolonged and challenging. It can also increase the likelihood of complications such as increased risk of instrumental delivery or cesarean section. Therefore, identifying the fetal position as persistent occiput posterior as a contributing cause to the difficult, prolonged labor with severe backache is crucial for effective management and intervention.
Question 3 of 5
A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?
Correct Answer: A
Rationale: The client who experienced a cesarean birth 4 hours ago and is reporting pain should be seen first by the nurse. Pain assessment and management are crucial following a cesarean birth to ensure the client's comfort and well-being. Uncontrolled pain can lead to complications and affect the client's recovery process. Addressing the client's pain promptly is a priority to promote their comfort and facilitate their recovery.
Question 4 of 5
The parents of a male newborn ask the nurse whether they should have their son circumcised. The nurse ‘s most appropriate response would be:
Correct Answer: B
Rationale: The most appropriate response for the nurse in this situation is to encourage open discussion between the parents and the doctor regarding the decision to circumcise their son. This allows the parents to make an informed decision based on their beliefs, values, and medical advice provided by the healthcare provider. It is important for parents to have all the necessary information and support to make the best decision for their child's well-being. The decision to circumcise is a personal one and should be made after careful consideration and consultation with a healthcare professional.
Question 5 of 5
A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:
Correct Answer: A
Rationale: The Moro reflex is a normal infantile reflex that is typically present at birth and disappears around 4-6 months of age. This reflex is triggered by a sudden loss of support or a loud noise, causing the infant to throw back the head and extend the arms in a gesture as if trying to grab something. In a situation where the newborn's birth was prolonged due to wide shoulders, there is a higher risk of injury to the brachial plexus (nerves that control arm movement) during delivery. Damage to the brachial plexus can result in weakness or paralysis of the affected arm, and this may impact the Moro reflex as it involves the arms' movement. Therefore, the nurse would be particularly observant for any abnormality or lack of response in the Moro reflex as it may indicate potential nerve injury related to the difficult birth.