ATI PN Maternal Newborn 2023 | Nurselytic

Questions 57

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ATI PN Maternal Newborn 2023 Questions

Extract:

Nurses' Notes: Client at 18 weeks of gestation with nausea and vomiting for weeks, unable to retain fluids for 48 hr. Vital Signs: Heart rate 112/min, BP 92/52 mm Hg. Labs: Hgb 18 g/dL, Potassium 3.2 mEq/L, Ketones positive.


Question 1 of 5

Complete the diagram by specifying what condition the client is most likely experiencing, 2 actions the nurse should take, and 2 parameters to monitor.

Action to Take

Ectopic pregnancy
Hydatidiform mole
Hyperemesis gravidarum
Gestational diabetes;

Potential Condition

Check fundal height.
Insert a peripheral venous access device.
Assist with preparing the client for surgery.
Perform daily fetal movement counts
Monitor and manage electrolyte values

Parameter to Monitor

Blood glucose results
Electrolyte values
Serum human chorionic gonadotropin (hCG) levels
Urine ketones

Correct Answer:

Rationale: Condition: Hyperemesis gravidarum - severe nausea and dehydration. Actions: IV access for fluids; manage electrolytes. Parameters: Monitor electrolytes and ketones for treatment efficacy.

Extract:

Nurses' Notes: Client at 28 weeks of gestation with vaginal bleeding for 2 hr, saturating pads with bright red blood. Fundal height 27 cm, FHR 170/min with minimal variability. Vital Signs: Heart rate 120/min, BP 86/48 mm Hg.


Question 2 of 5

Complete the diagram by specifying what condition the client is most likely experiencing, 2 actions the nurse should take, and 2 parameters to monitor.

Action to Take

Placenta previa
Chorioamnionitis
Cervical insufficiency
Ectopic pregnancy;

Potential Condition

Monitor the administration of ampicillin 2 g IV bolus
Insert a large-bore peripheral IV catheter.
Reinforce with the client to maintain bed rest
Administer methotrexate.

Parameter to Monitor

WBC count
Fetal well-being
Cervical dilation
Vaginal bleeding

Correct Answer:

Rationale: Condition: Placenta previa - painless bright red bleeding. Actions: IV access for fluids; bed rest reduces bleeding. Parameters: Monitor fetal status and bleeding.

Extract:

A nurse is assisting with the care of a client who is in the latent phase of labor and just had an amniotomy.


Question 3 of 5

Which of the following findings indicates that the fetus is at risk?

Correct Answer: C

Rationale: Recurrent variable decelerations in FHR indicate possible umbilical cord compression, suggesting a risk to the fetus.

Extract:

History and Physical: 41 weeks of gestation, cesarean birth. Nurses' Notes: Client reports malaise, chills, decreased appetite 3 days postpartum. Vital Signs: Temperature 38.4° C, Heart rate 108/min. Assessment: Boggy uterus, foul-smelling lochia.


Question 4 of 5

Complete the diagram by specifying what condition the client is most likely experiencing, 2 actions the nurse should take, and 2 parameters to monitor.

Action to Take

Potential Conditions: A. Deep vein thrombosis
B. Urinary tract infection
C. Endometritis; Actions: B. Monitor lochia amount and odor
C. Assist with anticoagulant therapy; Parameters: C. Temperature
E. Heart rate

Potential Condition

Potential Condition: C

Parameter to Monitor

Actions: B
C

Correct Answer: C, B, C, C, E

Rationale: Condition: Endometritis - infection signs like fever and foul lochia. Actions: Monitor lochia; assist with antibiotics (not anticoagulants, corrected). Parameters: Temperature and heart rate assess infection response.

Extract:

Nurses' Notes: Postpartum client 8 hr after vaginal delivery. 0700: Uterus firm, moderate lochia rubra. 1100: Uterus soft, laterally deviated, large lochia rubra.


Question 5 of 5

Select the 3 findings that require immediate follow-up.

Correct Answer: C, F, G

Rationale: C: Lateral deviation suggests displacement; F: Soft uterus risks hemorrhage; G: Large lochia indicates excessive bleeding.

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