Preview Extract
ATI Maternal Newborn 2.0 quiz 1
1. A nurse is assessing a client who is at 34 weeks gestation and has a mild placental abruption.
Which finding should the nurse expect?
a. Dark red vaginal bleeding
b. Painless vaginal bleeding
c. Bright red vaginal bleeding
d. Increased fetal movement
Answer: a. Dark red vaginal bleeding
Rationale:
Mild placental abruption typically presents with dark red vaginal bleeding due to the separation
of the placenta from the uterine wall, leading to blood accumulation.
2. A nurse is caring for a client who is at 32 weeks of gestation and is experiencing preterm labor.
Which of the following medications should the nurse plan to administer?
a. Betamethasone
b. Misoprostol
c. Methylergonovine
d. Poractant alfa
Answer: a. Betamethasone
Rationale:
Betamethasone is administered to stimulate fetal lung maturity and reduce the risk of respiratory
distress syndrome in preterm infants. Misoprostol is used to induce labor, methylergonovine is
used to control postpartum hemorrhage, and poractant alfa is used as a surfactant for neonatal
respiratory distress syndrome but is not administered pre-birth.
3. A nurse is teaching a client who is at 30 weeks of gestation about warning signs of
complications that she should report to her provider. Which finding should the nurse include in
the teaching?
a. Leg cramps
b. Mild nausea
c. Vaginal bleeding
d. Mild back pain
Answer: c. Vaginal bleeding
Rationale:
Vaginal bleeding during pregnancy, especially in the third trimester, is a significant warning sign
of complications such as placental abruption or previa and should be reported to the healthcare
provider immediately.
4. A nurse is reviewing the medical record of a client who is at 39 weeks of gestation and has
polyhydramnios. Which finding should the nurse expect?
a. Oligohydramnios
b. Fetal renal anomaly
c. Fetal gastrointestinal anomaly
d. Gestational diabetes
Answer: c. Fetal gastrointestinal anomaly
Rationale:
Polyhydramnios, or excessive amniotic fluid, is often associated with fetal gastrointestinal
anomalies because these conditions can prevent the fetus from swallowing and absorbing
amniotic fluid normally.
5. A nurse is teaching a client who has pre-eclampsia and is to receive magnesium sulfate via
continuous IV infusion about expected adverse effects. Which adverse effect should the nurse
include in the teaching?
a. Increased appetite
b. Feeling of warmth
c. Hypertension
d. Constipation
Answer: b. Feeling of warmth
Rationale:
Magnesium sulfate administration can cause a feeling of warmth as a common side effect. Other
possible side effects include flushing, nausea, and muscle weakness. It is used to prevent seizures
in pre-eclampsia, not to manage hypertension directly.
6. A nurse is assessing a client who is at 35 weeks of gestation and has mild gestational
hypertension. Which finding should the nurse identify as priority?
a. Elevated liver enzymes
b. Low urine output (<30 mL per hour)
c. 1+ proteinuria
d. Mild headache
Answer: b. Low urine output (<30 mL per hour)
Rationale:
Low urine output is a priority finding because it may indicate decreased renal perfusion and
potential progression to severe pre-eclampsia or HELLP syndrome, both of which are serious
complications that require immediate attention.
7. A nurse is teaching a client who is at 12 weeks of gestation about the manifestations of
potential complications that she should report to her provider. Which information should the
nurse include in the teaching?
a. Mild nausea
b. Increased appetite
c. Swelling of the face
d. Fatigue
Answer: c. Swelling of the face
Rationale:
Swelling of the face can be a sign of pre-eclampsia, a potentially dangerous pregnancy
complication characterized by high blood pressure and damage to other organs, typically the
liver and kidneys. Early reporting and management are crucial.
8. A nurse is reviewing lab results for a client who is at 37 weeks of gestation. The nurse notes
that the client is rubella non-immune, positive for group A beta-hemolytic strep, and has a blood
type of O negative. Which action should the nurse take?
a. Administer Rho(D) immune globulin
b. Instruct the client to obtain a rubella immunization after delivery
c. Prepare the client for an immediate cesarean delivery
d. Treat the client with antibiotics for group A beta-hemolytic strep
Answer: b. Instruct the client to obtain a rubella immunization after delivery
Rationale:
The client should be instructed to receive a rubella immunization postpartum because live
vaccines are contraindicated during pregnancy. Rubella can cause serious fetal harm, so
vaccination after delivery helps prevent future infections in subsequent pregnancies.
