Week 2 ATI Teacher Review Ch. 9 -12

Question 1

A nurse is assisting with the care of a client who has severe preeclampsia and is receiving magnesium sulfate IV. Which of the following findings should the nurse identify and report as magnesium toxicity? (Select all that apply)

A) Respirations less than 12/min
B) Urinary output less than 25ml/hr
C) Hyperreflexive deep-tenon reflexes
D) Decreased level of consciousness
E) Flushing and sweating

Answer 1

A) Respirations less than 12/min
B) Urinary output less than 25ml/hr
D) Decreased level of consciousness

Question 2

A nurse is caring for a client who is at 40 weeks of gestation and reports having a large gush of fluid from the vagina while
walking from the bathroom. Which of the following actions should the nurse take first?

A. Examine the amniotic fluid for
meconium
B. Check the fetal heart rate
(FHR)
C. Dry the client and make them
comfortable
D. Apply a tocotransducer to
monitor uterine contractions

Answer 2

B. Check the fetal heart rate
(FHR)

Question 3

A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions every 3 to 5 minutes and becoming stronger. A vaginal exam reveals that the client’s cervix is 3cm dilated, 80% effaced, and -1 station. The client asks for pain medication. Which of the following actions should the nurse take?
(Select all that apply)

A. Encourage use of patterned breathing techniques
B. Insert an indwelling catheter
C. Administer opioid analgesic medication
D. Suggest application of cold
E. Provide ice chips

Answer 3

A. Encourage use of patterned breathing techniques.
C. Administer opioid analgesic medication.
D. Suggest application of cold.