Review ATI Maternal newborn exam

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ATI Maternal newborn exam

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Total Questions : 41

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Question 1:

A nurse is caring for a postpartum client who delivered their third infant 2 days ago. Which of the following manifestations could indicate postpartum depression?

A. Delusions. B. Euphoria. C. Flat affect. D. Insomnia. E. Fatigue.

Answer and Explanation

Choice A:

Delusions indicate severe psychiatric conditions like postpartum psychosis, not depression. Depression involves low mood, energy, and interest, without detachment from reality. Delusions reflect loss of reality testing, requiring different interventions. Common in severe psychoses like schizophrenia.

Choice B:

Euphoria indicates abnormally elevated mood, seen in manic episodes of bipolar disorder, not depression. Depression involves sadness, hopelessness, and low energy. Euphoria's excessive positivity contrasts with depressive symptoms, including impaired functioning and behavior regulation.

Choice C:

Flat affect signifies reduced emotional expression, common in depression. Depressed individuals exhibit lack of response to pleasurable activities, social withdrawal, and emotional blunting. This impairment in emotional expressiveness reflects major depressive disorder.

Choice D:

Insomnia, common in depression, affects sleep patterns, causing difficulty initiating or maintaining sleep. It contributes to fatigue, cognitive impairment, and mood disturbances. Insomnia reflects dysregulated sleep-wake cycles in depression, impacting daily functioning.

Choice E:

Fatigue is frequent in depression, marked by persistent tiredness despite rest. It stems from sleep disturbances, low energy, and anhedonia. Fatigue affects concentration, motivation, and physical activity, manifesting as psychomotor retardation in depression.

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Question 2:

A patient is admitted to labor and delivery for management of severe preeclampsia. An IV infusion of magnesium sulfate is ordered. What is the primary goal for magnesium sulfate therapy?

A. Decrease proteinuria. B. Prevent maternal seizures. C. Reduce deep tendon reflexes.

Answer and Explanation

Choice A:

Decrease proteinuria is not the primary goal for magnesium sulfate therapy. It's an indicator of kidney function and hypertension severity. Therapy focuses on neuroprotection and seizure prevention. Proteinuria reflects preeclampsia's renal impact, not neuroprotection.

Choice B:

Prevent maternal seizures is magnesium sulfate's primary goal. It stabilizes neuronal membranes, reducing seizure risk in severe preeclampsia. By inhibiting NMDA receptors and calcium channels, it prevents seizures, critical for maternal-fetal safety.

Choice C:

Reduce deep tendon reflexes is not magnesium sulfate's primary goal, but a side effect. It signifies therapeutic levels, indicating potential toxicity. Reflex reduction helps assess magnesium toxicity risk, ensuring safe neuroprotective dosing.

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Question 3:

A nurse is caring for a patient who has postpartum psychosis. Which of the following actions is the nurse’s priority?

A. Reinforce the need to take antipsychotics as prescribed. B. Monitor the infant for indications of failure to thrive. C. Ask the patient if they have thoughts of harming themselves or their infant. D. Review the client’s medical record for a history of bipolar disorder.

Answer and Explanation

Choice A:

While taking antipsychotics is important, the nurse’s immediate priority should be to assess for harm to the patient or infant, which poses an immediate danger.

Choice B:

Monitoring the infant’s health is important but secondary to ensuring the patient and infant's immediate safety from potential harm due to psychosis.

Choice C:

Assessing thoughts of harm is crucial in postpartum psychosis as it helps in identifying immediate risks to the patient and infant, allowing for timely interventions.

Choice D:

Reviewing the medical record for bipolar disorder is important for treatment planning but not as immediately critical as assessing for thoughts of harm.

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Question 4:

A nurse is instructing a female client about how to check basal temperature in order to determine if the client is ovulating. The nurse should instruct the client to check her temperature at which of the following times?

A. On days 13 to 17 of her menstrual cycle. B. Before going to bed every night. C. Every morning before arising. D. One hour following intercourse.

Answer and Explanation

Choice A:

Checking basal temperature during specific days of the menstrual cycle does not provide as accurate an indication of ovulation as consistent daily measurements.

Choice B:

Checking temperature before bed may not accurately reflect basal body temperature due to daily activities affecting body temperature.

Choice C:

Basal body temperature should be measured every morning before arising, as this reflects the body’s lowest resting temperature and helps identify ovulation.

Choice D:

Checking temperature after intercourse may be affected by physical activity and does not provide an accurate basal temperature reading for ovulation tracking.

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Question 5:

What physical assessment finding is expected in a newborn after a precipitous delivery?

A. Bruising on the head. B. Low birth weight. C. Hypotonia. D. Hyperthermia.

Answer and Explanation

Choice A:

Bruising on the head is common in newborns after a precipitous delivery due to rapid passage through the birth canal, causing trauma to the head.

Choice B:

Low birth weight is not specifically associated with precipitous delivery but could be related to other prenatal factors affecting fetal growth.

