ATI-MN ATI Maternal Newborn Exam - Set 2 - Part 2

Correct Answer: It reinforces the cervix to maintain pregnancy

A cerclage places a supportive stitch to reinforce a weak cervix, helping keep it closed so the pregnancy can continue toward term. Option a is incorrect because the goal is to keep the cervix closed, not to speed dilation, which would risk pregnancy loss. Option b is incorrect because a cerclage is a structural support, not a test for infection. Option c is incorrect because the procedure aims to maintain the pregnancy rather than to bring on early labor.

Correct Answer: It guides antibiotics to protect the newborn

Screening identifies carriers so the client can receive antibiotics during labor, which protects the newborn from a serious group B streptococcus infection at birth. Option b is incorrect because lung maturity is assessed through amniotic fluid studies rather than this culture. Option c is incorrect because birth weight is estimated by ultrasound, not by a vaginal and rectal culture. Option d is incorrect because glucose is checked through separate testing, not the group B streptococcus culture.

Correct Answer: Intravenous antibiotics during labor

A client positive for group B streptococcus receives intravenous antibiotics during labor to lower the risk of passing the infection to the newborn during birth. Option a is incorrect because labor progresses normally; the key intervention is antibiotic coverage rather than delaying pushing. Option b is incorrect because a positive group B streptococcus result calls for antibiotics, not an automatic cesarean birth. Option d is incorrect because fluids are still provided in labor, and withholding them would not address the infection risk.

Correct Answer: Avoid breastfeeding the newborn

HIV can pass to the newborn through breast milk, so the client is taught to avoid breastfeeding and use formula to lower the risk of transmission. Option a is incorrect because the newborn receives prescribed antiviral medication after birth, which should not be skipped. Option c is incorrect because breastfeeding can transmit HIV, so it is avoided rather than encouraged for these newborns. Option d is incorrect because the concern is breast milk transmission, and the priority teaching is to avoid breastfeeding, not utensil sharing.

Correct Answer: Avoid changing the cat litter box

Toxoplasmosis can spread through cat feces, so the client avoids changing the litter box during pregnancy to reduce the risk of infecting the fetus. Option b is incorrect because undercooked meat can carry the organism, so meat should be cooked thoroughly rather than left rare. Option c is incorrect because frequent handling of raw meat increases exposure, which is the opposite of safe practice. Option d is incorrect because washing produce removes possible contamination, so skipping it would raise the risk.

Correct Answer: Give the vaccine after birth

The rubella vaccine is a live virus and is not given during pregnancy, so a nonimmune client is vaccinated after birth to protect future pregnancies. Option a is incorrect because antiviral medication is not the plan for rubella nonimmunity; vaccination after birth is. Option b is incorrect because repeating the titer weekly serves no purpose when the plan is simply to vaccinate after delivery. Option c is incorrect because giving a live vaccine during pregnancy is avoided due to potential risk to the fetus.

Correct Answer: Cesarean birth

Active genital herpes lesions can infect the newborn during a vaginal birth, so a cesarean birth is planned to protect the newborn from exposure. Option b is incorrect because a water birth is still a vaginal birth and does not prevent exposure to the active lesions. Option c is incorrect because any vaginal birth, even with an episiotomy, risks transmitting the infection to the newborn. Option d is incorrect because a forceps-assisted vaginal birth still exposes the newborn to the lesions in the birth canal.

Correct Answer: Erythromycin eye ointment

Erythromycin eye ointment is applied after birth to prevent serious eye infection that could be passed from maternal gonorrhea or chlamydia during delivery. Option a is incorrect because the hepatitis B vaccine protects against a viral liver infection, not the eyes. Option c is incorrect because vitamin K prevents bleeding, not eye infection. Option d is incorrect because acetaminophen treats pain or fever and has no role in preventing newborn eye infection.

Correct Answer: Make sure your partner is treated

Sexual partners must also be treated to prevent reinfection, so the nurse teaches the client to ensure her partner receives treatment along with completing her own. Option a is incorrect because chlamydia is a reportable condition, so this statement is inaccurate. Option b is incorrect because the full prescription must be completed even after symptoms improve, or the infection can persist. Option d is incorrect because there is no need to avoid fluids; staying hydrated supports overall health during treatment.

Correct Answer: Penicillin G

Penicillin G is the treatment of choice for syphilis in pregnancy, and it is used even when the client reports an allergy after appropriate desensitization. Option a is incorrect because acyclovir is an antiviral for herpes and is not effective against the bacterium that causes syphilis. Option b is incorrect because fluconazole is an antifungal used for yeast infections, not syphilis. Option c is incorrect because metronidazole treats trichomoniasis and bacterial vaginosis, not syphilis.

