Skip to content
Past Exams

ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions)

ATI RN Maternal Newborn NGN Proctored Exam with Answers simplifies your exam prep with solved past exams that mirror the actual test questions.

Preview 16 of 239 pages

See the first 16 pages exactly as they appear in the document.

  1. Page 1
    Read page 1 as text

    (NGN) ATI RN MATERNAL NEWBORN PROCTORED EXAM TESTBANKACTUAL QUESTIONS WITH VERIFIED DETAILED SOLUTIONS/A+ GRADE ASSURED 1. A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagno sis? A. Painless red vaginal bleeding Rationale: Placenta previa is a condition of pregnancy when the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical os ( outlet to the vagina). Bright red, painless vaginal bleeding occurs in the second and third trimester. B. Increasing abdominal pain with a nonrelaxed uterus Rationale: Abruptio placenta is separation of the placenta from the site of uterine implantation bef ore delivery of the fetus. When the placenta separates prematurely, there is internal bleeding, which is painful, and the uterus is nonrelaxed or becomes rigid as the separation advances. C. Abdominal pain with scant red vaginal bleeding Rationale: Placenta previa involves minimal to severe bright red vaginal bleeding in the absence of abdominal pain. D. Intermittent abdominal pain following passage of bloody mucus Rationale: Intermittent abdominal pain following passage of bloody mucus is a description of normal labor. The passage of bloody mucus represents the loss of the cervical mucous plug, also referred to

  2. Page 2
  3. Page 3
    Read page 3 as text

    as the "bloody show." 2. A nurse is caring for a client who is 1 hr postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take? A. Document the findings and continue to monitor the client. Rationale: These are expected findings. At 1 hr postpartum, l ochia rubra should be intermittent and associated with uterine contractions. The volume of lochia resembles that of a heavy menstrual period. Small clots are common. The nurse should document the findings and continue to monitor the client. B. Notify the clie nt‟s provider. Rationale: These are expected findings, so there is no need to notify the provider. C. Increase the frequency of fundal massage. Rationale: These are expected findings and the fundus is already firm. Increasing the frequency of fundal massa ge is not indicated at this time. D. Encourage the client to empty her bladder. Rationale: These are expected findings, and the fundus is firm at the midline. If the fundus was deviated, this would be an indication of a distended bladder and the client shou ld be encouraged to void to prevent uterine atony. A+ Test Bank Page

  4. Page 4
    Read page 4 as text

    3. A nurse is caring for a newborn immediately following birth. After assuring a patent airway, what is the priority nursing action? A. Adminis ter vitamin K. Rationale: Administration of vitamin K is important, but it can be delayed until the newborn is held by the mother and is breastfed. There is another, more important nursing action. B. Dry the skin. Rationale: The newborn should be thorou ghly dried, covered with a warm blanket, placed on the mother‟s abdomen, and a cap applied to the newborn‟s head to prevent cold stress. The newborn responds to the cooler environment by increasing his respiratory rate, which can lead to respiratory distress. Based on Maslow‟s hierarc hy of needs, this is th e most important nursing action after securing the airway. C. Administer eye prophylaxis. Rationale: Administration of eye prophylaxis should occur within the first hour after birth. There is another, more important nursing action. D. Place an identification bracelet. Rationale: Correct identification of the newborn is important, but it can be delayed, as long as it is completed prior to the mother and newborn leaving the delivery room. There is another, more important nursing action. A+ Test Bank Page 3

  5. Page 5
    Read page 5 as text

    4. A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make? A. "It's a minor inco nvenience, which you should ignore." Rationale: This is a nontherapeutic response that disregards the client‟s concern and offers unwarranted reassurance. B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." Rationale: The presence or absence of bladder tone has no bearing on urinary frequency during p regnancy. C. "There is no way to predict how long it will last in each individual client." Rationale: This is a nontherapeutic response that does not provide appropriate information to the client. D. "It occurs during the first trimester and near the end of the pregnancy." Rationale: Urinary frequency is due to increased bladder sensitivity during the first trimester and recurs near the end of the pregnancy as the enlarging uterus places pressure on the bladder. A+ Test Bank Page 4

  6. Page 6
    Read page 6 as text

    A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work, the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella i mmunization? E. Shortly after giving birth Rationale: The rubella immunization should be offered to the client following birth, preferably prior to discharge from the hospital. This prevents the client from contracting rubella during the current or subsequ ent pregnancies, which would put her fetus at risk for rubella syndrome. F. In the third trimester Rationale: Because the rubella vaccine contains a live virus, immunizing the client at this point in pregnancy would put her fetus at risk for developing rube lla syndrome. G. Immediately Rationale: Because the rubella vaccine contains a live virus, immunizing the client during the first trimester would put the fetus at risk for developing a severe manifestations of rubella syndrome. H. During her next attempt to g et pregnant Rationale: Rubella immunization must be given at least 28 days prior to pregnancy to assure that the developing fetu s is not exposed to the virus and put at risk for rubella syndrome. 5. A nurse is caring for a client who just delivered a newborn. Following the delivery, which nursing action should be done first to care for the newborn? A+ Test Bank Page 5

