LPN LPN
ATI Maternal Newborn Proctored
1. A client in active labor has 7 cm of cervical dilation, 100% effacement, and the fetus at 1+ station. The client's amniotic membranes are intact, but she suddenly expresses the need to push. What should the nurse do?
- A. Assist the client into a comfortable position.
- B. Observe the perineum for signs of crowning.
- C. Have the client pant during the next contractions.
- D. Help the client to the bathroom to void.
Correct answer: C
Rationale: Having the client pant during contractions is crucial to prevent premature pushing, particularly when the cervix is not fully dilated. Premature pushing can lead to cervical swelling and may impede the progress of labor. It is important to allow the cervix to fully dilate before active pushing to prevent complications. Assisting the client into a comfortable position (Choice A) may not address the urge to push and can lead to premature pushing. Observing the perineum for signs of crowning (Choice B) is important but does not address the immediate need to prevent premature pushing. Helping the client to the bathroom to void (Choice D) does not address the urge to push and may not be appropriate at this stage of labor.
2. A client is scheduled for a cesarean birth based on fetal lung maturity. Which finding indicates that the fetal lungs are mature?
- A. Absence of Phosphatidylglycerol (PG)
- B. Biophysical profile score of 8
- C. Lecithin/sphingomyelin (L/S) ratio of 2:1
- D. Reactive nonstress test
Correct answer: C
Rationale: An L/S ratio of 2:1 indicates fetal lung maturity, as it signifies the presence of surfactant in the amniotic fluid, which helps with lung expansion and prevents collapse at the end of expiration. The absence of PG indicates immaturity of the fetal lungs, as PG appears in the amniotic fluid during the later stages of lung maturation. Biophysical profile scores and nonstress tests are assessments of fetal well-being and do not directly indicate fetal lung maturity. Therefore, choice C is the correct answer.
3. A client in active labor is being prepared for epidural analgesia. Which of the following actions should the nurse take?
- A. Have the client sit upright on the bed with legs crossed.
- B. Administer a 500 mL bolus of lactated Ringer's solution prior to induction.
- C. Inform the client that the anesthetic effect will last for approximately 2 hours.
- D. Obtain a 30-minute electronic fetal monitoring (EFM) strip prior to induction.
Correct answer: D
Rationale: Obtaining a 30-minute electronic fetal monitoring (EFM) strip prior to epidural analgesia is crucial to establish a baseline for fetal heart rate and uterine activity. This baseline helps in monitoring fetal well-being during labor and assessing the effect of analgesia on the baby. It enables the healthcare team to identify any changes in the fetal heart rate pattern and uterine contractions, ensuring the safety of both the mother and the baby. Choices A, B, and C are incorrect because having the client sit upright with legs crossed is not necessary for epidural placement, administering a bolus of lactated Ringer's solution is not typically done before epidural analgesia, and the duration of the anesthetic effect varies and is not accurately 2 hours.
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 inconvenience, which you should ignore.
- B. In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.
- C. There is no way to predict how long it will last in each individual client.
- D. It occurs during the first trimester and near the end of the pregnancy.
Correct answer: D
Rationale: Urinary frequency is common during the first trimester and again at the end of pregnancy when the baby drops into the pelvis, putting pressure on the bladder.
5. During an assessment of a newborn following a vacuum-assisted delivery, which of the following findings should the healthcare provider be informed about?
- A. Poor sucking
- B. Blue discoloration of the hands and feet
- C. Soft, edematous area on the scalp
- D. Facial edema
Correct answer: A
Rationale: Poor sucking in a newborn following a vacuum-assisted delivery could indicate potential issues with feeding or neurological function, which need to be promptly addressed by the healthcare provider to ensure the well-being of the infant. It is essential for the healthcare provider to be informed about poor sucking to facilitate further evaluation and intervention. Choices B, C, and D are not typically associated with vacuum-assisted delivery and do not pose immediate concerns that require urgent attention.
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