Choice C:

Hypotonia is not a typical finding in a newborn after a precipitous delivery, though it could indicate other neurological or muscular issues.

Choice D:

Hyperthermia is not a common finding directly associated with precipitous delivery but could be related to other factors or conditions in the newborn.

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Question 6:

A client has been diagnosed with a ruptured ectopic pregnancy. Which of the following signs or symptoms is characteristic of this diagnosis?

A. Severe nausea and vomiting. B. Bradycardia. C. Referred shoulder pain. D. Heavy vaginal bleeding.

Answer and Explanation

Choice A:

Severe nausea and vomiting are not specific symptoms of a ruptured ectopic pregnancy but may occur due to other unrelated conditions.

Choice B:

Bradycardia is not characteristic of a ruptured ectopic pregnancy but could indicate other cardiovascular issues or conditions.

Choice C:

Referred shoulder pain is a hallmark symptom of a ruptured ectopic pregnancy due to diaphragmatic irritation from internal bleeding, indicating potential rupture.

Choice D:

Heavy vaginal bleeding can occur in various conditions but is not as specific to ruptured ectopic pregnancy as referred shoulder pain indicating internal bleeding.

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Question 7:

Which of the following would lead the nurse to suspect that a laboring client is experiencing Amniotic Fluid Embolism?

A. Sudden onset of respiratory distress. B. Maternal bradycardia. C. Category 1 fetal heart tracing. D. Acute, continuous abdominal pain.

Answer and Explanation

Choice A:

Amniotic fluid embolism is characterized by the sudden onset of respiratory distress due to the entry of amniotic fluid into the maternal circulation.

Choice B:

Maternal bradycardia is not a specific symptom of amniotic fluid embolism and may be related to other cardiovascular conditions.

Choice C:

Category 1 fetal heart tracing indicates normal fetal heart rate and is not associated with amniotic fluid embolism.

Choice D:

Acute, continuous abdominal pain could indicate other obstetric emergencies but is not specifically linked to amniotic fluid embolism symptoms like respiratory distress.

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Question 8:

A nurse is caring for a client who is grieving the loss of their newborn. Which of the following interventions should the nurse include in the plan of care?

A. Explain that the newborn is no longer in pain to facilitate grieving. B. Share the nurse’s own experiences and feelings to facilitate grieving. C. Avoid calling the newborn by their name to facilitate grieving. D. Allow the client to hold or be with their newborn to facilitate grief.

Answer and Explanation

Choice A:

Explaining that the newborn is no longer in pain may not facilitate grieving, as it does not acknowledge the emotional connection and grief the parents are experiencing.

Choice B:

Sharing the nurse's own experiences and feelings may shift the focus away from the client's emotions, potentially hindering their grieving process.

Choice C:

Avoiding calling the newborn by their name can create a sense of detachment and may prevent the client from fully processing their grief.

Choice D:

Allowing the client to hold or be with their newborn provides a tangible connection, facilitating the grieving process and helping them come to terms with their loss.

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Question 9:

A nurse is assisting with providing care for a client who is in preterm labor at 32 weeks of gestation. Which of the following medications should the nurse anticipate the provider will prescribe to help with lung maturity?

A. Azithromycin. B. Indomethacin. C. Magnesium sulfate. D. Betamethasone.

Answer and Explanation

Choice A:

Azithromycin is an antibiotic used to treat infections and is not indicated for promoting lung maturity in preterm infants.

Choice B:

Indomethacin is a tocolytic agent used to delay preterm labor but does not promote lung maturity in the fetus.

Choice C:

Magnesium sulfate is used for neuroprotection and to prevent seizures in preeclampsia, but it does not enhance lung maturity.

Choice D:

Betamethasone is a corticosteroid that accelerates fetal lung development and surfactant production, promoting lung maturity in preterm infants.

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Question 10:

A nurse is teaching a client who is postpartum and has a new prescription for an injection of Rh (D) immunoglobulin. Which of the following should be included in the teaching?

A. It destroys Rh antibodies in newborns who are Rh positive. B. It damages Rh antibodies in mothers who are Rh negative. C. It stops the formation of Rh antibodies in newborns who are Rh positive. D. It prevents the formation of Rh antibodies in mothers who are Rh negative.

Answer and Explanation

Choice A:

Rh (D) immunoglobulin does not destroy Rh antibodies in newborns; it prevents maternal immune response.

Choice B:

Rh (D) immunoglobulin does not damage Rh antibodies in Rh-negative mothers; it prevents antibody formation.

Choice C:

Rh (D) immunoglobulin does not stop Rh antibody formation in Rh-positive newborns but prevents it in Rh-negative mothers.

Choice D:

Rh (D) immunoglobulin prevents the formation of Rh antibodies in Rh-negative mothers, reducing the risk of hemolytic disease in future pregnancies.

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Total Questions : 41

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ATI Maternal newborn exam

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