9. A nurse is caring for a client who has oligohydramnios. Which fetal anomaly should the nurse
expect?
a. Neural tube defects
b. Cardiac defects
c. Renal agenesis
d. Limb abnormalities
Answer: c. Renal agenesis
Rationale:
Oligohydramnios, or low amniotic fluid, is often associated with renal agenesis (absence of one
or both kidneys) because the kidneys contribute significantly to the production of amniotic fluid
through fetal urine.
10. A nurse is caring for a client who believes she may be pregnant. Which finding should the
nurse identify as a positive sign of pregnancy?
a. Amenorrhea
b. Positive urine pregnancy test
c. Chadwick's sign
d. Palpable fetal movement
Answer: d. Palpable fetal movement
Rationale:
Palpable fetal movement is a positive sign of pregnancy as it directly indicates the presence of a
fetus. Amenorrhea, a positive urine pregnancy test, and Chadwick's sign are presumptive and
probable signs but not definitive proof of pregnancy.
11. A nurse is assessing a client who is at 37 weeks of gestation and has a suspected pelvic
fracture due to blunt abdominal trauma. What finding should the nurse expect?
a. Decreased fetal movement
b. Uterine contractions
c. Painless vaginal bleeding
d. Hyperreflexia
Answer: b. Uterine contractions
Rationale:
Blunt abdominal trauma can stimulate the uterus to contract, potentially leading to preterm labor.
Uterine contractions are a common finding in such cases and should be closely monitored.
12. A nurse is caring for a client at 26 weeks of gestation who reports constipation. How should
the nurse respond?
a. "You should drink more milk."
b. "You should walk for at least 30 minutes a day."
c. "You should take a daily laxative."
d. "You should increase your protein intake."
Answer: b. "You should walk for at least 30 minutes a day."
Rationale:
Regular physical activity, such as walking, helps stimulate bowel movements and can alleviate
constipation. Increasing fiber and fluid intake is also recommended, but the option given
emphasizes the importance of exercise.
13. A nurse is caring for a client who is in the latent phase of labor and is experiencing low back
pain. Which action should the nurse take?
a. Encourage the client to lie on her back
b. Apply a warm compress to the abdomen
c. Apply pressure to the client's sacral area during contractions
d. Administer an epidural analgesia
Answer: c. Apply pressure to the client's sacral area during contractions
Rationale:
Applying pressure to the sacral area during contractions can help relieve low back pain
commonly experienced during the latent phase of labor. This technique is part of nonpharmacologic pain management.
14. A nurse is assessing a client who is at 35 weeks of gestation and is receiving magnesium
sulfate via continuous IV infusion for severe pre-eclampsia. Which finding should the nurse
report to the provider?
a. DTR +2
b. BP 150/96
c. Urinary output 20 mL/hour
d. RR 16
Answer: c. Urinary output 20 mL/hour
Rationale:
A urinary output of 20 mL/hour is significantly low and can indicate renal impairment, a
potential side effect of magnesium sulfate toxicity. This finding should be reported to the
provider for further evaluation and management.
15. A nurse is teaching a client who is at 10 weeks of gestation about an abdominal ultrasound in
the first trimester. What should the nurse include in the teaching?
a. "You will need to have a full bladder during the ultrasound."
b. "You should avoid eating for 6 hours before the ultrasound."
c. "You will be given a sedative before the ultrasound."
d. "You should drink a liter of water during the ultrasound."
Answer: a. "You will need to have a full bladder during the ultrasound."
Rationale:
A full bladder helps to lift the uterus out of the pelvis and provides a clearer image during an
abdominal ultrasound in the first trimester. This is crucial for accurate visualization and
assessment.
