ATI PRACTICE B MATERNAL NEWBORN – Q&A A nurse is teaching a client who has a new prescription for combined oral contraceptives about potential adverse effects of the medication. For which of the following findings should the nurse instruct the client to notify the provider?
A. Shortness of bre...
A nurse is teaching a client who has a new prescription for combined oral
contraceptives about potential adverse effects of the medication. For which
of the following findings should the nurse instruct the client to notify the
provider?
A. Shortness of breath
B. Breakthrough bleeding
C. Vomiting
D. Breast tenderness Correct Ans - A. Shortness of breath
The nurse should instruct the client to notify the provider immediately of
any shortness of breath. Shortness of breath and chest pain can indicate a
pulmonary embolus or myocardial infarction. Also, the nurse should
instruct the client to notify the provider of other adverse effects that can
indicate potential complications, including abdominal pain, sudden or
persistent headaches, blurred vision, and severe leg pain.
A nurse is caring for a client following an amniocentesis at 18 weeks of
gestation. Which of the following findings should the nurse report to the
provider as a potential complication?
A. Increased fetal movement
B. Leakage of fluid from the vagina
C. Upper abdominal discomfort
D. Urinary frequency Correct Ans - B. Leakage of fluid from the
vagina
Leakage of fluid from the vagina could indicate premature leakage of
amniotic fluid and should be reported to the provider.
A nurse is calculating a client's expected date of birth using Nagele's rule.
The client tells the nurse that her last menstrual cycle started on November
27th. Which of the following dates is the client's expected date of birth?
Correct Ans - September 3rd
When using Nägele's rule to calculate the estimated date of birth for a
client, the nurse should subtract 3 months from the first day of the client's
,last menstrual cycle and then add 7 days. November 27th minus 3 months
equals August 27th. August 27th plus 7 days equals September 3rd.
A nurse is caring for a client who is at 41 weeks of gestation and has a
positive contraction stress test. For which of the following diagnostic tests
should the nurse prepare the client?
A. Percutaneous umbilical blood sampling
B. Amnioinfusion
C. Biophysical profile (BPP)
D. Chorionic villus sampling (CVS) Correct Ans - C. Biophysical
profile (BPP)
The nurse should prepare the client for a BPP to further assess fetal well-
being. A positive contraction stress test indicates there is potential
uteroplacental insufficiency. A BPP uses a real time ultrasound to visualize
physical and physiological characteristics of the fetus and observe for fetal
biophysical responses to stimuli.
A nurse is teaching a new parent about newborn safety. Which of the
following instructions should the nurse include in the teaching?
A. "You can share your room with your baby for the next few weeks."
B. "Cover your baby with a light blanket while sleeping."
C. "Check the temperature of your baby's bath water with your hand."
D. "Your baby can nap in the car seat during the daytime." Correct Ans
- A. "You can share your room with your baby for the next few weeks."
The nurse should recommend room-sharing during the first few weeks.
This allows the parent to be readily available to the newborn and learn the
newborn's cues. However, the nurse should instruct the parent to avoid
placing the newborn in their bed as it increases the risk for sudden infant
death syndrome.
A nurse is caring for a client who is in labor and whose fetus is in the right
occiput posterior position. The client is dilated to 8 cm and reports back
pain. Which of the following actions should the nurse take?
A. Apply sacral counterpressure.
, B. Perform transcutaneous electrical nerve stimulation (TENS).
C. Initiate slow-paced breathing.
D. Assist with biofeedback. Correct Ans - A. Apply sacral
counterpressure.
The nurse should apply sacral counterpressure to assist in relieving back
labor pain related to fetal posterior position.
A nurse is caring for a newborn who is undergoing phototherapy to treat
hyperbilirubinemia. Which of the following actions should the nurse take?
A. Cover the newborn's eyes while under the phototherapy light.
B. Keep the newborn in a shirt while under the phototherapy light.
C. Apply a light moisturizing lotion to the newborn's skin.
D. Turn and reposition the newborn every 4 hr while undergoing
phototherapy Correct Ans - A. Cover the newborn's eyes while
under the phototherapy light.
Applying an opaque eye mask prevents damage to the newborn's retinas
and corneas from the phototherapy light.
A nurse is performing a vaginal examination on a client who is in labor and
observes the umbilical cord protruding from the vagina. After calling for
assistance, which of the following actions should the nurse take next?
A. Place a rolled towel beneath one of the client's hips.
B. Apply internal upward pressure to the presenting part using two gloved
fingers
C. Administer oxygen to the client via a nonrebreather mask at 10 L/min
D. Increase the IV infusion rate. Correct Ans - B. Apply internal
upward pressure to the presenting part using two gloved fingers
Using evidence-based practice, the first action the nurse should take is to
apply internal upward pressure to the presenting part. Prolapse of the
umbilical cord during labor can result in decreased perfusion to the fetus,
which can lead to hypoxia. After calling for assistance, the nurse should
relieve the compression on the umbilical cord by applying upward internal
pressure on the presenting part with two gloved fingers. The nurse should
not move their hand.
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