ATI RN
ATI Maternal Newborn Proctored Exam Latest Update Questions
Extract:
Question 1 of 5
What is the main cause of mastitis in the postpartum client?
Correct Answer: A
Rationale: The correct answer is A: Poor breastfeeding technique. Mastitis in postpartum clients is commonly caused by milk stasis due to inadequate milk removal, which can result from poor breastfeeding technique such as improper latch or infrequent feedings. This leads to inflammation and infection. Inadequate hand washing (
B) is important for preventing infection but not the main cause of mastitis. Systemic maternal infection (
C) may contribute but is not the primary cause. Prolonged nursing (
D) can actually help prevent mastitis by promoting milk flow.
Question 2 of 5
A postterm infant is delivered by cesarean section because of fetal distress and meconium-stained amniotic fluid. The nursery nurse frequently monitors the baby's respiratory rate, observing for tachypnea. Which is the reason for the nurse's actions? The infant may:
Correct Answer: B
Rationale: The correct answer is B: develop meconium aspiration pneumonia. Meconium-stained amniotic fluid can lead to the infant inhaling meconium, which can cause blockage and inflammation in the airways, leading to meconium aspiration pneumonia. This can result in respiratory distress, tachypnea, and potential complications like respiratory failure. The nurse monitors the respiratory rate to detect any signs of respiratory distress early on.
Incorrect choices:
A: Respiratory depression from medications used during delivery is less likely to be the cause of tachypnea in this scenario.
C: Elevated temperature is not directly related to meconium aspiration pneumonia or respiratory distress in this case.
D: A pneumothorax related to delivery is possible but less likely than meconium aspiration pneumonia as the cause of tachypnea in this case.
Question 3 of 5
The nurse notices a variable deceleration on a fetal monitor strip. Which nursing action is appropriate?
Correct Answer: C
Rationale: The correct answer is C: Turn the woman onto her left side to relieve pressure on the umbilical cord. Variable decelerations are associated with umbilical cord compression. Turning the woman onto her left side can help relieve pressure on the cord, improving fetal oxygenation. This position change is a non-invasive, quick intervention that can potentially resolve the variable decelerations.
Choice A is incorrect because variable decelerations are not typically associated with hyperventilation.
Choice B is incorrect as decreasing Pitocin may not directly address the underlying cause of the variable decelerations.
Choice D is incorrect because reducing fluids may not address the immediate concern of umbilical cord compression.
Question 4 of 5
The nursery nurse delays the first bottle feeding of a newborn. Which is the most common reason for the nurse's actions? The infant has:
Correct Answer: B
Rationale: The correct answer is B: a respiratory rate above 60. The nurse delays feeding because a high respiratory rate may indicate respiratory distress, making feeding unsafe. Feeding can lead to aspiration in infants with respiratory issues. A blood glucose of 45 gm/dL (choice
A) is low but not typically a reason to delay feeding. Blue hands and feet (choice
C) may indicate poor circulation, but it's not a common reason to delay feeding. A heart murmur (choice
D) doesn't directly impact feeding safety.
Question 5 of 5
During active labor, after a sudden slowing of the fetal heart rate, the nurse assesses the woman's perineum and observes a prolapsed cord. Which nursing action is most appropriate?
Correct Answer: A
Rationale: The correct answer is A: Hold the presenting part away from the cord. This action helps relieve pressure on the cord, preventing further compromise of blood flow to the fetus. It is crucial to maintain fetal perfusion.
Choice B (Insert a scalp electrode) and D (Cover the cord with gauze) are not appropriate as they do not address the immediate risk of cord compression.
Choice C (Reverse Trendelenburg) may worsen the prolapse by shifting the presenting part higher.