ATI NUR 209 Reproductive Health Final Assessment

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Sample questions from ATI NUR 209 Reproductive Health Final Assessment

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 24-year-old client at 34 weeks of gestation arrives at the emergency department with painless bright-red vaginal bleeding. Blood pressure is 112/70 mm Hg, pulse is 88/min, and fetal heart rate is 144/min. Which action should the nurse take first?

   • A.Perform a digital vaginal examination to assess cervical dilation.
   • B.Apply external fetal monitoring and assess the bleeding.
   • C.Encourage the client to walk to determine whether bleeding increases.
   • D.Prepare the client for an immediate induction of labor.

   Rationale: External fetal monitoring and assessment of bleeding help evaluate maternal and fetal status while minimizing risk. A digital vaginal examination can provoke severe hemorrhage if placenta previa is present, and walking is unsafe with active bleeding. Immediate induction is not appropriate before the cause and maternal-fetal status are evaluated.

2. 2.A 29-year-old client at 35 weeks of gestation reports sudden severe abdominal pain and dark vaginal bleeding. The uterus is firm and tender, blood pressure is 92/58 mm Hg, pulse is 122/min, and fetal heart rate is 170/min. Which action should the nurse take first?

   • A.Establish large-bore intravenous access and begin isotonic fluid resuscitation.
   • B.Perform a digital cervical examination.
   • C.Place the client in a warm shower to reduce discomfort.
   • D.Administer an oral analgesic and reassess in 30 minutes.

   Rationale: The findings suggest placental abruption with maternal hypovolemia, so rapid vascular access and fluid resuscitation support maternal perfusion. A digital examination can worsen bleeding and does not address instability. A shower and delayed oral analgesia are unsafe because they delay emergency stabilization.

3. 3.A 32-year-old client at 30 weeks of gestation has blood pressure readings of 168/112 and 166/110 mm Hg 15 minutes apart, a persistent headache, and 3+ proteinuria. Which prescribed intervention should the nurse anticipate?

   • A.Administer magnesium sulfate and an antihypertensive medication.
   • B.Encourage ambulation to lower blood pressure.
   • C.Restrict all fluids and postpone treatment until the next prenatal visit.
   • D.Administer oxytocin to induce contractions immediately.

   Rationale: Severe-range hypertension with headache and proteinuria indicates preeclampsia with severe features, requiring seizure prophylaxis and prompt blood pressure treatment. Ambulation does not treat the condition and increases fall risk. Delaying care is dangerous, while oxytocin is not the first stabilizing intervention.

4. 4.A 27-year-old client at 31 weeks of gestation is receiving magnesium sulfate for severe preeclampsia. The nurse notes a respiratory rate of 10/min, absent patellar reflexes, and urine output of 20 mL/hr. Which action should the nurse take?

   • A.Stop the magnesium sulfate infusion and prepare to administer calcium gluconate.
   • B.Increase the infusion rate because urine output is low.
   • C.Place the client flat and reassess in 1 hour.
   • D.Encourage oral fluids and continue the infusion.

   Answer and rationale are in the full material.

5. 5.A 23-year-old client at 29 weeks of gestation reports a gush of clear fluid. Temperature is 37.1 C (98.8 F), fetal heart rate is 142/min, and there are no contractions. Which nursing action is most appropriate?

   • A.Perform a sterile speculum examination to assess for pooling of fluid.
   • B.Perform repeated digital vaginal examinations to assess the cervix.
   • C.Encourage the client to take a tub bath.
   • D.Discharge the client because contractions have not started.

   Answer and rationale are in the full material.