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ATI Maternity final review, Exams of Nursing

University of Colorado - Colorado Springs (UCCS)Nursing

ATI Maternity final exam review

Typology: Exams

2024/2025

Available from 07/03/2025

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ATI Maternity final
What is an amniocentesis used for?
- To determine lung maturity, detect congenital anomalies, and diagnose fetal hemolytic
disease
What is a cordocentisis used for?
- To identify fetal blood type and RBC when there is a risk of isoimmune hemolytic
anemia
What is the Kleihauer-Betke test used for?
- To determine the amount of fetal blood In the maternal circulation when there is a risk
of Rh isoimmunization
Abdominal cramping at 11 weeks indicates what?
- It can indicate ectopic pregnancy or manifestations of spontaneous abortion. This
would be a priority action.
Blood nose (epistaxis) at 8 weeks gestation..
- Is a normal sign
5 steps in bathing a newborn
- 1. Wipe eyes from inner canthus outwards
2. Wash neck by lifting chin
3. Cleanse skin around umbilical cord stump
4. wash legs/feet
5. clean diaper area
Swelling in the face of a pregnant woman is indicative of what? Is it emergent?
- Swelling of the face, scaral area, and hands indicate gestational HTN or preeclampsia.
Reduction in renal perfusion leads to water and sodium retention. Fluid moves out of the
intravascular compartment into the tissues, causing edema. This patient should be
addressed immediately.
Acrocyanosis
- blueish discoloration of the hands and feet and is an expected finding in a newborn 12
hr after birth.
Transient strabimus
- Normal variation in the newborn's eyes that can persist until 4 months of age
Jaundice
- Occurring within the first 24hr of birth is associated with ABO incompatibility,
hemolysis, or Rh-isoimmunization and should be reported to the provider immediately.
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ATI Maternity final

What is an amniocentesis used for?

  • To determine lung maturity, detect congenital anomalies, and diagnose fetal hemolytic disease What is a cordocentisis used for?
  • To identify fetal blood type and RBC when there is a risk of isoimmune hemolytic anemia What is the Kleihauer-Betke test used for?
  • To determine the amount of fetal blood In the maternal circulation when there is a risk of Rh isoimmunization Abdominal cramping at 11 weeks indicates what?
  • It can indicate ectopic pregnancy or manifestations of spontaneous abortion. This would be a priority action. Blood nose (epistaxis) at 8 weeks gestation..
  • Is a normal sign 5 steps in bathing a newborn
    1. Wipe eyes from inner canthus outwards
  1. Wash neck by lifting chin
  2. Cleanse skin around umbilical cord stump
  3. wash legs/feet
  4. clean diaper area Swelling in the face of a pregnant woman is indicative of what? Is it emergent?
  • Swelling of the face, scaral area, and hands indicate gestational HTN or preeclampsia. Reduction in renal perfusion leads to water and sodium retention. Fluid moves out of the intravascular compartment into the tissues, causing edema. This patient should be addressed immediately. Acrocyanosis
  • blueish discoloration of the hands and feet and is an expected finding in a newborn 12 hr after birth. Transient strabimus
  • Normal variation in the newborn's eyes that can persist until 4 months of age Jaundice
  • Occurring within the first 24hr of birth is associated with ABO incompatibility, hemolysis, or Rh-isoimmunization and should be reported to the provider immediately.

