ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?
Correct Answer: D
Rationale: The correct answer is D: Postpartum hemorrhage. The client being 80% effaced and 8 cm dilated indicates she is in active labor, not experiencing an ectopic pregnancy, hyperemesis gravidarum, or incompetent cervix. Postpartum hemorrhage is a potential risk due to the advanced stage of labor, increasing the likelihood of excessive bleeding post-delivery. It is crucial for the nurse to monitor the client closely for signs of hemorrhage and be prepared to intervene promptly to prevent complications.
Question 2 of 5
A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Assist the client in pulling their knees toward their abdomen. In shoulder dystocia, the McRoberts maneuver involves hyperflexing the mother's legs against her abdomen. This action helps to widen the pelvic outlet and reduce the angle of the pubic symphysis, facilitating the delivery of the infant's shoulder. Pressing on the fundus (
A) does not address the shoulder dystocia issue. Pressing on the suprapubic area (
B) may not provide the necessary assistance in this situation. Moving the client onto their hands and knees (
C) does not facilitate the specific maneuver required.
Therefore, assisting the client in pulling their knees toward their abdomen (
D) is the correct action in this scenario.
Question 3 of 5
A nurse is assessing a client who is 1 hr postpartum following a vaginal birth. The nurse notes that the client has excessive vaginal bleeding. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct action for the nurse to take first is to massage the client's fundus. This is because excessive vaginal bleeding postpartum could indicate uterine atony, which is a common cause of postpartum hemorrhage. By massaging the fundus, the nurse can help stimulate uterine contractions and reduce bleeding. Administering oxytocin (choice
B) may be necessary but massaging the fundus should be done first. Emptying the client's bladder (choice
C) can also help, but addressing uterine atony is the priority. Providing oxygen (choice
D) is not the immediate action needed for excessive vaginal bleeding.
Question 4 of 5
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
Correct Answer: B
Rationale: The correct answer is B: Cover the umbilical cord with a sterile saline-saturated towel. This action is important to prevent compression of the umbilical cord, which can lead to decreased blood flow to the fetus resulting in fetal distress or demise. By covering the protruding cord with a sterile saline-saturated towel, the nurse can protect the cord and maintain adequate blood flow until further interventions can be performed by the healthcare team. Performing a vaginal examination by applying upward pressure on the presenting part (choice
A) can further compress the cord and worsen the situation. Administering oxygen via nonrebreather mask (choice
C) and initiating an infusion of IV fluids (choice
D) are important interventions but should be done after addressing the umbilical cord protrusion to ensure adequate oxygenation and perfusion to the fetus.
Question 5 of 5
A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Excessive crying. Neonatal abstinence syndrome is characterized by withdrawal symptoms in newborns exposed to addictive substances in utero. Excessive crying is a common manifestation due to neurological irritability. Diminished deep tendon reflexes (
A) would not be expected as the central nervous system is hyperactive. Decreased muscle tone (
C) is unlikely as muscle rigidity or tremors are more common. Absent Moro reflex (
D) is not typically seen as it is a primitive reflex present in newborns.