Maternal Newborn ATI latest Practice

Maternal Newborn ATI latest Practice

A nurse is assessing a client who has gestational diabetes mellitus and is experiencing hyperglycemia.Which of the following findings should the nurse expect?

• Reports increased urinary output
• Diaphoresis
• Reports blurred vision
• Shallow respirations
• Reports increased urinary output

Increased urinary output, nausea and vomiting, reports of thirst, abdominal pain, constipation, drowsiness, and headaches are manifestations of hyperglycemia. Other manifestations include weak rapid pulse, fruity breath odor, urine positive for sugar and acetone, and a blood glucose level greater than 200

A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take?

• Administer penicillin G 2.4 million units IM to the client
• Instruct the client to schedule an annual pelvic examination.
• Tell the client she will start medication for HIV immediately after delivery
• Report the client's condition to the local health department
• Report the client's condition to the local health department

The nurse should report the condition to the local health department. HIV is one of the conditions on the list of Nationally Notifiable Infectious Conditions that is required to be reported.

A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives.Which of the following findings should the nurse include as an adverse effect of this medication?

• Depression
• Polyuria
• Hypotension
• Urticaria
• Depression

The nurse should instruct the client that depression is a common adverse effect of combined oral contraceptives. Other common adverse effects of the medication include amenorrhea, weight gain, headache, nausea, breakthrough bleeding, and breast tenderness.

A nurse is providing teaching to a client who is at 40 weeks of gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching?

• "I can administer oxytocin 4 hours after the insertion of the medication."
• "You will need a full bladder prior to the insertion of the medication."
• "Remain in a side-lying position for 15 minutes after the medication is inserted."
• "An antacid will be given 20 minutes prior to the insertion of the medication."
• "I can administer oxytocin 4 hours after the insertion of the medication."

The nurse can administer oxytocin no sooner than 4 hours after the last dose of misoprostol. Oxytocin can be administered following misoprostol for clients who have cervical ripening and have not begun labor.

A nurse is caring for a prenatal client who has parovirus B19 (fifth disease). Which of the following actions should the nurse take?

• Administer antiviral medication
• Schedule an ultrasound examination
• Administer Haemophilus influenzae type b vaccine
• Schedule an indirect Coombs' test
• Schedule an ultrasound examination

The nurse should serial ultrasound examinations to monitor the fetus during the pregnancy to detect the possible development of fetal hydrops. Also, the virus can cause miscarriage, intrauterine growth restriction, fetal anemia, or stillbirth.

A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn?

• Apply a cool pack fo 10 minutes to the heel prior to the puncture.
• Request a prescription for IM analgesic
• Use a manual lance blade to pierce the skin
• Place the newborn skin to skin on the mother's chest.
• Place the newborn skin to skin on the mother's chest.

Placing the newborn skin to skin on the mother's chest is an effective technique to significantly decrease the newborn's pain level and anxiety. The nurse should implement the technique before, during, and after the procedure.

A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take?

• Insert two gloved fingers into the vagina and apply upward pressure to the presenting part.
• Wrap the visible cord tightly with sterile, dry gauze.
• Apply oxygen to the client at 2L/min via nasal cannula.
• Place the client in the lithotomy position and apply fundal pressure.
• Insert two gloved fingers into the vagina and apply upward pressure to the presenting part.

The nurse should quickly apply gloves and insert two fingers into the vagina toward the cervix, exerting upward pressure onto the presenting part to relieve umbilical cord compression and increase oxygenation to the fetus.

The nurse is caring for a client who is at 24 weeks of gestation and has suspected placental abruption.Which of the following laboratory tests should the nurse expect the provider to prescribe?

• Kleihauer-Betke test
• Progesterone serum level
• Lecithin/sphingomyelin (L/S) ratio
• Maternal Alpha-fetoprotein (AFP)
• Kleihauer-Betke test

The nurse should expect the provider to prescribe a Kleihauer-Betke test for a client who has suspected placental abruption to determine if fetal blood is in maternal circulation. This test is useful to determine if Rho-gam therapy should be administered to the client who is Rh (-)

A nurse is admitting a client who is in labor. The client admits to recent cocaine use. For which of the following complications should the nurse assess?

• Abruptio placenta
• Placenta previa
• Preeclampsia
• Maternal bradycardia
• Abruptio placenta

Cocaine use increases the risk for vasoconstriction and possible abruptio placenta.

A nurse is assessing a client who has severe preeclampsia. Which of the following manifestations should the nurse expect?

• 2+ deep tendon reflexes
• Proteinurua of 200 mg in a 24 hours specimen
• Polyuria