ATI Maternal Newborn Final Study Guide Practice Test

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1. A client complains to you of abdominal cramping and pain after breastfeeding. what should you explain to the client about this type of pain?

Explanation

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.

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About This Quiz
ATI Maternal Newborn Final Study Guide Practice Test - Quiz

The maternal and newborn study is not an easy subject. If you're learning it, then you must try this ATI Maternal Newborn final study guide practice test that is given below. In this test, you'll get a chance to revise your concepts and even learn something new. This is not... see morean official test from ATI but just a similar one with essential exam questions so that you can get prepared for this subject. So, give it a try and see how much you can score. Good luck!
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2. To verify a patient's pregnancy blood and urine are checked for the presence of what?

Explanation

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.

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3. What is the best sleeping position for a pregnant patient with PIH?

Explanation

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.

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4. LMP was July 8th. When is EDB?

Explanation

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.

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5. Suppose a patient is in premature labor and is receiving MGSO4 2 g I V, what finding should you report to the provider?

Explanation

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.

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6. A young woman calls the clinic and reports missing her period. she states that she used a home pregnancy test last night and the results were negative. she tells you that her breasts are tender and that she feels nauseated most of the day. what do you understand about the home pregnancy test?

Explanation

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.

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7. You are encouraging the client to eat a diet rich in folic acid. which of the following food sources would provide the most folic acid

Explanation

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.

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8. What does the initial nursing care of an infant include?

Explanation

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.

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9. You are taking care of a patient having amniocentesis done what is the appropriate action for you to take prior to procedure?

Explanation

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.

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10. The patient is diagnosed with a hydatidiform mole. What should you expect?

Explanation

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.

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11. The newoborn you are taking care of has congenital hip displasia, you know that

Explanation

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.

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12. A patient is on MGSO4 IV for PIH her BP=162/112mm/Hg, RR=32/min, HR=90 deep tendon reflex is +4. What other assessment should you immediately report?

Explanation

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.

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13. Your patient is HIV positive, what should you include in her care plan?

Explanation

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.

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14. You are caring for a woman in the afternoon who delivered at 8 am. she complians to you about the big blue veins in her legs. you observe her mothers legs and notes mutiple variscosities on her lower legs what will be the most important thing for you to teach her regarding variscosities

Explanation

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.

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15. You are caring for a patient who is 18 weeks her MSAFP is high. What is the appropriate action?

Explanation

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.

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16. Themain distinction between abprutio placenta and placenta previa is

Explanation

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.

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17. How can a primigravida client most readily meeet her increased daily iron requirement?

Explanation

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.

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18. Which statement best describes the problem of regulation of body temperature in a 3lb premature infant?

Explanation

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.

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19. A lecithin-sphingomyelin ratio is ordered fora primigravida client at 35 weeks gesttation. what is the goal of this test

Explanation

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.

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20. A positive pregnancy test result is related to the presence of which hormone?

Explanation

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.

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21. A client is 30 weeks gestation when she comes in for her regular prenatal checkup. what nursing assessment findings would cause you concern

Explanation

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.

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22. Your patient is in active labor, she said she has had bright red bleeding since contractions started. when you are monitoring her VS at frequent intervals. What are you assessing for?

Explanation

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.

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23. A primigravida just gave birth to a 7 lbs newborn vaginal delivery. she wants to breastfeed four hours later. you assess her fundus and find that it is firm and 1 fingerbreadth above the umbilicus and deviated to the left. she has moderate lochia rubra and has voided 150 mL. what is your first action?

Explanation

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.

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24. You are taking care of a patient post partially, this client has heart disease. Which order would you question from the physician?

Explanation

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.

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25. The beginning of her third trimester a client reports that she is having some discomfort in her lower back. what would you check?

Explanation

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.

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26. A patient has received oxytocin to augment pregnancy. What is a contraindication?

Explanation

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.

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27. A primigravida is experiencing Bracton hicks contractions. what statement is true concerning these contractions?

Explanation

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.

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28. At a prenatal clinic a patient comes in and says she is 2 weeks late for her period and thinks she may be pregnant. What would you tell this patient?

Explanation

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.

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29. A patient is in labor with spontaneous ROM. Meconium-stained fluid is noted and FHR is normal. what should you do?

Explanation

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.

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30. You are caring for a client who is not pregnant but is considering pregnancy. a rubella titer has been done and the titer was negative. what will be important for you to tell the client?

