Review ATI NURS 306 maternal newborn exam

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ATI NURS 306 maternal newborn exam

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Total Questions : 26

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Question 1:

You are the nurse providing teaching to a pregnant woman on how to do kick counts. You will tell her all of the following except:

A. Report fetal movement below normal as this is an indication for further assessment. B. If fetal movement is decreased, you should eat something, rest, and focus on fetal movement for 1 hour. C. You must lay prone to perform fetal kick counts. D. Fetal movement counting is based on the physiological principles that compromised fetuses reduce activity in response to decreased oxygenation.

Answer and Explanation

Choice A:

Fetal movement below normal may indicate compromised oxygenation or fetal distress. Reporting such observations is crucial for further assessment and timely intervention.

Choice B:

Consuming food and resting can increase glucose levels, potentially enhancing fetal movement. Monitoring for 1 hour helps to evaluate if decreased movement persists, indicating the need for further assessment.

Choice C:

Pregnant women should not lay prone for kick counts. This position can compress major blood vessels, reducing blood flow and oxygenation to the fetus. The left lateral position is preferred.

Choice D:

Reduced fetal movement can indicate decreased oxygenation in compromised fetuses. Monitoring fetal activity helps assess fetal well-being and identify potential hypoxia or distress.

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Question 2:

Given the following information, identify the adverse effects related to each medication order. AG1PO delivered a baby that weighs 10 lbs. Patient has a boggy uterus, it is midline, and +1 hour after delivery. Perineal pad is saturated with large golf size clots in 30 minutes. Identify the adverse effects of the medications listed in the order set. Medication: Methergine (Methylergonovine), Oxytocin (Pitocin), Hemabate (carboprost tromethamine), Misoprostol (Cytotec).

A. Diarrhea. B. Hypertensive crisis. C. Asthma exacerbation. D. Fever, chills, hypotension.

Answer and Explanation

Choice A:

Diarrhea is a common adverse effect of Hemabate (carboprost tromethamine). It stimulates smooth muscle contractions, including gastrointestinal tract muscles, leading to increased bowel movements.

Choice B:

Methergine (Methylergonovine) can cause a hypertensive crisis due to its potent vasoconstrictive properties. It is contraindicated in patients with hypertension or preeclampsia.

Choice C:

Hemabate (carboprost tromethamine) may exacerbate asthma. It can cause bronchoconstriction by stimulating prostaglandin receptors, worsening asthma symptoms or triggering attacks.

Choice D:

Misoprostol (Cytotec) can cause fever, chills, and hypotension due to its inflammatory and vasodilatory effects. It increases prostaglandin synthesis, leading to these systemic responses.

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Question 3:

A. Diarrhea. B. Hypertensive crisis. C. Asthma exacerbation. D. Fever, chills, hypotension.

Answer and Explanation

Choice A:

Misoprostol (Cytotec) stimulates smooth muscle contraction, including the gastrointestinal tract, leading to increased bowel motility and diarrhea. Normal bowel frequency ranges from 3 times per day to 3 times per week.

Choice B:

Methergine (Methylergonovine) constricts blood vessels, leading to increased blood pressure and a risk of hypertensive crisis. Normal blood pressure is around 120/80 mmHg.

Choice C:

Hemabate (carboprost tromethamine) is a prostaglandin analog, which can cause bronchoconstriction, exacerbating asthma symptoms in patients. Normal peak flow ranges from 400-700 L/min.

Choice D:

Oxytocin (Pitocin) can cause fever, chills, and hypotension due to its effects on vascular smooth muscle and thermoregulatory centers. Normal body temperature is around 37°C (98.6°F).

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Question 4:

You are the nurse providing teaching to a pregnant woman on how to do kick counts. You will tell her all of the following except:

Answer and Explanation

Choice A:

Decreased fetal movement can be a sign of fetal distress or hypoxia, necessitating further assessment. Normal fetal movements range from 10 movements in 2 hours.

Choice B:

Eating and resting can stimulate fetal activity, providing a clearer assessment of fetal well-being. Normal fetal movements range from 10 movements in 2 hours.

Choice C:

Lying prone is incorrect as it can decrease blood flow to the fetus; the recommended position is the left lateral position.

Choice D:

Compromised fetuses may reduce activity in response to decreased oxygenation, which can be an early indicator of fetal hypoxia.

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Question 5:

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

A. This test assesses fetal lung maturity. B. This test identifies an Rh incompatibility between the mother and fetus. C. It assesses various markers of fetal well-being. D. This is a screening test for neural tube defects in the fetus.

Answer and Explanation

Choice A:

Fetal lung maturity is typically assessed using amniocentesis or lecithin-sphingomyelin (L/S) ratio. Normal L/S ratio is 2: or greater.

Choice B:

Rh incompatibility is assessed using indirect Coombs test, not maternal serum alpha-fetoprotein. Normal Coombs test is negative.

Choice C:

Various markers of fetal well-being are assessed using biophysical profile or non-stress test, not maternal serum alpha-fetoprotein. Normal biophysical profile score is 8-10.

Choice D:

Maternal serum alpha-fetoprotein is a screening test for neural tube defects such as spina bifida and anencephaly. Normal alpha-fetoprotein levels range from 10-150 ng/mL.