16. A nurse is caring for a client who is at 35 weeks of gestation and has severe preeclampsia.
Which assessment provides the most accurate reading of fluid and electrolyte status?
a. Serum electrolyte levels
b. Daily weight
c. Urine specific gravity
d. Blood pressure
Answer: b. Daily weight
Rationale:
Daily weight monitoring provides the most accurate assessment of fluid and electrolyte status
because it reflects changes in fluid balance, which is critical in managing severe preeclampsia.
17. Which lab test confirms pregnancy?
a. Complete blood count (CBC)
b. Urine test for human chorionic gonadotropin (hCG)
c. Blood glucose test
d. Serum creatinine test
Answer: b. Urine test for human chorionic gonadotropin (hCG)
Rationale:
The presence of human chorionic gonadotropin (hCG) in the urine is a definitive indicator of
pregnancy, as this hormone is produced by the placenta shortly after implantation.
18. A nurse is caring for a client whose last menstrual period (LMP) began on July 8. What is her
estimated date of birth (EDB)?
a. March 8
b. April 1
c. April 15
d. May 8
Answer: c. April 15
Rationale:
Using Naegele's rule (LMP + 7 days - 3 months + 1 year), the estimated date of birth for a last
menstrual period starting on July 8 is April 15 of the following year.
19. A nurse is caring for a client who is at 38 weeks of gestation and reports no fetal movement
for 24 hours. What should the nurse do?
a. Perform an ultrasound
b. Instruct the client to monitor for another 24 hours
c. Auscultate for a fetal heart rate (FHR)
d. Administer oxygen
Answer: c. Auscultate for a fetal heart rate (FHR)
Rationale:
The absence of fetal movement for 24 hours at 38 weeks of gestation is concerning. The
immediate action is to auscultate for a fetal heart rate to assess fetal well-being.
20. A nurse is assessing a client who is at 12 weeks of gestation and has a hydatidiform mole.
What finding should the nurse expect?
a. Dark brown vaginal discharge
b. Bright red vaginal bleeding
c. Severe abdominal pain
d. Increased fetal movement
Answer: a. Dark brown vaginal discharge
Rationale:
A hydatidiform mole, a type of gestational trophoblastic disease, typically presents with dark
brown vaginal discharge (often described as "prune juice" discharge) due to the abnormal growth
of trophoblastic tissue.
21. A nurse is caring for a client in their latent phase of labor and is receiving oxytocin via
continuous IV infusion. The client is having contractions every 2 minutes which last 100 to 110
seconds and the fetal heart rate (FHR) is reassuring. What should the nurse do?
a. Increase the dose of oxytocin by half
b. Maintain the current dose of oxytocin
c. Decrease the dose of oxytocin by half
d. Discontinue the oxytocin infusion
Answer: c. Decrease the dose of oxytocin by half
Rationale:
Contractions that are very frequent and long (every 2 minutes lasting 100 to 110 seconds) can
lead to uterine tachysystole, which can compromise fetal oxygenation over time. Even though
the FHR is currently reassuring, reducing the oxytocin dose can help prevent potential
complications.
22. A nurse is teaching a client who is at 8 weeks of gestation and has a uterine fibroid about
potential effects of the fibroid during pregnancy. What information should they include in the
teaching?
a. The fibroid can increase the risk for preterm labor
b. The fibroid can cause severe abdominal pain
c. The fibroid can lead to fetal growth restriction
d. The fibroid can increase the risk for postpartum hemorrhage
Answer: d. The fibroid can increase the risk for postpartum hemorrhage
Rationale:
Uterine fibroids can interfere with the normal contraction of the uterus after delivery, increasing
the risk for postpartum hemorrhage due to insufficient uterine contraction and resultant blood
loss.
23. A nurse is providing teaching to a client who is at 8 weeks of gestation about manifestations
to report to the provider during pregnancy. What information should the nurse include in the
teaching?
a. Morning sickness
b. Leg cramps
c. Blurred or double vision
d. Increased urinary frequency
Answer: c. Blurred or double vision
Rationale:
Blurred or double vision can be a sign of pre-eclampsia, a potentially serious condition
characterized by high blood pressure and organ damage, most often the liver and kidneys. Early
reporting and management are crucial.