Caput succedaneum

  • benign, edematous area of the scalp and is commonly found on the occiput Diaphragm teaching
    • Replace every 2years
  • Keep the diaphragm in place for at least 6hr after intercourse to provide protection against pregnancy.
  • Avoid using oil-based lubricant because they can weaken the rubber
  • The client should have an empty bladder prior to inserting the diaphragm. How much should a pregnant patient increase her protein intake daily during the second and third trimesters?
  • Increase to 71g. How many liters of water should a pregnant client consume each day?
  • 3L A client who is pregnant should increase her caloric intake by how much during the second trimester? Third trimester?
  • Second: 340cal, third: 452cal How much should a pregnant client increase her folic acid intake?
  • 600mcg daily. Naegele's rule
  • Subtract 3 months from the first day the clients last menstrual period, dd 7 days. Ex: Last cycle started Nov 27th. Minus 3 months equals August 27th, plus 7 days equals Sept 3rd. Phototherapy
  • Used for hyperbilirubinemia. Do not apply lotion or creams, they can absorb heat and lead to burns. Do not discontinue therapy if a baby develops a rash because this is normal during therapy. DO remove all clothing except diaper while under phototherapy. What is epigastric pain a clinical manifestation of?
  • Preeclampsia and indicates hepatic involvement, which is an urgent finding. Terbutaline
  • Helps slow and control contractions in preterm labor. Admininistered Sc Q4hr, for no longer than 24 hours. Adverse effect is hyperglycemia, hypokalemia, and hypotension. Parvovirus B19 (fifth disease)
  • The nurse should massage the fundus because the greatest risk is hemorrhage. A baby at 26 weeks gestation..
  • Should have decreased muscular tone, minimal arm recoil. Nonstress test
  • A client does not need to be NPO for a NST. The client should be placed in semi- fowlers position or sitting and tilted to the right or left to promote uterine perfusion and prevent supine hypotension. Instruct the client to press the button provided each time fetal movement is detected-it may not be evident on the monitor and tracing. Newborn HR
  • 110 - 160 Newborn temp
  • 97.7-100.0F newborn RR
  • 30 - 60 Newborn length
  • 45 - 55cm (17.7-21.7) newborn weight
  • 2.5-4kg (5.5-8.8lb) Postpartum gestational diabetes
  • Blood glucose returns to expected reference range after childbirth. The client needs to get a 2hr oral glucose tolerance test 6-13wks postpartum and every 3years for type 2 DM. Expected manifestation of fetal expose to SSRIs include...
  • irritability, agitation, tremors, diarrhea, and vomiting. What type of deceleration would a prolapsed umbilical cord cause?
  • Variable Placenta previa would cause what kind of decelerations?
  • Late Fetal head compression would cause what type of decelerations?
  • Early Maternal hypotension can cause what type of decelerations?
  • late

What is a true sign of labor?

  • Bloody show, blood-tinged discharge from the vagina that occurs when the cervix begins to efface and dilate. RR up to 30 mins after birth
  • 20 - 100 Leuokrrhea
  • Normal finding during all stages of pregnancy. It is white discharge that is a result of hormone secretion during pregnancy. Supine HTN is normal when?
  • 2nd/3rd trimesters Periodic numbness of the fingers..
  • is a normal finding in pregnancy during the 2nd/3rd trimesters. Indications of preeclampsia
  • Decrease urine output, increase BP, proteinuria, decrease fetal activity Recommended weight gain for woman who has a BMI within the expected reference range ..
  • 25 - 35lbs Recommended weight gain for woman with BMI larger than expected reference range?
  • 15 - 20lb Iron intake during pregnancy
  • 27mg/day Early decels
  • Normal, benign, cause no need for intervention. Caused by vaginal exams, contractions, etc. Carboprost..
  • is given for a PPH. It is a vasoconstrictor and can cause HTN. Active phase of labor
  • Characterized by cervical dilation of 4-7cm and contractions every 3-5min, each lasting 40-70s. Transition phase
  • Cervical dilation of 8-10cm and contractions every 2-3 mins, each lasting 45-90s. Latent phase of labor
  • Cervical dilation of 0-3cm and contractions every 5-30min, each lasting 30-45s.

What increases a clients risk of preeclampsia?

