ATI LPN
ATI PN Maternal Newborn 2023 II Questions
Extract:
Vital Signs: Temperature: 36.6°C (98°F), Heart rate: 112/min, Respiratory rate: 20/min, Blood pressure: 92/52 mm Hg. Diagnostic Results: Hct: 50% (Normal: 37% to 47%), Blood glucose: 110 mg/dL (Normal: 74 to 106 mg/dL), Hgb: 18 g/dL (Normal: 12 to 16 g/dL), Urinalysis: Potassium: 3.2 mEq/L (Normal: 3.5 to 5 mEq/L), Ketones: positive (Normal: none), Protein: negative (Normal: none). Nurses' Notes: Client presents with reports of nausea and vomiting for the past several weeks, which has worsened in severity. Client states that they have been unable to retain even clear fluids for the past 48 hours. Client denies pain. Client reports a history of migraines and asthma.
Question 1 of 5
Complete the diagram by selecting from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: C
Rationale: Hyperemesis gravidarum is characterized by severe nausea and vomiting. Actions: Inspect mucous membranes for dehydration; administer antiemetics. Parameters: Monitor electrolyte values and urine ketones.
Extract:
Vital Signs: Heart rate: 84/min, Temperature: 37.3°C (99.1°F), Blood pressure: 128/82 mm Hg, Respiratory rate: 18/min. Diagnostic Results: Blood glucose: 120 mg/dL (Normal: 74 to 106 mg/dL). Medical History: The client is a 24-year-old female with a history of type 1 diabetes mellitus first diagnosed at 14 years of age. The client is on insulin for diabetes management. No other significant prenatal history is noted. The client is gravida 1 para 1 following a spontaneous vaginal birth at 37 weeks of gestation. The newborn was large for gestational age, weighing 4.1 kg (9 lb). The client has a third-degree laceration that required several stitches. Nurses' Notes: Client was admitted to the postpartum unit 4 hours after delivery. The fundus is firm and midline at the level of the umbilicus. Lochia is moderate. A lunch tray was given. The newborn is sleeping in a bassinet next to the client's bed. The client is diaphoretic, with skin that is clammy. Pulse is rapid, strong, and regular, and respirations are shallow. The client reports a headache, slight nausea, and feeling weak.
Question 2 of 5
Complete the following sentence by using the list of options. The nurse should plan to ___ then ___
Correct Answer: A
Rationale: The nurse should plan to check the client's blood glucose level then implement seizure precautions. Symptoms suggest hypoglycemia, common in diabetic patients, requiring glucose check and seizure precautions.
Extract:
Vital Signs: Heart rate: 88/min, Temperature: 37.1°C (98.8°F), Respiratory rate: 16/min, Blood pressure: 122/78 mm Hg. History and Physical: The client is gravida 2 para 1, with a previous vaginal delivery. She has a history of hypothyroidism and Herpes simplex virus type 2. She is currently undergoing labor induction at 39 weeks and 3 days of gestation. Assessment: The fetal heart rate is 140/min with moderate variability, and mild uterine irritability is noted. The abdomen is soft and nontender upon palpation. Cervical examination reveals dilation of 1 cm, thickness, and no presenting part palpable. An ultrasound shows a footling breech presentation. There are clusters of lesions noted on the vaginal introitus and labia majora. Laboratory Results: WBC count: 9,500/mm³ (Normal: 5,000 to 15,000/mm³), Hgb: 10.5 mg/dL (Normal: greater than 11 mg/dL), Hct: 31% (Normal: greater than 33%), Platelets: 225,000/mm³ (Normal: 150,000 to 400,000/mm³), Blood Type/Rh: O+. Provider Prescriptions: Levothyroxine 100 mcg PO once daily in PM, Acetaminophen 325 mg PO every 6 hr PRN, Dinoprostone 10 mg intravaginally x one dose now, Terbutaline 2.5 mcg/min intravenous per provider's instructions.
Question 3 of 5
For which of the following findings should the nurse anticipate a provider's prescription to withhold the dinoprostone? Select all that apply.
Correct Answer: A,C,E
Rationale: Breech presentation, abnormal FHR, and lesions (Herpes simplex) are contraindications for dinoprostone due to increased risks of complications and neonatal herpes transmission.
Extract:
Vital Signs: Heart rate: 80/min, Temperature: 37.2°C (99°F), Blood pressure: 120/80 mm Hg, Respiratory rate: 18/min. Diagnostic Results: January 8 / 0900: Oral Glucose Tolerance Test with 75-g glucose load - 190 mg/dL (Normal: less than 180 mg/dL). February 8 / 0900: Fasting: 110 mg/dL (Normal: less than 110 mg/dL), 1000: 220 mg/dL (Normal: less than 180 mg/dL), 1100: 165 mg/dL (Normal: less than 140 mg/dL), 1200: 142 mg/dL (Normal: 70 to 115 mg/dL). Nurses' Notes: On January 8 at 0900, the fundal height was measured at 22 cm and fetal heart tones were 150/min. On February 8 at 0900, the fundal height was measured at 27 cm and fetal heart tones were 145/min. The client reports positive fetal movement, denies abdominal cramping, vaginal bleeding, and leaking of fluids. The client also denies headaches, visual disturbances, and epigastric pain. History and Physical: The client is a 32-year-old female, gravida 2 para 1, with a history of gestational diabetes mellitus (GDM) during her previous pregnancy. She is currently at 28 weeks of gestation. The client reports no other significant medical history. She is adhering to a diabetic diet and taking insulin as prescribed.
Question 4 of 5
Complete the following sentence by using the lists of options. The nurse should prepare to reinforce teaching with the client about a ___ with a prescription of ___
Correct Answer: A
Rationale: The nurse should prepare to reinforce teaching with the client about a diabetic diet with a prescription of insulin therapy. Elevated glucose levels indicate the need for continued dietary and insulin management.
Extract:
Vital Signs: Heart rate: 80/min (January 8), Temperature: 36°C (96.8°F) (January 8), Respiratory rate: 12/min (January 8), Pulse oximetry: 99% (January 8), Blood pressure: 132/82 mm Hg (January 8), Heart rate: 90/min (February 8), Temperature: 36°C (96.8°F) (February 8), Respiratory rate: 16/min (February 8), Pulse oximetry: 99% (February 8), Blood pressure: 140/88 mm Hg (February 8). History and Physical: The client is a 24-year-old gravida 2 para 1 who is at 21 weeks of gestation. The client has a history of obesity and hypertension. She is 62 inches tall and weighs 93 kg (205 lb), with a BMI of 37.5. Her prepregnancy weight was 90.7 kg (200 lb) and BMI was 36.6. Scheduled return visit for follow-up in 4 weeks. Provider Prescriptions: Nifedipine 30 mg PO once daily.
Question 5 of 5
Complete the following sentence by using the lists of options. The nurse should prepare to reinforce teaching with the client about a ___ with a prescription of ___
Correct Answer: A
Rationale: The nurse should prepare to reinforce teaching with the client about a low-sodium diet with a prescription of nifedipine. Hypertension management requires dietary sodium reduction and nifedipine.