ATI Maternal Newborn Final Study Guide Practice Test

Breastfeeding causes the release of oxytocin, which causes uterine contractions. This is a normal physiological response that helps the uterus to contract and return to its pre-pregnancy size. The cramping and pain experienced by the client after breastfeeding is a common occurrence and not a cause for concern. It is important for the client to understand that this type of pain is a natural part of the postpartum period and will gradually decrease over time.

To verify a patient's pregnancy, blood and urine are checked for the presence of hCG (human chorionic gonadotropin). hCG is a hormone that is produced by the placenta during pregnancy. It can be detected in the blood and urine of pregnant women, serving as a reliable indicator of pregnancy. Checking for the presence of hCG helps to confirm whether or not a patient is pregnant.

The best sleeping position for a pregnant patient with PIH (pregnancy-induced hypertension) is left side-lying. This position allows for optimal blood flow to the uterus, placenta, and fetus. It also helps to reduce pressure on the inferior vena cava, which can be compressed in the supine position and lead to decreased blood flow and oxygenation to the fetus. Left side-lying position promotes better circulation and can help prevent complications associated with PIH.

The EDB (Estimated Date of Birth) is typically calculated by adding 280 days (or 40 weeks) to the LMP (Last Menstrual Period). In this case, if the LMP was on July 8th, adding 280 days would result in April 15th. Therefore, April 15th is the estimated date of birth.

Absent deep tendon reflexes should be reported to the provider when a patient in premature labor is receiving MGSO4 2 g IV. This finding could indicate magnesium toxicity, which can lead to respiratory depression and cardiac arrest. Therefore, it is important to notify the provider so that appropriate interventions can be initiated to prevent further complications.

The correct answer suggests that even if the home pregnancy test results are negative, it is important to follow up with further testing or medical consultation if the individual is experiencing pregnancy symptoms such as tender breasts and nausea. This implies that false-negative results can occur, and it is necessary to investigate further to confirm or rule out pregnancy.

Meat and dark green leafy vegetables are the best food sources for folic acid. Folic acid is a B-vitamin that is essential for the production and maintenance of new cells in the body. It is especially important during periods of rapid cell division and growth, such as pregnancy and infancy. Meat, such as liver and kidney, and dark green leafy vegetables, such as spinach and broccoli, are rich sources of folic acid. Dairy products, carrots, raisins, and shellfish do not contain as much folic acid as meat and dark green leafy vegetables.

The initial nursing care of an infant includes placing the infant under a radiant heater to maintain regulation of body temperature. This is important because newborns are unable to regulate their body temperature effectively and are at risk of hypothermia. The radiant heater helps to keep the baby warm and prevent heat loss. The other options mentioned, such as placing the infant in protective isolation, feeding a low-phenylalanine formula, and providing gavage feedings, are not typically part of the initial nursing care of an infant.

Prior to an amniocentesis procedure, it is important to assess the fetal heart rate. This is because the procedure involves inserting a needle into the amniotic sac, which carries a risk of potential harm to the fetus. By assessing the fetal heart rate, any abnormalities or distress can be detected before proceeding with the procedure, ensuring the safety of the fetus. Assessing fetal movement or symptoms like nausea and vomiting may not provide crucial information about the fetus's well-being in this specific context.

A hydatidiform mole is a rare condition where abnormal tissue grows inside the uterus instead of a baby. Dark brownish vaginal discharge can be a symptom of a hydatidiform mole due to the presence of abnormal tissue. This discharge may also contain blood. Therefore, it is expected that a patient diagnosed with a hydatidiform mole may experience dark brownish vaginal discharge.

The presence of limited abduction in one hip suggests that the newborn has congenital hip dysplasia. This condition occurs when the hip joint is not properly formed, leading to instability and potential dislocation. It is not appropriate to assume that the mother has abused the child based solely on this finding. The negative Ortolani's sign indicates that there is no audible click or sensation felt during hip examination, which further supports the diagnosis of hip dysplasia. Symmetrical gluteal folds may also be present in a newborn with this condition.

The patient's urinary output of 20 mL/hr is a cause for concern and should be immediately reported. A low urinary output can indicate inadequate renal perfusion, which can be a sign of worsening kidney function or decreased blood flow to the kidneys. This can be a serious complication in a patient with preeclampsia or pregnancy-induced hypertension (PIH), as it can lead to further organ damage and potentially progress to eclampsia. Therefore, it is important to notify the healthcare provider promptly to assess and address the situation.