Correct Answer: Candidiasis

A thick, white, cottage-cheese-like discharge with itching is typical of candidiasis, a yeast infection that occurs more often during pregnancy. Option a is incorrect because chlamydia often causes no symptoms, unlike the clear itching and thick discharge described here. Option c is incorrect because trichomoniasis produces a frothy yellow-green discharge, which differs from the cottage-cheese description. Option d is incorrect because bacterial vaginosis causes a thin gray discharge with a fishy odor rather than a thick white one.

Correct Answer: Preterm labor

Regular contractions with low back pain and pelvic pressure before term suggest preterm labor, which needs prompt evaluation to try to stop the contractions. Option b is incorrect because normal fetal movement does not cause regular contractions and rhythmic pelvic pressure. Option c is incorrect because round ligament pain is brief and sharp with movement, not a pattern of regular contractions. Option d is incorrect because false labor produces irregular contractions that ease with rest, unlike the regular pattern described here.

Correct Answer: It speeds the baby's lung development

Betamethasone is a glucocorticoid that speeds fetal lung development and surfactant production, which helps the newborn breathe if an early birth occurs. Option a is incorrect because the medication targets fetal lung maturity, not the client's blood pressure. Option b is incorrect because betamethasone is a steroid for lung maturity, not an antibiotic for infection. Option d is incorrect because betamethasone does not stop contractions; separate tocolytic medications are used for that purpose.

Correct Answer: Heart rate of 132 per minute

Terbutaline can cause a rapid maternal heart rate, so a rate above the expected range should be reported, since it may require holding the medication. Option a is incorrect because this blood pressure is within normal limits and is not a concern. Option b is incorrect because mild dry mouth is a minor side effect that does not require provider notification. Option c is incorrect because fetal movement is a reassuring sign rather than an adverse effect of the medication.

Correct Answer: Assess the fetal heart rate

After membranes rupture, the nurse first checks the fetal heart rate to rule out a prolapsed cord, which can compress and cut off the fetal blood supply. Option a is incorrect because repeated vaginal examinations after rupture raise the risk of infection and are limited. Option b is incorrect because walking is not the priority and could worsen a cord problem before the fetus is assessed. Option d is incorrect because a tub bath after rupture increases infection risk and delays the needed fetal assessment.

Correct Answer: Nitrazine paper turns blue

Amniotic fluid is alkaline, so it turns nitrazine paper blue, which helps confirm that the membranes have ruptured rather than the leakage being urine. Option a is incorrect because cloudy, foul fluid suggests infection rather than confirming the fluid is amniotic. Option b is incorrect because paper that stays yellow suggests acidic urine, not amniotic fluid. Option c is incorrect because burning points to a urinary or vaginal problem and does not identify amniotic fluid.

Correct Answer: Maternal fever and fetal tachycardia

Maternal fever with a rising fetal heart rate suggests chorioamnionitis, an infection of the membranes, so the nurse reports these findings for prompt treatment. Option b is incorrect because fetal hiccups are a normal, harmless finding rather than a warning of infection. Option c is incorrect because clear, odorless fluid is expected after rupture and does not by itself indicate infection. Option d is incorrect because this blood pressure is within normal limits and is not a sign of infection.

Correct Answer: Do not place anything in the vagina

The client is taught to keep anything out of the vagina, including tampons and intercourse, to lower the risk of introducing infection after membranes rupture. Option a is incorrect because adequate fluids are encouraged, and restricting them offers no benefit and may cause dehydration. Option c is incorrect because tub baths increase the risk of infection once the membranes have ruptured. Option d is incorrect because intercourse can introduce bacteria and is avoided after rupture.

Correct Answer: Respiratory rate of 10 per minute

A respiratory rate that falls too low signals magnesium toxicity from nervous system depression, so the nurse stops the infusion and notifies the provider. Option a is incorrect because this fetal heart rate is within the normal range and is reassuring. Option b is incorrect because a warm sensation during the loading dose is an expected effect and not a reason to stop the infusion. Option d is incorrect because this blood pressure is within normal limits and does not indicate toxicity.

Correct Answer: Allow the client to express grief

Allowing the client to express grief acknowledges the loss and supports healthy coping, which is more therapeutic than minimizing or avoiding her feelings. Option a is incorrect because avoiding the topic can leave the client feeling unsupported and isolated. Option b is incorrect because urging her to try again soon dismisses her current grief and rushes her past the loss. Option c is incorrect because saying it was for the best minimizes her loss and discounts her feelings.