  7. Page 7
    Read page 7 as text

    A. Clear the respiratory tract. Rationale: Clearing the airway of the infant is the first action the nurse should take immediate ly following delivery. B. Dry the infant off and cover the head. Rationale: Drying the infant and covering the head should be done shortly after the delivery, but it is not the first action the nurse should take. C. Stimulate the infant to cry. Rationale: Stimulating the infant to cry should be done shortly after the delivery, but it is not the first action the nurse should take. D. Cut the umbilical cord. Rationale: Cutting the umbilical cord should be done shortly after the delivery, but it is not the firs t action the nurse should take. 6. A nurse in a family planning clinic is caring for a 17 - year - old female client who is requesting oral contraceptives. The client states that she is nervous because she has never had a pelvic examination. Which of the f ollowing responses should the nurse make? A+ Test Bank Page 6

  8. Page 8
    Read page 8 as text

    A. "What part of the exam makes you most nervous?" Rationale: This therapeutic response recognizes the client's feelings. It also uses the therapeutic technique of clarification to encourage the client to tell the nurse more about her concerns. B. "Don't worry, I will be with you during the exam." Rationale: This closed - ended nontherapeutic response discounts the client's feelings and does not encourage further discussion. C. "All y ou need to do is relax." Rationale: This closed - ended nontherapeutic response does not address the client's concerns and does not encourage further discussion. It blocks communication by using a cliché and false reassurance. D. "A pelvic exam is required if you want birth control pills." Rationale: This statement fails to address the client‟s feelings that she shared with the nurse. It blocks communication and does not encourage further discussion. 7. A nurse in labor and delivery is caring for a clien t. Following delivery of the placenta, the nurse examines the umbilical cord. Which of the following vessels should the nurse expect to observe in the umbilical cord? A. Two veins and one artery Rationale: T his is not the correct combination of vessels. A+ Test Bank Page 7

  9. Page 9
    Read page 9 as text

    B. One artery and one vein Rationale: This is not the correct combination of vessels. C. Two arteries and one vein Rationale: The vein carried the oxygenated, nutrient - rich blood from the placenta to the fetus, and the two arteries r eturned the blood to the placenta. D. Two arteries and two veins Rationale: This is not the correct combination of vessels. 8. A nurse is caring for a client who is considering several methods of contraception. Which of the following methods of contracep tion should the nurse identify as being most reliable? A. A male condom Rationale: This method of contraception has 11 to 16 failures for every 100 users. B. An intrauterine device (IUD) Rationale: An IUD is found to have a failure rate of less than 1 in 100 users, which makes it one of the most A+ Test Bank Page 8

  10. Page 10
    Read page 10 as text

    reliable methods of contraception. C. An oral contraceptive Rationale: This method of contraception has about 8 failures for every 100 users, due to failure to take pill con sistently and decreased efficacy when taken with certain medications. D. A diaphragm with spermicide. Rationale: This method of contraception has about 16 failures for every 100 users during the first year of use. 9. A nurse is caring for an antepartum c lient whose laboratory findings indicate a negative rubella titer. Which of the following is the corr ect interpretation of this data? A. The client is not experiencing a rubella infection at this time. Rationale: A negative rubella titer indicates the cl ient is susceptible to the rubella virus. It does not indicate the presence or absence of a rubella infection. B. The client is immune to the rubella virus. Rationale: A negative rubella titer indicates the client is susceptible to the rubella virus. C. The c lient requires a rubella vaccination at this time. Rationale : Rubella vaccination during pregnancy is contraindicated because of possible injury to the developing fetus. A+ Test Bank Page 9

  11. Page 11
    Read page 11 as text

    D. The client requires a rubella immunization following delivery. Rationale: A negative rubella titer indicates that the client is susceptible to the rubella virus and needs vaccination following delivery. Immunization during pregnancy is contraindicated because of possible injury to the developing fetus. Fol lowing rubella immunization, the client should be cautioned not to conceive for 1 month. 10. A nurse in a hospital is caring for a client who is at 38 weeks of gestation and has a large amount of painless, bright red vaginal bleeding. The client is place d on a fetal monitor indicating a regular fetal heart rate of 138/min and no uterine contractions. The client's vital signs are: blood pressure 98/52 mm Hg, heart rate 118/min, respiratory rate 24/m in, and temperature 36.4° C (97.6° F). Which of the follow ing is the priority nursing action? A. Insert an indwelling urinary catheter. Rationale: An indwelling urinary catheter can be inserted in the delivery room just prior to delivery. This is not the priority nursing action. B. Initiate IV access. Rational e: Insertion of a large - bore IV catheter is the priority nursing action. The client is losing blood rapidly, has hypotension, and tachycardia. IV access will allow IV fluids and blood to be administered quickly if hypovolemia develops. A+ Test Ba nk Page 10