The correct answer is importance of taking medication daily. This is because for a patient who is HIV positive, taking medication daily is crucial for managing the infection and preventing its progression. Consistent adherence to medication helps in controlling the viral load, maintaining a healthy immune system, and reducing the risk of transmitting the virus to others. Therefore, emphasizing the importance of taking medication daily is essential in the care plan for an HIV positive patient.

The most important thing to teach the woman regarding varicose veins is to wear elastic support stockings when out of bed and avoid prolonged sitting. This is because elastic support stockings help improve blood circulation and reduce the appearance of varicose veins. Avoiding prolonged sitting also helps prevent blood from pooling in the legs, which can worsen varicose veins. Resting in bed for at least 1 hour three times during the day, elevating legs, and applying warm moist soaks are helpful but not as crucial as wearing support stockings and avoiding prolonged sitting. There is no mention of moist lesions forming around the ankles, so notifying the healthcare provider about this is not necessary.

Based on the information provided, the appropriate action would be to request an ultrasound. This is because a high MSAFP (Maternal Serum Alpha-Fetoprotein) level at 18 weeks of pregnancy can indicate potential issues with the baby's development. An ultrasound can help further assess the situation and provide more information about the baby's health. This will enable the healthcare provider to make appropriate decisions and provide necessary support and care to the patient.

The main distinction between abruption placenta and placenta previa is abdominal pain. This symptom is characteristic of abruption placenta, where the placenta separates from the uterine wall before delivery, causing severe pain in the abdomen. Placenta previa, on the other hand, is characterized by painless vaginal bleeding, without abdominal pain. Therefore, abdominal pain is the key differentiating factor between these two conditions.

A primigravida client can most readily meet her increased daily iron requirement by taking an iron supplement with a vitamin C source. Vitamin C helps in the absorption of iron in the body, so taking the supplement with a vitamin C source will enhance the absorption and utilization of iron. This is important during pregnancy as the body's iron requirement increases to support the growing fetus and prevent iron deficiency anemia. Adding an extra source of red meat to her diet, consuming milk, and including extra sources of fruits and vegetables can also contribute to meeting her iron requirement, but taking an iron supplement with vitamin C is the most efficient way.

Premature infants have an underdeveloped layer of subcutaneous fat, which is responsible for providing insulation and regulating body temperature. Without this layer of fat, the infant is more susceptible to heat loss and struggles to maintain a stable body temperature. This is why the statement "there is lack of subcutaneous fat, which furnishes insulation" best describes the problem of regulating body temperature in a 3lb premature infant.

The lecithin-sphingomyelin ratio is a test used to determine fetal lung maturity. It measures the ratio of two substances found in the amniotic fluid, lecithin and sphingomyelin. A high ratio indicates that the fetal lungs are mature and capable of producing surfactant, a substance necessary for proper lung function. This test is commonly performed in pregnant women who may be at risk of preterm labor, as it helps to assess the readiness of the baby's lungs for breathing outside the womb.

A positive pregnancy test result is related to the presence of chronic gonadotropin hormone. This hormone is produced by the placenta after implantation of a fertilized egg in the uterus. Chronic gonadotropin helps to maintain the production of progesterone by the ovaries, which is essential for sustaining the pregnancy. Therefore, the presence of chronic gonadotropin in the body indicates pregnancy. Progesterone, lactogen, and estrogen are also involved in pregnancy, but chronic gonadotropin is specifically associated with pregnancy test results.

The presence of 2 g of protein in a 24-hour urine collection, swelling of the face and hands, and a weight gain of 7 lbs are concerning findings because they indicate the possibility of preeclampsia. Preeclampsia is a condition that can occur during pregnancy and is characterized by high blood pressure, protein in the urine, and swelling. It can be dangerous for both the mother and the baby if left untreated. Therefore, these symptoms should be monitored closely and reported to the healthcare provider for further evaluation and management.

When a patient in active labor experiences bright red bleeding since contractions started, it is important to assess for hemorrhage. Hemorrhage refers to excessive bleeding and can be a serious complication during labor and delivery. Monitoring the patient's vital signs at frequent intervals allows for early detection of any signs of hemorrhage such as a drop in blood pressure, increased heart rate, or signs of shock. Prompt identification and intervention can help prevent further complications and ensure the safety of both the mother and the baby.

The first action would be to palpate the client's bladder. This is because the fundus being firm and deviated to the left, along with the moderate lochia rubra and voiding of 150 mL, indicate that the bladder may be distended. Palpating the bladder will help determine if it is full and needs to be emptied, as a full bladder can prevent the uterus from contracting properly and may lead to postpartum hemorrhage.

