a nurse is caring for a client who is at 37 weeks of gestation and has placenta previa the client asks the nurse why the provider does not do an inter
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ATI Maternal Newborn Proctored Exam 2023

1. A client at 37 weeks of gestation with placenta previa asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

Correct answer: C

Rationale: Performing an internal examination in a client with placenta previa can lead to significant bleeding due to the proximity of the placenta to the cervical os. This bleeding can be severe and potentially life-threatening. Therefore, it is crucial to avoid any unnecessary manipulation that could disrupt the delicate balance and lead to hemorrhage.

2. A client in a prenatal clinic is being taught by a nurse in her second trimester with a new diagnosis of gestational diabetes. Which of the following client statements indicates a need for further teaching?

Correct answer: B

Rationale: Choice B, 'I will reduce my exercise schedule to 3 days a week,' indicates a need for further teaching. Regular exercise is beneficial in managing gestational diabetes and should not be reduced without proper guidance. Choices A, C, and D demonstrate understanding and appropriate actions in managing gestational diabetes.

3. A client who is 2 hours postpartum following a cesarean birth has a history of thromboembolic disease. Which of the following nursing interventions should be included in the plan of care?

Correct answer: D

Rationale: The correct intervention for a client who is 2 hours postpartum following a cesarean birth with a history of thromboembolic disease is to have the client ambulate. Early ambulation is crucial in preventing complications such as deep vein thrombosis in postpartum clients. Applying warm, moist heat, massaging the legs, or placing pillows under the knees do not directly address the risk of thromboembolic disease in this scenario.

4. A newborn is born to a mother with poorly controlled type 2 diabetes. The newborn is macrosomic and presents with respiratory distress syndrome. The most likely cause of the respiratory distress is which of the following?

Correct answer: A

Rationale: The correct answer is hyperinsulinemia. In infants born to mothers with poorly controlled diabetes, the excess glucose crosses the placenta, leading to fetal hyperglycemia. This results in fetal hyperinsulinemia, which in turn can cause macrosomia (large birth weight), increasing the risk of respiratory distress syndrome due to the immature lungs' inability to handle the increased workload. Hyperinsulinemia, not increased deposits of fat, brachial plexus injury, or increased blood viscosity, is the most likely cause of respiratory distress in this scenario.

5. A client at 11 weeks of gestation reports slight occasional vaginal bleeding over the past 2 weeks. Following an examination, the provider informs the client that the fetus has died, indicating a:

Correct answer: B

Rationale: A missed miscarriage, also known as a silent or delayed miscarriage, occurs when the embryo or fetus has died, but no bleeding or contractions have occurred to expel it from the uterus. In this scenario, the client's experiencing slight occasional vaginal bleeding over the past two weeks indicates a missed miscarriage as the fetus has died, but the body has not recognized the loss or expelled the products of conception.

Similar Questions

When admitting a client at 33 weeks of gestation with a diagnosis of placenta previa, which action should the nurse prioritize?
A nurse on the postpartum unit is caring for a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?
A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, PaCO2 68 mm Hg, Base excess -2, PaO2 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L
A client who experienced a cesarean birth due to dysfunctional labor expresses disappointment for not having a natural childbirth. Which response should the nurse make?
When reviewing the arterial blood gas values for a client, a nurse notes a pH of 7.32, PaCO2 of 48 mm Hg, and HCO3 of 23 mEq/L. What does this indicate about the acid-base balance?

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