  • BMI over 30, multifetal gestation, maternal age younger than 19, over than 40, DM, HTN, renal disease, lupus, RA. Contractions that occur during true labor have what characteristics?
  • Stronger and more regular w change in activity, such as walking, felt in the lower back and abd pain, discomfort continues regardless of comfort measures. Discomfort during false labor is felt where?
  • Above umbilicus What are the steps, in order, performing Leopold maneuvers?
  • Palpate the client's fundus to identify the fetal part, determine the location of the fetal back, palpate for the fetal part presenting at the inlet, palpate the cephalic prominence to identify the altitude of the head. S/S of hypoglycemia in newborn
  • hypotonia, poor feeding behaviors, hypothermia, respiratory distress, abnormal cry, jitteriness, lethargy, apnea, seizures. Normal newborn assessment
  • Creases over 2/3 of the soles of the feet (fewer creases indicates prematurity, creases over entire soles is postmaturity), molding of the head, lanugo. Plan of care for pt with preeclampsia
  • BP Q15-30min, restrict total hourly intake to no more than 125mL/hr because may have altered kidneys., monitor FHR continuously. Priority action after amniocentesis?
  • Must monitor FHR. greatest risk is fetal death, give RhoD immune globulin, but it id not priority, Pt with back pain w contractions, what position do you put her in?
  • Hands and knees 1 - hr glucose tolerance test
  • BG of 130-140 is a positive test, fast 12hr prior to the test, do not limit carbs. In order to increase placental circulation, the nurse should recommend what position?
  • side-lying-this avoids compression on the vena cava, decreased circulation in the uterus can lead to having a child who is small for GA. contraception
  • strategies or devices used to reduce the risk of fertilization or implantation in the attempt to prevent pregnancy. The human ovum can be fertilized no later than 12- 24 hours after ovulataion. Methods of contraception include..
  • Natural family planning, barrier, hormonal, and intrauterine methods; and surgical procedures Coitus interrptus
  • withdrawal of the penis Calendar method
  • Record menstrual cycle by calculating her fertile period based on the assumption that ovulation occurs about 14 days before the onset of her next menstrual cycle. Sperm are viable for 48-120hr and ovum is viable for 24hr. Record number of days in each cycle from the first day of menses. Start fertile period (days 8-19) by subtracting 18 days from the number of days in the shortest cycle. The end of the fertile period is established by subtracting 11 days from the number of days of the longest cycle. Basal body temperature
  • body temp can drop slightly at ovulation. Monitor oral temp before getting out of bed each morning. Spinnbarkeit sign
  • cervical mucus can stretch between fingers female condom
  • vaginal sheath made of nitrile, a nonlatex synthetic rubber with flexible rings on both ends. Diaphragm and spermicide
  • Dome-shaped cup with flexible rim made of silicone that fits snugly over cervix with spermicidal cream or get placed into the dome and around the rim. REPLACED EVERY 2 HOURS AND REFITTED FOR A 20 PERCENT WEIGHT FLUCTUATION, abd or pelvic surgery, and after pregnancy. Insert 6hr before sex, must stay in place 6 hr after, no more than 24hr. Side effects/risk of combined oral contraceptives
  • Chest pain, SOB, leg pain from clot, headache, eye problems from stroke, HTN. INCREASES the risk of thromboembolism, stroke, MI, HTN, gallbladder disease, liver tumor. Common adverse effects of progesterin
  • increase appetite, tiredness, depression, tender breasts, oily skin/scalp, hirsutism. Progestin-only pills (minipill)