The order to question from the physician would be "force fluids" because patients with heart disease often have fluid restrictions due to the potential for fluid overload and worsening of symptoms. Therefore, it is important to clarify with the physician whether forcing fluids is appropriate for this particular patient.

During the third trimester of pregnancy, the growing uterus puts pressure on the lower back, causing discomfort. Checking the client's posture can help identify any misalignments or poor body mechanics that may contribute to the back pain. Additionally, the type of shoes she wears is important as improper footwear can worsen back pain. By assessing these factors, appropriate recommendations can be made to alleviate the discomfort and improve the client's comfort during pregnancy.

Late decelerations are a contraindication for the use of oxytocin to augment pregnancy. Late decelerations refer to a decrease in the fetal heart rate that occurs after the peak of a contraction. This can indicate fetal distress and may be a sign of inadequate oxygen supply to the fetus. Therefore, if late decelerations are present, it would not be safe to continue using oxytocin to augment labor.

Braxton Hicks contractions are often referred to as "practice contractions" and are considered to be a normal part of pregnancy. Unlike true labor contractions, Braxton Hicks contractions do not increase in intensity and frequency. They are typically irregular and sporadic, and they may lessen or disappear with rest or a change in activity. While they can be uncomfortable, they are not usually painful and do not lead to cervical effacement and dilation.

The correct answer suggests that there can be other reasons for a missed or skipped period, not just pregnancy. The healthcare professional should gather more information about the patient's typical menstrual cycle to determine the possible causes for the late period.

When meconium-stained fluid is noted during labor, it indicates that the fetus has passed stool in utero. This can be a sign of fetal distress. However, since the FHR is normal, it suggests that the fetus is currently tolerating the situation well. Suctioning the airway as soon as the fetus head is delivered is the appropriate action in this scenario to prevent meconium aspiration syndrome. Performing vaginal examinations or getting an ultrasound may not be necessary at this point, and an emergency c-section is not indicated based on the information given.

The client should get a rubella vaccine now and not get pregnant for at least a month because a negative rubella titer indicates that the client is not immune to rubella. Rubella infection during pregnancy can lead to serious complications for the fetus, including congenital rubella syndrome. Therefore, it is important for the client to receive the vaccine to protect herself and her future baby before attempting to conceive. Waiting for at least a month after vaccination allows time for the vaccine to take effect and provide adequate protection.

The given answer is incorrect. Wearing a tight bra and applying ice packs to both breasts is not the appropriate care for a mother who has decided to bottle feed her baby. This may actually inhibit milk production and cause discomfort. The correct answer should focus on teaching the mother about techniques to prevent engorgement and maintain breast health, such as pumping her breasts regularly, using warm showers for comfort, and maintaining a balanced fluid intake to support milk production.

Based on the information provided, the client's last menstrual period was on November 10th. To estimate the due date, we can add 9 months and 7 days to that date. This calculation suggests that the baby is due in the first or second week of August.

Fetal movement felt by a physician can be a reliable indication of a positive pregnancy. As the fetus grows and develops, it starts to move, and a trained physician can feel these movements during a physical examination. This method is often used in the early stages of pregnancy when other signs may not be as apparent. However, it is important to note that other factors and tests, such as ultrasound and pregnancy tests, are also used to confirm pregnancy.

The infant's symptoms, such as expiratory grunting and substernal retractions, suggest respiratory distress. A temperature of 99 degrees may indicate an underlying infection. Administering 40% humidified oxygen would help improve oxygenation and alleviate respiratory distress. This would be the first action to take in order to address the infant's symptoms and provide immediate support for breathing.

The priority intervention in this situation is to monitor the fetus' heart rate. This is important because the client's water breaking indicates that the amniotic sac has ruptured, which can potentially lead to complications such as umbilical cord compression or prolapse. Monitoring the fetus' heart rate will help assess its well-being and detect any signs of distress or abnormalities. This intervention takes precedence over other options like cleaning up the mess or checking cervical dilation, as the focus should be on ensuring the safety and health of the fetus and addressing any potential complications.

The patient's symptoms, such as increased rectal pressure, along with the findings from the vaginal exam, indicate that she is in the transition phase of labor. During this phase, the cervix dilates from 8-9 cm to 10 cm, which is the fully dilated stage. The contractions are also close together and long-lasting, which is characteristic of the transition phase. This phase is known to be intense and can be accompanied by strong contractions and pressure in the rectum.

A glucose tolerance test measures how well the body can process glucose. In a pregnant woman, a blood glucose level of 110 mg/L at 3 hours would be considered within the normal range. This indicates that the woman's body is able to effectively regulate blood sugar levels after consuming a high amount of glucose. The other options provided, such as a glycosylated hemoglobin A1c of 5.0%, blood glucose of 200 mg/L at 60 minutes, and a 24-hour urine glucose level of 5 mg/dL, do not provide information about the body's ability to process glucose during a glucose tolerance test.

