ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?
Correct Answer: C
Rationale:
Correct
Answer: C (Hypotension)
Rationale: Opioid analgesics can cause vasodilation leading to hypotension. The epidural route can potentiate this effect due to direct spinal cord vasodilation. Monitoring for hypotension is crucial to prevent adverse outcomes such as decreased perfusion.
Incorrect
Choices:
A: Hyperglycemia - Opioid analgesics typically do not cause hyperglycemia.
B: Bilateral crackles - Crackles are indicative of fluid accumulation in the lungs, not a typical adverse effect of opioid analgesics.
D: Polyuria - Opioid analgesics do not commonly cause increased urine output.
Question 2 of 5
A nurse is providing teaching to a client who is at 35 weeks of gestation and has a prescription for an amniocentesis. Which of the following client statements indicates an understanding of the teaching?
Correct Answer: A
Rationale:
Correct
Answer: A. "I should empty my bladder before the procedure."
Rationale: Emptying the bladder before amniocentesis helps avoid accidental puncture during the procedure. A full bladder can be in the needle's path, increasing the risk of injury. This statement demonstrates the client's understanding of the importance of bladder emptying.
Incorrect
Choices:
B: "I will be lying on my side during the procedure." - Incorrect. The client will typically be lying flat on their back during amniocentesis.
C: "I will be asleep during the procedure." - Incorrect. Amniocentesis is usually done with local anesthesia, so the client will be awake.
D: "I should start fasting 24 hours before the procedure." - Incorrect. Fasting is not required for amniocentesis. It is a simple procedure that does not involve general anesthesia or fasting.
Question 3 of 5
A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Initiate seizure precautions. Neonatal abstinence syndrome can lead to seizures due to drug withdrawal. Seizure precautions involve ensuring a safe environment, padded crib, monitoring vital signs closely, and having emergency medications and equipment readily available. Monitoring blood glucose every hour (
A) is not typically necessary for neonatal abstinence syndrome. Placing the infant on their back with legs extended (
B) is a basic positioning technique and not specific to addressing the syndrome. Providing a stimulating environment (
D) would be inappropriate and could exacerbate symptoms.
Question 4 of 5
A nurse is administering a hepatitis B vaccine to a newborn. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Administer the injection into the vastus lateralis muscle. For newborns, the vastus lateralis muscle is the preferred site for intramuscular injections due to its size and well-developed muscle mass, ensuring proper absorption and minimizing the risk of injury to surrounding structures. Administering the vaccine into this muscle also helps improve vaccine efficacy.
Choices B, C, and D are incorrect.
Choice B, vigorously massaging the site, can cause discomfort, bruising, and potential tissue damage.
Choice C, inserting the needle at a 45° angle, is not recommended for intramuscular injections as the needle should be inserted at a 90° angle to ensure proper delivery into the muscle.
Choice D, using a 21-gauge needle, is not specific for newborns and can be too large for their small muscle mass, causing unnecessary pain and potential tissue damage.
Question 5 of 5
A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Administer 500 mL lactated Ringer’s IV bolus. This action is necessary to address the persistent vaginal bleeding after cesarean birth, as it could be a sign of postpartum hemorrhage. Administering IV fluids helps to improve circulating volume and maintain adequate perfusion to vital organs. This can help stabilize the client's condition while further assessments and interventions are carried out.
Choice A: Replacing the surgical dressing does not address the underlying cause of the bleeding and is not a priority at this time.
Choice B: Evaluating urinary output is important but not the immediate action needed to address the vaginal bleeding.
Choice C: Applying an ice pack to the incision site is not appropriate for controlling postpartum bleeding.
In summary, administering IV fluids is the priority to address potential postpartum hemorrhage, while the other options do not directly address the urgent issue at hand.