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Question 6:

A client in labor is agitated and nervous about the birth of her child. The nurse explains to the client that fear and anxiety cause the release of certain compounds that can prolong labor. The nurse is referring to which compounds?

A. Prostaglandin. B. Catecholamines. C. Oxytocin. D. Orexin.

Answer and Explanation

Choice A:

Prostaglandins are involved in labor but primarily act to ripen the cervix and induce uterine contractions, not prolong labor. They are produced by the fetus and placenta during pregnancy.

Choice B:

Catecholamines, such as epinephrine and norepinephrine, are released in response to stress and anxiety, leading to vasoconstriction, reduced blood flow to the uterus, and prolonged labor. They are produced by the adrenal glands.

Choice C:

Oxytocin is a hormone that stimulates uterine contractions and accelerates labor. It is often administered to induce or augment labor, rather than prolong it. It is produced in the hypothalamus.

Choice D:

Orexin, also known as hypocretin, is involved in regulating arousal, wakefulness, and appetite, but has no direct role in labor. It is produced in the hypothalamus.

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Question 7:

The obstetrician is caring for a client with gestational hypertension. She is concerned about placental perfusion and intrauterine growth restriction (IUGR) after noting minimal fetal growth over the past month. What non-invasive antenatal test would the nurse anticipate the provider will order?

A. Magnetic Resonance Imaging (MRI). B. Doppler Flow Studies. C. Amniocentesis. D. Chorionic Villus Sampling (CVS).

Answer and Explanation

Choice A:

MRI is not typically used for assessing placental perfusion or IUGR. It provides detailed imaging but is not the primary tool for evaluating fetal growth.

Choice B:

Doppler Flow Studies are used to assess placental and fetal blood flow, making them crucial for evaluating placental perfusion and diagnosing IUGR in gestational hypertension.

Choice C:

Amniocentesis is used for genetic testing and assessing fetal lung maturity, not for evaluating placental perfusion or diagnosing IUGR in gestational hypertension.

Choice D:

Chorionic Villus Sampling (CVS) is for early genetic testing and not suitable for assessing placental perfusion or IUGR, which requires evaluation of blood flow.

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Question 8:

A nurse is educating a patient about the gate control theory of pain management. Which statement by the patient indicates an understanding of this theory?

A. The gate control theory states that pain perception is uniform and cannot be altered. B. Pain is only perceived in the brain and cannot be influenced by external factors. C. Pain signals can be blocked by stimulating other sensory nerves, like through massage or heat. D. Pain is solely determined by the amount of tissue damage experienced.

Answer and Explanation

Choice A:

The gate control theory suggests that pain perception is not uniform and can be modulated by non-painful stimuli, such as touch or temperature, influencing the pain pathways.

Choice B:

The theory emphasizes that pain perception can be influenced by external factors, including psychological and physical interventions, not solely confined to the brain.

Choice C:

Pain signals can be modulated by stimulating other sensory nerves. For instance, massage or heat can activate non-nociceptive fibers, blocking pain signals at the spinal cord level.

Choice D:

Pain perception is not solely determined by tissue damage. The gate control theory highlights the modulation of pain by psychological and physical factors, showing that pain is a complex experience.

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Question 9:

The nurse is caring for a client at 39 weeks gestation that arrived to OB triage with complaints of decreased fetal movement. The client was placed on external fetal monitors for an ordered non-stress test. The client was encouraged to drink some cold water and juice, as she reported she had not had anything to eat or drink yet for the day. The nurse observes the following tracing. How should the nurse document the non-stress test?

A. Reactive. B. Non-reactive.

Answer and Explanation

Choice A:

A reactive non-stress test shows at least two accelerations of the fetal heart rate, 15 beats per minute above baseline, lasting 15 seconds or more within 20 minutes, indicating fetal well-being.

Choice B:

A non-reactive non-stress test lacks sufficient accelerations in the fetal heart rate. This may require further assessment, such as a biophysical profile, to ensure fetal well-being.

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Question 10:

A nurse is educating a patient on the interpretation of a positive contraction stress test. Which of the following explanations is correct?

A. A positive contraction stress test shows that the baby has a strong heartbeat and will likely have a smooth delivery. B. A positive contraction stress test is a normal finding and requires no further monitoring or intervention. C. A positive contraction stress test indicates that the baby is healthy and there are no concerns with uterine contractions. D. A positive contraction stress test means that the baby’s heart rate decelerates in response to uterine contractions, which may indicate uteroplacental insufficiency.

Answer and Explanation

Choice A:

A positive contraction stress test shows that fetal heart rate decelerations occur with contractions, indicating potential issues with uteroplacental blood flow and not a smooth delivery.

Choice B:

A positive result is concerning and necessitates further monitoring and possible interventions to ensure fetal health, rather than being a normal finding.

Choice C:

A positive contraction stress test raises concerns about fetal well-being due to heart rate decelerations with contractions, which could indicate uteroplacental insufficiency.

Choice D:

Positive contraction stress test means the fetus experiences heart rate decelerations with contractions, suggesting uteroplacental insufficiency and potential risk for fetal compromise during labor.

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Total Questions : 26

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ATI NURS 306 maternal newborn exam

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