Explanation

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.

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31. A mother dleivers a healthy term infant and has decided  she wants to bottle feed her baby. what will important to teach her regarding care of her breasts?

Explanation

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.

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32. Client reporst that her last menstrual period was NOvember 10th. she asks you a when will my baby be due? what is the best answer?

Explanation

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.

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33. A positive pregnancy can be determined by ________. 

Explanation

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.

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34. You're nursing assessment of the infant reveals expiratory grunting, substernal retractions, and a temp of 99. What is your first action?

Explanation

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.

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35. You have just admitted a patient into L&D, client says 'my water just broke". what is your priority intervention?

Explanation

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.

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36. You are caring for a patient in labor, patient reports she is having increased rectal pressure. Her vaginal exam shows that her cervix is 8-9 cm dilated, her contractions are 2-3min apart and they last for about 80-90 seconds. You realize that the client is in _____________. 

Explanation

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.

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37. A primigravida is 26 weeks gestation and has been administered a glucose tolerance test. what would you expect the result to be considered within the normal range?

Explanation

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.

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38. If you are about to administer methergine to your patient. What should you do before administration?

Explanation

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.

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39. The characterisitcs of a neonate who is 39 weeks includes

Explanation

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.

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40. A fetal anomaly associated with oligohydraminos is __________. 

Explanation

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.

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41. The infant you are assessing is 2 days old and has a soft spot on the left side with a  bluish discoloration and some edema. it doesn't cross the suture line the mother asks you about this and shows concern, your response to her is going to be ________. 

Explanation

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.

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42. You are caring for 4 neonates. Which one is at risk for hypoglycemia?

Explanation

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.

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43. You are assessing a primigravide who is 26 weeks gestation, her blood type is AB negative and she has a history of one miscarriage at 20 weeks gestation. based on this information you anticipate, what is going to be ordered for this client?

Explanation

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.

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44. The labor monitor tracing shows cariable deceleration. what complication would you anticipate is occurring?

Explanation

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.

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45. You have four patients in antepartum all with preeclampsia. Which patient requires further assessment?

Explanation

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.

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46. Infants HR IS 136/min RR are 36/min vigorous cry active movement acrocyanosis, what is this baby's APGAR score?

Explanation

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.

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47. You are caring for a cleitn in labor. how do you time her contractions?

Explanation

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.

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48. One hour after administering Pitocin to your patient her contractions were 90-100 seconds and 1-2 min apart. what needs to happen?

Explanation

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.

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49. You are caring for an infnat with an unrepaired tracheoesophageal fistula. in planning care, you will identify what prioirty nursing goal.

Explanation

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.

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50. You are caring for a 20 year old primigravida who has been in the first stage of labor for about 8 hours. what assessment findings would indicate the client is progressing into the second stage of labor.

Explanation

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.

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51. Which statement made by a patient indicates that she has a good understanding of breastfeeding?

Explanation

The statement "fluid intake is important for adequate breast milk production" indicates that the patient understands the importance of staying hydrated in order to produce enough breast milk for her baby. This shows that she has a good understanding of the factors that contribute to successful breastfeeding.

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52. In teaching newborn care, in discharging patient and family the highest priority is:

Explanation

In teaching newborn care, the highest priority is providing instruction on how to suction with a bulb syringe. This is because newborns often have mucus or amniotic fluid in their airways, which can make it difficult for them to breathe. Suctioning with a bulb syringe helps to clear their airways and ensures proper breathing. This instruction is crucial for the safety and well-being of the newborn, making it the highest priority in discharging the patient and their family.

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53. A woman who gave birth 3 weeks ago is calling you to ask what she should do for her sore, cracked nipples. what do you tell her?

Explanation

Ensuring that the entire areola is in the baby's mouth while breastfeeding is the correct answer because it promotes proper latch and reduces the chances of sore and cracked nipples. When the baby latches on correctly, it helps distribute the pressure evenly and prevents excessive friction on the nipples. This can help in healing the soreness and preventing further damage.

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54. Patient is tensing at the onset of a contraction. What can you tell her regarding breathing techniques.

Explanation

Taking a cleansing breath in is a recommended breathing technique during contractions. It helps the patient to relax and focus, preparing them for the upcoming contraction. This technique allows the patient to take a deep breath in through their nose, hold it for a few seconds, and then exhale slowly through their mouth. This type of breathing can help manage pain and provide a sense of control during labor.