  12. Page 12
    Read page 12 as text

    D. Excessive uterine enlargement C. Witness the signature for informed consent for surgery. Rationale: Rationale C. This is not the nurse's priority action at this time. A family member can sign the consent form if needed. D. Prepare the abdominal and perineal areas. Rationale: Skin preparation can be delayed until just prior to a cesarean delivery. This is no the priority nursing action. 12 . AA nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client? A. Rapid decline in human chorionic gonadotropin (hCG) levels Rationale: A client who has a hydatidiform mole usually has an elevated serum hCG level. B. Profuse, clear vaginal discharge Rationale : A client who has a hydatidiform mole often has vaginal bleeding later in the pregnancy. This discharge can be dark brown, bright red, scant, or profuse. C. Irregular fetal heart rate Rationale: When a client has a hyd atidiform mole, fetal heart tones are not heard since there is no developing fetus. A+ Test Bank Page 11

  13. Page 13
    Read page 13 as text

    Rationale: A hydatidiform mole is a rare tumor that forms inside the uterus at the beginning of a pregnancy and results in the over - production of tissue that would normally develop i nto the placenta. This tissue consists of fluid - filled vesicles. A rapidly enlarging uterus is a classic finding in clients who have a molar pregnancy. It is often accompanied by severe nausea and vomiting, elevated human chorionic gonadotropin levels, sig ns of hyperthyroidism, and early onset of preeclampsia. 13 . AA nurse is caring for a new mother who is concerned that her newborn's eyes cross. Which of the following statements is a therapeutic response by the nurse? A. "I will call your primary care provi der to report your concerns." Rationale: This is an inappropriate response by the nurse because it does not address the client's feelings of concern. B. "I will take your baby to the nursery for further examination." Rationale: It is not necessary for th e nurse to complete additional examination of the newborn. This also does not address the client‟s concerns. C. "This occurs because newborns lack muscle control to regulate eye movement." Rationale: A+ Test Bank Page 12

  14. Page 14
    Read page 14 as text

    This addresse s the client‟s concerns because it provides information that addresses her concerns. The eyes of newborns are structurally incomplete and muscle control is not fully developed for 3 months. D. "This is a concern, but strabismus is easily treated with pat ching." Rationale: This is an inappropriate statement by the nurse because it offers unwarranted reassurance. The nurse is making an assumption that that should be addressed by the provider. 14 . AA nurse is caring for a client who is having a nonstre ss test performed. The fetal heart rate (FHR) is 130 to 150/min, but there has been no fetal movement for 15 min. Which of the following actions should the nurse perform? A. Immediately report the situation to the cl ient's provider and prepare the client for induction of labor. Rationale: The fetus might not be moving because it is asleep, or there might be another benign reason. B. Encourage the client to walk around without the monitoring unit for 10 min, then resume monitoring. Rationale: Having the clie nt walk is not likely to promote fetal movement. C. Offer the client a snack of orange juice and crackers. Rationale: A nonstress test depends upon fetal movement, and this fetus is most likely asleep. Most fetuses are more active after meals due to t he increase in the mother's blood sugar. Giving the mother a snack will promote fetal movement. D. Turn the client onto her left side. A+ Test Bank Page 13

  15. Page 15
    Read page 15 as text

    Rationale: Turning the client onto her left side increases the placental perfusion of oxyg en to the fetus, but the FHR of 130 to 150/min is not indicative of fetal distress. 15 . AA nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 min and a frequency o f 3 min. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min and matern al blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take? A. Notify the provider of the findings. Rationale: Calling the provider may be appropriate; however, this is not the priority intervention. B. Position the client with one hip elevated. Rationale: Based on Maslow‟s hierarchy of needs, the client's need for an adequate blood pressure to perfuse herself and her fetus is a physiological need that requires immediate intervention. Supine hypotension is a frequent cause of low blood pressure in clients who are pre gnant. By turning the client on her side and retaking her blood pressure, the nurse is attempting to correct the low blood pressure and reassess. C. Ask the client if she needs pain medication. Rationale: A+ Test Bank Page 14

  16. Page 16
    Read page 16 as text

    The clien t's comfort should be addressed; however, this is not the priority intervention. D. Have the client void. Rationale: The client should be encouraged to empty her bladder every 2 hr during labor; however, this is not the priority intervention. 16 . AA nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not." Which of the following should the nurse recognize as a sign of true labor? A. Rupture of the membranes Rationale: The membranes can rupture spontaneously long before the onset of labor. B. Changes in the cervix Rationale: Assessment of progressive changes in the effacement and dilation of the cervix is the most accurate indication of true labor. C. Station of the presenting part Rationale: A client who is a primigravida will typically engage before labor and can enter labor at - 1, 0, or even +1 station. D. Pattern of contractions Rationale: A client can have regular contractions for a significan t period of time prior to the onset of true labor. A+ Test Bank Page 1 5

223 more pages in the full document

Unlock it once and it stays in your library, ready to chat with or turn into flashcards.

Unlock the full document

More Assessment Technologies Institute study materials

See all

Study this document with CramX

Once it is in your library, every tool can work from it.