Before administering methergine to a patient, it is important to check their blood pressure. Methergine is a medication that is commonly used to prevent or treat excessive bleeding after childbirth. However, it can cause a sudden increase in blood pressure as a side effect. Therefore, it is crucial to assess the patient's blood pressure to ensure that it is within a safe range before administering the medication. This helps to prevent any potential complications or adverse reactions that may occur due to the medication's effect on blood pressure.

At 39 weeks gestation, a neonate (a newborn baby) would typically have creases on the entire bottom of both feet. This is a normal characteristic observed in newborns at this stage of development. The presence of these creases indicates that the baby's feet have fully developed and are ready for weight-bearing and walking.

Oligohydramnios refers to a condition where there is a decreased amount of amniotic fluid surrounding the fetus in the uterus. This can be caused by various factors, one of which is renal issues. Renal issues can affect the development and functioning of the kidneys, leading to a decrease in urine production and subsequently a decrease in amniotic fluid levels. Therefore, a fetal anomaly associated with oligohydramnios is renal issues.

The soft spot on the left side with bluish discoloration and edema is likely a cephalohematoma, which is a collection of blood under the scalp. It is a common condition in newborns and typically resolves on its own without treatment within 2-6 weeks. Therefore, there is no need for the mother to worry as it is a normal and temporary condition.

LGA stands for Large for Gestational Age, which means the baby is larger than average at birth. LGA babies are at a higher risk for hypoglycemia because their larger size can lead to difficulties in regulating blood sugar levels.

Based on the information provided, the client has AB negative blood type, which means she lacks the Rh factor. Since she has a history of a previous miscarriage, there is a possibility of Rh incompatibility if the fetus is Rh positive. To prevent potential complications, the administration of RHo(D) at 28 weeks is ordered. RHo(D) is a medication that prevents the mother's immune system from producing antibodies against the Rh factor in case the fetus is Rh positive. This treatment helps protect future pregnancies from Rh incompatibility issues.

The labor monitor tracing showing variable deceleration suggests that there may be cord compression occurring. This means that the umbilical cord, which supplies oxygen and nutrients to the fetus, is being compressed or squeezed, leading to a temporary decrease in blood flow and oxygen to the baby. This can result in fetal distress and potential complications if not addressed promptly.

The patient with deep tendon reflexes +4 requires further assessment. Deep tendon reflexes +4 indicate hyperreflexia, which can be a sign of severe preeclampsia. This patient may be at risk for complications and requires further evaluation and monitoring.

The baby's APGAR score is 9. The APGAR score is a quick assessment of a newborn's overall well-being and is based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. In this case, the baby has a heart rate of 136/min, which is within the normal range, and a respiratory rate of 36/min, also within the normal range. The baby is crying vigorously, showing active movement, and has acrocyanosis (bluish discoloration of the extremities), which indicates good reflex irritability and color. Therefore, the baby's APGAR score is 9, which is considered excellent.

To time a client's contractions, you measure the duration from the beginning of one contraction to the beginning of the next contraction. This is because the beginning of a contraction indicates the start of the uterus contracting and the end of a contraction indicates the relaxation of the uterus. By timing from the beginning of one contraction to the beginning of the next, you can accurately track the frequency and duration of contractions, which is important for monitoring the progress of labor.

The contractions of the patient are too frequent and lasting longer than normal, indicating hyperstimulation of the uterus. This can lead to fetal distress and compromise the blood flow to the placenta. To ensure the safety of both the mother and the baby, it is necessary to discontinue the administration of Pitocin.

The priority nursing goal in caring for an infant with an unrepaired tracheoesophageal fistula would be to promote oxygen exchange. This is because a tracheoesophageal fistula can cause respiratory distress and compromise the infant's ability to breathe properly. By promoting oxygen exchange, the nurse can ensure that the infant is receiving adequate oxygenation and prevent any further complications related to respiratory distress.

The assessment finding of cervical effacement of 100% dilation at 10 cm indicates that the client is progressing into the second stage of labor. Cervical effacement refers to the thinning and shortening of the cervix, and 100% effacement means that the cervix is completely thinned out. Dilation refers to the opening of the cervix, and 10 cm dilation indicates that the cervix is fully dilated. These changes in the cervix are indicative of the transition from the first stage of labor to the second stage, where the client will start pushing and actively participate in the delivery of the baby.