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55. Patient has uterine fibroids at 14 weeks which is the MOST correct answer

Explanation

The correct answer is "uterus may not contract". Uterine fibroids are noncancerous growths that can develop in the uterus. These fibroids can interfere with the normal contraction of the uterus during labor, potentially leading to complications such as prolonged labor or the need for a cesarean section. Therefore, it is important to consider the possibility that the presence of uterine fibroids at 14 weeks gestation may affect the contraction of the uterus during labor.

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56. Your patient has abruption placenta, what should you be assessing for in her lab results?

Explanation

In a patient with abruption placenta, prolonged partial thromboplastin time (PTT) should be assessed in her lab results. PTT measures the time it takes for blood to clot and is used to evaluate the function of the intrinsic pathway of coagulation. A prolonged PTT may indicate a clotting disorder or a deficiency in clotting factors, which could be relevant in a patient with abruption placenta where there is a risk of excessive bleeding. Assessing PTT helps in monitoring the patient's coagulation status and guiding appropriate management.

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57. Re checkin a laboring client. her assessment reveals the head at +3 station. you should

Explanation

Based on the information provided, the laboring client's assessment reveals the head at +3 station. This indicates that the baby's head is descending into the birth canal and is close to being delivered. Therefore, it is appropriate to prepare for the delivery of the infant.

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58. The pelvic examination reveals the fetus to be at -1 station. what information does this indicate to you about the presenting part of the fetus

Explanation

The correct answer indicates that the presenting part of the fetus is above the ischial spines. This means that the fetus has not yet descended into the true pelvis and is still higher in the pelvis. The -1 station suggests that the fetus has started to engage in the pelvis but has not yet descended to the level of the ischial spines.

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59. You are assessing a client 12 hours after prolonged labor and delivery. what assessment data would you be the most concerned with?

Explanation

The correct answer is uterine fundus palpated to the right of the umbilicus. After prolonged labor and delivery, the uterus should be contracting and the fundus should be located at the midline or slightly above the umbilicus. If the fundus is palpated to the right of the umbilicus, it may indicate uterine atony or a possible uterine infection, which are concerning postpartum complications that require immediate attention and intervention. This assessment finding should be addressed promptly to prevent further complications.

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60. In the fourth stage of labor patient is experiencing hemorrhage, what is the last thing you would do?

Explanation

In the fourth stage of labor, the last thing you would do is give MGSO4. This is because MGSO4, also known as magnesium sulfate, is typically used as a tocolytic agent to prevent preterm labor or as a treatment for preeclampsia and eclampsia. It is not typically used to address hemorrhage. Therefore, it would be more appropriate to prioritize other interventions such as giving pitocin to help control bleeding, assessing the bladder for potential causes of hemorrhage, and massaging the fundus to promote uterine contraction and prevent excessive bleeding.

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61. Inactive labor the fetal heart rate decrease from 166/min to 100/min after the acme of contractions. the heart rate then returns to baseline when the contraction is finished. What should you document?

Explanation

The given scenario describes a decrease in fetal heart rate from 166/min to 100/min after the peak of contractions, with the heart rate returning to baseline once the contraction is over. This pattern is indicative of late decelerations, which are characterized by a gradual decrease in heart rate that occurs after the peak of a contraction. Late decelerations are associated with uteroplacental insufficiency, where the placenta is unable to provide adequate oxygen to the fetus during contractions. Therefore, documenting late decelerations would be the appropriate response in this case.

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62. At 12 weeks patient's blood work reveals that her rubella is negative, VDRL is negative and her blood type is O negative. What does this mean?

Explanation

This means that the patient does not have immunity against rubella and will need to receive the rubella vaccine after giving birth. Rubella is a viral infection that can cause serious harm to a developing fetus if the mother contracts it during pregnancy. Therefore, it is important for the patient to be vaccinated after delivery to protect herself and any future pregnancies from rubella.

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63. What is the correct conversion of lbs to kg if the infant is 4lbs 4 oz?

Explanation

The correct conversion of lbs to kg for an infant weighing 4lbs 4 oz is 1.93 kg.