Presumptive pregnancy signs

  • Make a woman think she might be pregnant. These may be subjective/objective signs. These consist of amenorrhea, fatgiue, N/V, Breast changes (dark areolae, enlarge montgomery glands), quickening (slight fluttering movements of fetus felt by a woman between 16-20wks), uterine enlargement. Probably signs of pregnancy
  • Make the examiner suspect a woman is pregnant (primarily related to physical changes of the uterus). Can be causes by physiological factors other than pregnancy. Consist of abd enlargement, hegar's sign(softening and compressibility of lower uterus), chadwick's sign (deepened violet-blush color of the cervix and vaginal mucosa), ballottement (rebound of engaged fetus), braxton hicks (false contractions), + pregnancy test, fetal outline felt by examiner Positive signs of pregnancy
  • fetal hard signs, visualization of fetus by ultrasound, fetal movement (palpated by experienced examiner) Higher level of hCG indicates what?
  • multifetal, ectopic, hydatidiform mole, genetic abnormality. What types of meds can cause false pregnancy tests?
  • Anticonvulsants, diuretics, tranquilizers nagele's rule
  • first day of womans last menstrual cycle, subtract 3 months, add 7 days and a year. gravity
  • number of pregnancies null: never primi: first multi: two or more parity
  • pregnancies in which fetus reach 20weeks of pregnancy viability
  • infants born between 22-25 are consider threshold of viability term births
  • 38 weeks + preterm births
  • viability to 37 weeks cardiovascular changes
  • cardiac output increases 30-50 and blood volume increases 30-45. HR increased during pregnancy about 10-15/min. Respiratory changes
  • RR increase, TLC decrease Endocrine changes
  • placenta becomes endocrine organ, produces hCG, progesterone, estrogen, human placental lactogen, prostaglandins. BP changes
  • Diastolic B decreases around 24-32 weeks gestation. In supine postion, BP lower due to the pressure on the vena cava, which decreased BF to heart. S/S of this include dizziness, light headedness, and pale clammy skin. Encourage Left lateral side, semi- fowlers. how much does the diaphragm increase?
  • 4cm What do goodell's, balottement, and chadwick's sign all have in common?
  • They are all presumptive signs of pregnancy When do a majority of birth defects occur?
  • between 2-8weeks gestation venereal disease research lab (VDRL)
  • syphilis screening mandated by law Maternal serum alpha-fetoprotein (MSAFP)
  • 15 - 22weeks gestation. rule out down syndrome and neural tube defects Fetal movement/kick counts
  • count 2-3 times a day for 2hr after meals or bedtime. Fetal movements less than 3 per hour or cease entirely for 12hr indicate further eval. Foods high in folic acid include..
  • leafy veggies, dried peas and beans, seeds, orange juice. Breads, cereals, and other grains are fortified with folic acid. Food sources of iron..
  • beef liver, red meats, fish, poultry, dried peas an beans, fortified cereals and breads. sources of calcium..
  • milk, soy milk, fortified OJ, nuts, legumes, dark green leafy veggies how much fluids should a pregnant woman drink

lower estrial could mean what?

  • down syndrome L/S ratio tests examine what?
  • fetal lung maturity T/F Vaginal bleeding during pregnancy is ALWAYS abnormal?
  • TRUE D&C
  • Dilate and scrape uterine walls to remove uterine contents for inevitable and incomplete abortions. D&E
  • Dilate and evacuate uterine contents after 16weeks gestation gestational trophoblastic disease
  • uterine size increasing abnormally fast, abnormally high levels of hcg, increased emesis, no fetus present, dark brown or red vag bleeding. placenta previa
  • painless vaginal bleeding, placenta abnormally implants in the lower segment of the uterus near or over the cervical os instead of attaching to the fundus. Incomplete- partially covered, marginal/low-lying: attached in lower uterine segment, but does not reach cervical os. At risk if scarring, old, multifetal, smoking, previous hx. Fundal height is normally greater than expected, decrease UO abruptio placentae
  • sharp abd pain, tender rigid uterus. Premature separation of placenta from uterus after 20 weeks. Leading cause of maternal death. DIC is often associated. RF include HTN, trauma, cocaine use, smoking, multifetal pregnancy. vasa previa
  • fetal umbilical vessels are implanted into fetal membranes rather than the placenta. Velamentous: branch at membranes and then course to placenta. Succenturiate: divided into two ore more lobes and not one mass. Battledore insertion of cord: marginal insertion, increased risk of FH. preterm labor causes what type of bleeding?
  • pink-stained vaginal dx what is the second most frequent cause of bleeding in early pregnancy and leading cause of infertility?
  • ectopic pregnancy- s/s could be referred shoulder pain. Progesterone and hcg are used to rule out.

complete mole

  • all genetic material is paternally developed. Hemorrhage into uterine cavity occurs and vaginal bleeding results. 20% of complete moles progress to choriocarcinoma. partial mole
  • genetic material from mom and dad. Contains abnormal embryonic or fetal parts, amniotic sac, and fetal blood, but congenital anomalies are present. 6% precent to choriocarcinoma Serum hCg analysis after molar pregnancy needs to be done when?
  • weekly for 3 weeks, monthly for 6 months up to 1 year to detect GTD. hydatiform mole
  • exhibits increased fundal height, excessive N/V, scant and dark discharge.