24. A nurse is admitting a client who is in labor and experiencing moderate bright red vaginal
bleeding. Which of the following actions should the nurse take?
a. Perform a vaginal examination
b. Prepare for an immediate cesarean delivery
c. Obtain blood samples for baseline laboratory values
d. Administer oxygen via nasal cannula
Answer: c. Obtain blood samples for baseline laboratory values
Rationale:
Obtaining baseline laboratory values, including hemoglobin and hematocrit, is essential to assess
the client's current blood status and prepare for potential interventions. A vaginal examination
should be avoided until placenta previa is ruled out.
25. A nurse is teaching a client who is at 12 weeks of gestation and has HIV. What should the
nurse include in the teaching?
a. "You should avoid taking any antiretroviral medications during pregnancy."
b. "You should plan for a cesarean delivery to prevent transmission."
c. "You should continue to take zidovudine throughout the pregnancy."
d. "You will need to be isolated during your hospital stay."
Answer: c. "You should continue to take zidovudine throughout the pregnancy."
Rationale:
Continuing antiretroviral therapy, including zidovudine, is crucial during pregnancy to reduce the
risk of mother-to-child transmission of HIV. Adherence to prescribed medications significantly
lowers the viral load and transmission risk.
26. A nurse is teaching a client who is at 13 weeks of gestation about the treatment of
incompetent cervix with cervical cerclage. Which statement by the client indicates an
understanding?
a. "I should avoid all physical activity for the rest of my pregnancy."
b. "I will need to have the cerclage removed at 36 to 37 weeks of gestation."
c. "I should go to the hospital if I think I may be in labor."
d. "I will require bed rest until delivery."
Answer: c. "I should go to the hospital if I think I may be in labor."
Rationale:
If the client experiences signs of labor, rupture of membranes, or contractions, they should go to
the hospital immediately because a cervical cerclage may need to be removed to prevent
complications during labor.
27. A nurse is caring for a client in active labor and has meconium-stained fluid. The nurse notes
a reassuring FHR tracing from the external fetal monitor. What should the nurse do?
a. Perform an amnioinfusion
b. Prepare equipment needed for newborn resuscitation
c. Administer oxygen to the mother
d. Notify the provider immediately
Answer: b. Prepare equipment needed for newborn resuscitation
Rationale:
Even with a reassuring FHR, the presence of meconium-stained fluid indicates a risk for
meconium aspiration syndrome in the newborn. Having resuscitation equipment ready is a
precautionary measure to manage any potential respiratory complications at birth.
28. A nurse is caring for a client who is at 39 weeks of gestation and is in the active phase of
labor. The nurse observes late decelerations in the FHR. Which finding causes late decelerations?
a. Uteroplacental insufficiency
b. Umbilical cord compression
c. Fetal head compression
d. Maternal hypotension
Answer: a. Uteroplacental insufficiency
Rationale:
Late decelerations are caused by uteroplacental insufficiency, where the placenta is not
delivering enough oxygen to the fetus. This is a sign of fetal distress and needs to be addressed
promptly.
29. Which order should be questioned with placenta previa?
a. Perform a vaginal exam
b. Administer IV fluids
c. Monitor FHR
d. Prepare for a cesarean delivery
Answer: a. Perform a vaginal exam
Rationale:
Performing a vaginal exam in a client with placenta previa is contraindicated because it can
cause severe bleeding. Placenta previa involves the placenta covering the cervical opening, and
manipulation can disrupt the placental attachment.
30. A nurse is caring for a client at 37 weeks of gestation and is undergoing a nonstress test. The
FHR is 130 without accelerations for the past 10 minutes. What should the nurse do?
a. Reposition the client
b. Use vibroacoustic stimulation on the client's abdomen for 3 seconds
c. Offer the client a sugary drink
d. Continue to monitor for another 10 minutes
Answer: b. Use vibroacoustic stimulation on the client's abdomen for 3 seconds
Rationale:
Vibroacoustic stimulation can be used to stimulate fetal movement and potentially elicit
accelerations in the FHR, which are reassuring signs of fetal well-being.