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64. You assess the psycholgic status of the mother and promotes bonding during delivery and after delivery, which of the following maternal  observations would cause you to be concerned regarding the bonding process

Explanation

If the mother is tired and does not want to see the infant at birth, it may indicate a lack of interest or emotional connection towards the baby. This could be concerning regarding the bonding process, as maternal-infant bonding typically involves the mother's desire to see and interact with her newborn immediately after birth. It is important for the mother to have an initial positive interaction with the infant to promote bonding and establish a nurturing relationship.

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65. A multigravida client comes to the emergency department complaining of abdominal pain. she is at 30 weeks gestation. on assessment you observe complete dilation and effecement of the cervix with perineal area bulging and the infants head crowing. the mother states she is feeling a strong urge to push. what is the best action you should take.

Explanation

Based on the given scenario, the best action to take is to place gentle pressure on the infant's head and support it through the birth canal. This is because the client is already at 30 weeks gestation with complete dilation and effacement of the cervix, and the infant's head is crowning. These signs indicate that the client is in the late stage of labor and ready to deliver. By providing gentle pressure and support, the healthcare provider can assist in the safe delivery of the baby.

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66. Client complais of severe perineal pain the first hour after delivery. what should you assess for

Explanation

After delivery, a client complaining of severe perineal pain should be assessed for a swollen, discolored area on the perineum. This could indicate perineal trauma or injury, such as a perineal tear or episiotomy. Assessing the perineum for swelling and discoloration is important to identify any potential complications or need for intervention, such as suturing or pain management. It is important to address perineal pain promptly to ensure the client's comfort and prevent any further complications.

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67. A newborn is given medication within one hour after birth this medication is

Explanation

Erythromycin is a medication that is commonly given to newborns within one hour after birth. It is an antibiotic that helps prevent eye infections caused by certain bacteria that can be present in the birth canal. This medication is typically administered as a preventive measure to protect the baby's eyes and ensure their overall health and well-being.

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68. You are monitoring a client during labor and observe an erratic fetal heart rate pattern on the monitor at the height of the contraction. what is the first action you should take?

Explanation

Checking the monitor lead for placement is the first action that should be taken in this situation. This is important because an erratic fetal heart rate pattern could be caused by a poor connection between the monitor lead and the mother's abdomen. By checking the placement of the monitor lead, it can be ensured that accurate and reliable fetal heart rate readings are being obtained. This will help in assessing the well-being of the fetus and making appropriate decisions regarding further interventions or actions.

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69. After 8-hour delivery who is at risk for postpartum atony? (choose all that may apply

Explanation

After an 8-hour delivery, individuals who are at risk for postpartum atony may include those who had a precipitous delivery, a distended bladder, and a macrosomic delivery. A precipitous delivery refers to a very rapid labor and delivery process, which can increase the risk of postpartum atony. A distended bladder can also contribute to postpartum atony as it can interfere with the contraction of the uterus. Macrosomic delivery, which refers to the birth of a larger-than-average baby, can also increase the risk of postpartum atony due to the strain it puts on the uterus during delivery.

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70. In the fourth stage of labor patient is experiencing hemorrhage, what is the second step you would do for the patient?

Explanation

In the fourth stage of labor, it is important to assess the bladder of the patient. This is because a full bladder can impede the contraction of the uterus and increase the risk of hemorrhage. By assessing the bladder, the healthcare provider can ensure that it is empty and not causing any complications. This step is crucial in managing postpartum hemorrhage and promoting the well-being of the patient.

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71. Which statement about the results of s stress test is considered accurate?

Explanation

The correct answer states that a stress test is considered positive if late decelerations occur in more than half of the contractions. This means that during the test, if there is a consistent pattern of late decelerations in the fetal heart rate, it indicates a potential issue with the baby's well-being and may require further medical intervention or monitoring. Late decelerations refer to a decrease in the fetal heart rate that occurs after the peak of a contraction, which can be a sign of fetal distress.

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72. A client is 38 weeks pregnant and is admitted with bright red vaginal bleeding. she complains of abdominal discomfort, but she is not having contractions. after you assess her VS and the FHR. What is the most important information you need to obtain?

Explanation

The most important information to obtain in this scenario is at what time the client last ate. This is because the client is 38 weeks pregnant and experiencing bright red vaginal bleeding, which may indicate a potential complication such as placenta previa or placental abruption. Knowing the time of her last meal is crucial as it helps determine if the client needs to undergo emergency surgery or if she can safely undergo anesthesia if needed.

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