ATI RN
ATI RN Maternal Newborn level 3 Final Exam 2023 (All Correct Answers). Maternal-Child Nursing Questions
Extract:
Question 1 of 5
A nurse is planning care immediately following birth for a newborn who has myelomeningocele that is leaking cerebrospinal fluid.
Correct Answer: A
Rationale: The correct answer is A. Administering broad-spectrum antibiotics is crucial to prevent infection since the exposed spinal cord increases the risk. Antibiotics help reduce the risk of meningitis and sepsis.
Choice B is incorrect as povidone-iodine can be irritating to the sensitive skin around the defect.
Choice C is incorrect as monitoring rectal temperature is not directly related to the immediate care needed for a myelomeningocele.
Choice D is incorrect because surgical closure should be done as soon as possible to prevent further complications.
Question 2 of 5
A nurse is caring for a newborn boy, 6 hours old, whose bedside glucose meter reading is 65 mg/dL. The newborn's mother has Type 2 diabetes mellitus.
Correct Answer: D
Rationale: The correct answer is D: Feed the newborn immediately. By feeding the newborn, the nurse can stimulate the release of insulin, which will help regulate the baby's blood sugar levels. This is important especially in the case of a newborn born to a mother with Type 2 diabetes mellitus, as the baby may be at risk for hypoglycemia. Administering IV dextrose solution (choice
A) is not necessary at this point as feeding is the initial intervention. Obtaining a blood sample for serum glucose level (choice
B) can be done later but immediate feeding takes precedence. Reassessing blood glucose prior to the next feeding (choice
C) may delay necessary intervention.
Question 3 of 5
A nurse is caring for four antepartum clients. Which of the following clients should the nurse assess first?
Correct Answer: B
Rationale: The correct answer is B. The nurse should assess the client who is at 32 weeks of gestation and reports seeing floating spots first. Seeing floating spots could be a sign of preeclampsia, a serious pregnancy complication characterized by high blood pressure and organ damage. Preeclampsia can lead to severe complications for both the mother and the baby if not managed promptly.
Therefore, this client needs immediate assessment to rule out preeclampsia and ensure appropriate interventions are initiated.
Choices A, C, and D do not present with urgent signs or symptoms that require immediate attention compared to the potential severity of preeclampsia in choice B.
Question 4 of 5
A nurse is planning care for a client who is pregnant and has HIV.
Correct Answer: B
Rationale: The correct answer is B: Bathe the newborn before initiating skin-to-skin contact. This is because bathing the newborn before skin-to-skin contact helps reduce the risk of HIV transmission from mother to baby. HIV can be present in maternal blood and other fluids, and washing the newborn can decrease the viral load on the baby's skin. Initiating skin-to-skin contact without bathing first may increase the risk of transmission.
Choice A is incorrect because using a fetal scalp electrode during labor and delivery is unrelated to preventing HIV transmission from mother to baby.
Choice C is incorrect as stopping antiretroviral medication can be harmful to both the mother and the baby's health.
Choice D is incorrect as pneumococcal immunization is not recommended within 4 hours following birth and is not directly related to HIV transmission prevention.
Question 5 of 5
A nurse is caring for a client who has placenta previa. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Painless vaginal bleeding. In placenta previa, the placenta partially or completely covers the cervix, leading to painless vaginal bleeding. This occurs due to separation of the placenta from the uterine wall. A firm rigid abdomen (
A) is more indicative of abruptio placentae. Uterine hypertonicity (
C) is seen in conditions like uterine rupture, not placenta previa. Persistent headache (
D) is not typically associated with placenta previa.