ATI RN Practice B Maternal Newborn

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Sample questions from ATI RN Practice B Maternal Newborn

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

1. 1.A 28-year-old client at 34 weeks of gestation is admitted with painless bright-red vaginal bleeding. Blood pressure is 118/72 mm Hg, pulse is 88/min, and fetal heart rate is 140/min. Which action should the nurse take?

   • A.Perform a digital cervical examination to determine dilation
   • B.Prepare for immediate oxytocin induction
   • C.Initiate continuous fetal monitoring and avoid vaginal examinations
   • D.Encourage ambulation to assess whether bleeding increases

   Rationale: Continuous fetal monitoring helps assess fetal well-being, and vaginal examinations are avoided because placenta previa may cause severe hemorrhage. A digital examination can disrupt the placenta, ambulation is not appropriate during active bleeding, and induction is not indicated without further assessment and a prescribed plan. The exam takeaway is to suspect placenta previa with painless third-trimester bleeding and avoid vaginal manipulation.

2. 2.A 30-year-old client at 39 weeks of gestation is in labor. The cervix is 6 cm dilated, contractions occur every 3 minutes, and the fetal heart rate is 140/min. The client requests pain relief. Which intervention is appropriate?

   • A.Offer an epidural after reviewing the client's status and prescribed plan
   • B.Tell the client pain relief is not available until the cervix is fully dilated
   • C.Ask the client to begin pushing with each contraction
   • D.Administer an oral sedative without checking the medication prescription

   Rationale: An epidural may be appropriate during labor after assessment and in accordance with the prescribed plan. Pain relief is not restricted until full dilation, and an unprescribed sedative must not be given. Pushing before complete dilation can cause cervical edema or injury; the nurse should support the client's informed pain-management choice.

3. 3.A 26-year-old client is 1 hour postpartum after a vaginal birth. The uterus is boggy and displaced to the right, and lochia is heavy. Blood pressure is 104/66 mm Hg and pulse is 102/min. Which actions should the nurse take? Select all that apply.

   • A.Apply an ice pack to the perineum as the only intervention
   • B.Reassess uterine tone and bleeding frequently
   • C.Assist the client to empty the bladder
   • D.Massage the fundus
   • E.Document the findings and wait for the next routine assessment

   Rationale: Fundal massage promotes uterine contraction, and bladder emptying can relieve displacement that interferes with contraction. Frequent reassessment is needed because heavy lochia can progress to postpartum hemorrhage. An ice pack may help perineal discomfort but does not treat uterine atony, and waiting delays needed care.

4. 4.A 25-year-old client at 38 weeks of gestation is admitted in active labor. The fetal heart rate is 138/min, contractions are every 2 minutes, and the client is 8 cm dilated. Which task may the nurse delegate to assistive personnel?

   • A.Teach the client how to use patterned breathing
   • B.Assess the client's cervical dilation
   • C.Interpret the fetal heart rate tracing
   • D.Obtain and document the client's routine temperature

   Answer and rationale are in the full material.

5. 5.A 36-year-old client at 30 weeks of gestation is hospitalized with severe preeclampsia. Blood pressure is 166/110 mm Hg, and the client reports a severe headache and visual spots. Which actions should the nurse take? Select all that apply.

   • A.Monitor blood pressure and neurologic status closely
   • B.Encourage frequent hallway ambulation
   • C.Place the client supine with legs elevated
   • D.Maintain a quiet, low-stimulation environment
   • E.Institute seizure precautions

   Answer and rationale are in the full material.