ATI LPN
ATI LPN Maternal Newborn 2023 IV Questions
Extract:
Nurses' Notes 0830: The client is a gravida 2 para 1 at 30 weeks of gestation. Reports low back pain and abdominal cramping for the past two days. History includes cesarean birth for breech presentation. Reports smoking half a pack of cigarettes per day. BMI is greater than 30. The client is grimacing and has a positive report of fetal movement. External electronic fetal monitoring applied, showing fetal heart rate of 148/min. The abdomen is soft and nontender to palpation. 0845: Uterine contractions every 2–3 minutes, moderate in strength. Sterile vaginal examination reveals cervix dilated to 2 cm, 80% effaced, and -1 station. Mucous vaginal discharge and a small amount of bright red bleeding noted on the perineal pad. Vital Signs: Temperature: 36.8°C (98.2°F), Heart rate: 98/min, Respiratory rate: 18/min, Blood pressure: 112/68 mm Hg, Oxygen saturation: 98% on room air.
Question 1 of 4
For each finding, click to specify if the client finding is consistent with placenta previa, preterm labor, or abruptio placentae: A. Pain report, B. Uterine contractions, C. Perineal pad findings, D. Cervical dilation.
| Findings | Placenta Previa | Preterm Labour | Abruptio Placentae |
|---|---|---|---|
| Pain report | |||
| Uterine contractions | |||
| Perineal pad findings | |||
| Cervical dilation |
Correct Answer: A,B,C,D
Rationale: Pain and contractions suggest preterm labor/abruptio placentae; bleeding fits all three; dilation aligns with preterm labor/placenta previa.
Extract:
Nurses' Notes Two weeks ago (32 weeks gestation): The client presented for a routine visit and denied vaginal bleeding or fluid leakage. Reports mild insomnia and occasional mild uterine cramping. 1+ nonpitting edema noted in bilateral feet and ankles. Weight recorded as 84 kg (185 lb). Today (0930): The client reports mild epigastric pain for the past three days and occasionally 'seeing spots' in her vision. 2+ nonpitting edema noted bilaterally in feet and ankles, and mild facial edema present. The client states her fingers 'swelled up overnight,' preventing her from wearing rings. Weight has increased to 86 kg (190 lb). Vital Signs: Blood pressure: 160/100 mm Hg, Heart rate: 88/min, Respiratory rate: 18/min, Temperature: 36.9°C (98.4°F), Oxygen saturation: 98% on room air. Diagnostic Results: Hemoglobin: 10 g/dL, Hematocrit: 35.9%, Platelet count: 95,000/mm³, AST: 200 U/L, ALT: 25 U/L, Total bilirubin: 1.8 mg/dL, Urine protein: 2+.
Question 2 of 4
Which of the following findings should the nurse report to the primary health care provider?
Correct Answer: A,D,E,F
Rationale: Low platelets, rapid weight gain, edema, high BP, and proteinuria indicate preeclampsia, requiring immediate reporting.
Extract:
History and Physical: The client reports a history of one previous cesarean section due to breech presentation. She smokes half a pack of cigarettes daily and has a BMI greater than 30. The client denies leakage of amniotic fluid and describes positive fetal movement. Vital Signs: Temperature: 98.6°F (37°C), Pulse: 88 beats/min, Respiratory Rate: 16 breaths/min, Blood Pressure: 128/78 mmHg, Oxygen Saturation: 98% on room air. Nurses' Notes (0830 and 0845): 0830: The client is grimacing and reports discomfort. Fetal heart rate is 148 beats per minute. Fundal height measures 28 cm. 0845: Uterine contractions every 2 to 3 minutes, moderate in intensity, lasting 60 seconds.
Question 3 of 4
The nurse should recommend to first address the client's ___, followed by the client's ___.
Correct Answer: A,B
Rationale: Frequent contractions indicate preterm labor risk at 30 weeks; prior cesarean increases uterine rupture risk, both needing prompt attention.
Extract:
Nurses' Notes: The client, who is 28 weeks gestation, gravida 4, para 3, reports a history of vaginal bleeding for the past 2 hours. She states, 'I started bleeding a couple of hours ago, but now I am saturating pads with bright red blood. I’m scared something is going to happen to my baby.' Blood is trickling down her legs. She denies abdominal pain. A perineal pad is saturated with bright red vaginal bleeding. Physical Examination Results: Fundal height is 27 cm. No uterine contractions or irritability. Fetal heart rate: 170/min, minimal variability, no decelerations. Diagnostic Results: Urine: Leukocyte esterase positive, Nitrites positive, Red blood cells: 6.
Question 4 of 4
Complete the diagram by dragging from the choices below to specify: Potential Condition, Actions to Take (Select 2), Parameters to Monitor (Select 2). Potential Condition Choices: A. Placenta previa, B. Abruptio placentae, C. Preterm labor, D. Uterine rupture. Actions: A. Administer methotrexate, B. Administer broad-spectrum antibiotics, C. Prepare for an emergency cesarean birth, D. Reinforce bed rest and maintain IV access, E. Encourage ambulation. Parameters: A. Fetal heart rate, B. Maternal oxygen saturation, C. WBC count, D. Urine output, E. Uterine contractions.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: A,C,D,A,B
Rationale: Painless bleeding suggests placenta previa; cesarean and bed rest manage it; fetal heart rate and oxygen saturation monitor stability.
Extract:
Nurses' Notes: The newborn is lying in a bassinet, lightly swaddled. Jitteriness observed when disturbed, weak cry, mottled extremities, mild acrocyanosis. Respirations rapid but unlabored. No lethargy, no feedings since birth. Vital Signs: Heart rate: 156/min, Respiratory rate: 64/min, Temperature: 36.1°C (97.0°F), Oxygen saturation: 96% on room air, Blood glucose level: 30 mg/dL.
Question 5 of 4
Complete the diagram by dragging from the choices below to specify: Condition, Actions to Take, Parameters to Monitor (2 Correct). Condition Choices: A. Hypoglycemia, B. Congenital heart defect, C. Neonatal sepsis, D. Neonatal abstinence syndrome. Actions: A. Obtain a capillary blood glucose reading, B. Feed the newborn immediately with breastmilk or formula, C. Administer IV glucose as prescribed, D. Initiate phototherapy, E. Place under a radiant warmer. Parameters: A. Blood glucose levels, B. Respiratory effort, C. Serum bilirubin levels, D. Skin integrity, E. Oxygen saturation.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: A,A,B,A,B
Rationale: Low glucose (30 mg/dL) and jitteriness indicate hypoglycemia; feeding and glucose checks address it; glucose and respiratory effort monitor progress.