ATI RN
ATI RN Maternal Newborn level 3 Final Exam 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has placenta previa. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Painless, vaginal bleeding. In placenta previa, the placenta implants low in the uterus, covering the cervix, leading to painless bleeding in the third trimester. A: Firm rigid abdomen is associated with abruptio placentae. C: Uterine hypertonicity is seen in conditions like uterine rupture. D: Persistent headache is not a typical finding in placenta previa.
Question 2 of 5
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Allow the baby to feed at least every 3 hours. This instruction is crucial for maintaining an adequate milk supply and ensuring the baby receives sufficient nutrition. Frequent feeding also helps prevent engorgement, promotes bonding, and supports the establishment of a successful breastfeeding relationship. Option A is incorrect because 2 to 4 wet diapers every 24 hours may indicate inadequate milk intake. Option C is incorrect as newborns should not be given water as it can interfere with breastfeeding and lead to water intoxication. Option D is incorrect because newborns should be allowed to feed as long as they want on each breast to ensure they receive hindmilk.
Question 3 of 5
A nurse is assessing a client who is in preterm labor and has a new prescription or terbutaline 0.25 mg subcutaneous. For which of the following findings should the nurse Withhold the medication and Report to the provider?
Correct Answer: B
Rationale: The correct answer is B: Blood pressure 88/58 mmHg. This blood pressure reading indicates hypotension, which could be a potential side effect of terbutaline. Hypotension can worsen maternal and fetal perfusion, leading to adverse outcomes. The nurse should withhold the medication and report this finding to the provider immediately.
Choices A, C, and D are within normal limits and do not require withholding the medication. A fasting blood glucose of 75 mg/dL is normal, urinary output of 40 ml/hr is adequate, and a fetal heart rate of 120/min is also within the normal range for a preterm fetus.
Question 4 of 5
A nurse is caring for a client who has gestational diabetes mellitus. Which of the following clinical findings should indicate to the nurse the client has hyperglycemia?
Correct Answer: B
Rationale: The correct answer is B: Increased urination. Hyperglycemia in gestational diabetes mellitus leads to elevated blood glucose levels, causing the kidneys to filter excess glucose into urine, leading to increased urination (polyuria). This is a classic symptom of hyperglycemia.
Double vision (
A) can be a sign of hypoglycemia, not hyperglycemia. Sweating (
C) and dizziness (
D) can be nonspecific symptoms and not specific to hyperglycemia.
Question 5 of 5
A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client which of the following vaccinations? Select all the apply
Correct Answer: C,D
Rationale: The correct vaccinations for a client at 30 weeks of gestation are Diphtheria-acellular pertussis (
C) and inactivated influenza (
D). Both are recommended during pregnancy to protect the mother and baby. Diphtheria-pertussis protects against respiratory infections, important for pregnant women due to increased susceptibility. Inactivated influenza is crucial to prevent severe flu complications. Varicella (
A) and human papillomavirus (
B) vaccines are contraindicated during pregnancy. The measles, mumps, and rubella (E) vaccine is a live attenuated vaccine, not recommended during pregnancy due to the theoretical risk of fetal harm.