ATI LPN
ATI PN Maternal Newborn 2023 II Questions
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 1 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.
Extract:
Vital Signs: Temperature: 38.4°C (101.1°F), Heart rate: 108/min, Respiratory rate: 20/min, Blood pressure: 118/72 mm Hg. History and Physical: The client is gravida 1 para 1, at 41 weeks of gestation. The client gave birth via cesarean following prolonged rupture of membranes and cephalopelvic disproportion. Assessment: The client's breasts are starting to feel firmer and heavier, and she denies nipple discomfort. The client is bottle-feeding. The uterus is boggy and tender to palpation, with the fundus at the umbilicus. The lochia discharge is moderate, dark brown, and foul-smelling. The client reports frequent voiding without difficulty. Bilateral edema is noted in the lower extremities, without pain, warmth, or tenderness.
Question 2 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: A
Rationale: Endometritis is indicated by fever, tender boggy uterus, and foul-smelling lochia. Actions: Administer antibiotics; monitor oxytocic medication. Parameters: Monitor temperature and lochia.
Extract:
Nurses' Notes: At 0625, the client is alert and oriented, at 38 weeks of gestation, presenting to the labor and delivery unit for evaluation of fluid leaking from the vagina. The client states they felt a small gush of fluid and thinks their membranes have ruptured. At 0830, mild contractions are occurring 20 minutes apart, irregular, lasting 40 seconds. The client rates the pain as a 3 on a scale of 0 to 10. An electronic fetal monitor is applied. The client voided 50 mL of clear yellow urine in a bedpan. Mild contractions are now 15 minutes apart, irregular, lasting 30 seconds. The cervix is 2 cm dilated with 20% effacement. The client rates pain as a 4 on a scale of 0 to 10. The fetal heart rate (FHR) is 132/min with moderate variability.
Question 3 of 5
The nurse is assisting with planning care for the client. After review of the client's electronic medical record (EMR), which of the following interventions should the nurse recommend as anticipated, nonessential, or contraindicated?
| Options | Indicated | Non-Essential | Contraindicated |
|---|---|---|---|
| Encourage frequent ambulation | |||
| Ensure the client maintains a supine position while in bed | |||
| Check FHR every 30 min | |||
| Perform a Nitrazine test | |||
| Prepare the client for catheterization | |||
| Obtain CBC blood sample | |||
| Check the client's temperature every hour |
Correct Answer: A: Anticipated, B: Contraindicated, C: Anticipated, D: Anticipated, E: Nonessential, F: Nonessential, G: Anticipated
Rationale: A: Encourages labor progression. B: Can impede labor and fetal oxygenation. C: Ensures fetal well-being. D: Confirms rupture of membranes. E: Not needed with spontaneous voiding. F: No signs of infection. G: Monitors for infection post-rupture.
Extract:
A nurse is reinforcing teaching with a client who is at 38 weeks of gestation and has a positive group B streptococcus B-hemolytic screening.
Question 4 of 5
Which of the following medications should the nurse discuss as the prophylaxis treatment during labor for this client?
Correct Answer: A
Rationale: Penicillin is the recommended prophylactic treatment for a client at 38 weeks of gestation with a positive group B streptococcus B-hemolytic screening. It is highly effective in preventing the transmission of group B strep from mother to baby during labor and delivery. Administering Penicillin reduces the risk of neonatal sepsis, pneumonia, and meningitis caused by group B strep.
Extract:
A nurse has just received change-of-shift report about four clients who are postpartum.
Question 5 of 5
Which of the following clients should the nurse plan to see first?
Correct Answer: B
Rationale: A client who received magnesium sulfate during labor is the priority because magnesium sulfate can cause serious side effects such as respiratory depression or hypotension, requiring close monitoring postpartum.