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Maternal Newborn ATI Proctored Exam 2023
1. An adolescent is being taught about levonorgestrel contraception by a school nurse. What information should the nurse include in the teaching?
- A. You should take the medication within 72 hours following unprotected sexual intercourse.
- B. Do not take this medication if you are on an oral contraceptive.
- C. If you do not start your period within 5 days of taking this medication, you will need a pregnancy test.
- D. One dose of this medication will prevent pregnancy for 14 days after taking it.
Correct answer: A
Rationale: Levonorgestrel is an emergency contraceptive that works by inhibiting ovulation to prevent conception. It is most effective when taken as soon as possible within 72 hours following unprotected sexual intercourse. Therefore, the nurse should instruct the adolescent to take the medication promptly to maximize its effectiveness. Choice B is incorrect because levonorgestrel can be used even if the individual is on oral contraceptives. Choice C is incorrect as the efficacy of levonorgestrel is not determined by the onset of menstruation. Choice D is incorrect because levonorgestrel is a single-dose emergency contraceptive and does not provide protection for 14 days after ingestion.
2. A healthcare professional is assessing a late preterm newborn. Which of the following clinical manifestations is an indication of hypoglycemia?
- A. Hypertonia
- B. Increased feeding
- C. Hyperthermia
- D. Respiratory distress
Correct answer: D
Rationale: The correct answer is D, respiratory distress, as it is a clinical manifestation of hypoglycemia in newborns. Other signs of hypoglycemia include an abnormal cry, jitteriness, lethargy, poor feeding, apnea, and seizures. Hypertonia, increased feeding, and hyperthermia are not typically associated with hypoglycemia in newborns. Hypertonia is more indicative of neurological issues, increased feeding is not a common sign of hypoglycemia, and hyperthermia is not a typical symptom of low blood sugar.
3. A healthcare professional in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the healthcare professional identify as a risk factor for the development of preeclampsia?
- A. Singleton pregnancy
- B. BMI of 20
- C. Maternal age of 32 years
- D. Pregestational diabetes mellitus
Correct answer: D
Rationale: Pregestational diabetes mellitus is a significant risk factor for the development of preeclampsia in pregnant individuals. Preeclampsia is more common in women with preexisting conditions such as diabetes, hypertension, renal disease, lupus, or rheumatoid arthritis. Singleton pregnancy, a BMI of 20, or maternal age of 32 years are not considered significant risk factors for developing preeclampsia.
4. A healthcare professional is assessing four newborns. Which of the following findings should the professional report to the provider?
- A. A newborn who is 26 hours old and has erythema toxicum on their face
- B. A newborn who is 32 hours old and has not passed meconium stool
- C. A newborn who is 12 hours old and has pink-tinged urine
- D. A newborn who is 18 hours old and has an axillary temperature of 37.7° C (99.9° F)
Correct answer: D
Rationale: An axillary temperature greater than 37.5° C (99.5° F) is above the expected reference range for a newborn and can be an indication of sepsis. Therefore, the healthcare professional should report this finding to the provider for further evaluation and management to rule out sepsis. Choices A, B, and C are within the expected range of normal findings for newborns. Erythema toxicum is a common and benign rash in newborns, not requiring immediate reporting. Not passing meconium stool within the first 24-48 hours can be normal, and pink-tinged urine can be due to uric acid crystals excretion, which is also common in newborns.
5. A newborn was transferred to the nursery 30 min after delivery. What should the nurse do first?
- A. Confirm the newborn's identification.
- B. Verify the newborn's identification.
- C. Administer vitamin K to the newborn.
- D. Determine obstetrical risk factors.
Correct answer: B
Rationale: When a newborn is transferred to the nursery, the first action the nurse should take is to verify the newborn's identification. This step is crucial for ensuring the correct care is provided to the right newborn, promoting patient safety and preventing errors. Administering vitamin K (Choice C) is important but should not be the first action. Determining obstetrical risk factors (Choice D) is not the priority when the newborn is transferred to the nursery. Confirming (Choice A) and verifying (Choice B) have similar meanings, but 'verify' is a more appropriate term in this context.
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