ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
“A nurse on an antepartum unit is caring for a client.
Exhibit1:
Nurses' Notes 0900:Client reports a small amount of bright red blood in their underwear upon
awakening. Client denies contractions or abdominal pain. External fetal monitor applied.
0930:Client passed large amount of bright red blood from vagina.
Denies pain Uterine tone soft and nontender to palpation.
contraction pattern, no contractions noted.
Fetal heart rate pattern: Fetal heart rate baseline 135/min.
Moderate variability. No decelerations noted.
Exhibit2:
Vital Signs 0900: Temperature 36.2°C (97.2° F) Pulse rate 78/min Respiratory rate 20/min Blood pressure
112/64 mm Hg Fetal heart rate 132/min Pulse rate 82/min Blood pressure 116/60 mm Hg Fetal heart
rate 160/min
Exhibit3:
Medical History. G4P3 30 weeks gestation Previous pregnancies delivered via cesarean section
Question 1 of 5
Which of the following nursing actions should the nurse plan to take? For each potential nursing action, click to specify it the intervention is indicated or contraindicated for the client.
| Potential Nursing Action | Indicated | Contraindicated | |
|---|---|---|---|
| Insert a large bore intravenous catheter. | |||
| Assess cervical dilation. | |||
| Weigh perineal pads. | |||
| Administer methotrexate. |
Correct Answer: A, C
Rationale: [1, 0, 1], [0, 1, 0], [0, 0, 0], [0, 0, 1]
Inserting a large bore IV catheter is indicated for rapid fluid resuscitation. Weighing perineal pads helps monitor postpartum hemorrhage. Assessing cervical dilation and administering methotrexate are not appropriate in this scenario.
Extract:
“A nurse is caring tor a newborn.
Exhibit1:
Medical History. Apgar score 9 at 1 min and 9 at 5 min Birth weight 4,706 g (10 lb 6 oz)| Gestational age
40 weeks Difficult vaginal birth with shoulder dystocia.
EXHIBIT2:
Nurses: Notes 1700: Newborn is active and moves all extremities except for right arm. No spontaneous
movement of the right arm noted, Right arm remains at side during Moro reflex.
Exhibit3:
Physical examination 1830: Absent Moro reflex noted in right arm. Right shoulder and arm are internally
rotated and adducted. Elbow extended. Forearm pronated with wrist and fingers flexed. Diagnosis.
brachial prexus injury resulting in trot Duchenne (Erb's palsy) paralysis
Question 2 of 5
Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is Indicated or contraindicated for the newborn
| Potential Nursing Action | Indicated | Contraindicated | |
|---|---|---|---|
| Educate the parents to begin range of motion exercises on the affected arm after 1 week. | |||
| Assess for grasp reflex in the affected extremity. | |||
| Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt. | |||
| Instruct parents to limit physical handling for 2 weeks. |
Correct Answer: B
Rationale: [0, 1, 0, 0]
Assess for grasp reflex in the affected extremity is the correct answer. This action is indicated as it allows the nurse to evaluate neurological function and muscle strength in the affected arm without causing harm. Educating parents to begin range of motion exercises after 1 week (
A) is contraindicated as it may exacerbate injury or delay healing. Immobilizing the arm across the abdomen (
C) is also contraindicated as it can restrict movement and hinder recovery. Instructing parents to limit physical handling for 2 weeks (
D) is not the best option as it may not provide the necessary assessment and treatment for the newborn's condition.
Extract:
A nurse in a clinic a caring for a 16-year-old adolescent
Exhibit1:
Provider Prescriptions: Standing prescriptions for clients who present with abdominal. Obtain laboratory
tests, Urinalysis, Cervical culture C-reactive protein Beta Hcg
Question 3 of 5
Which of the following findings should the nurse report to the provider? Select all that apply
| Abdominal assessment. |
| Vaginal Discharge. |
| Heart rate. |
| Temperature. |
| Dyspareunia. |
| Condom usage. |
Correct Answer: B, E
Rationale:
The nurse should report vaginal discharge (
B) as it could indicate infection or other issues. Dyspareunia (E) should also be reported as it can indicate underlying problems. Abdominal assessment (
A) may be part of routine care but doesn't necessarily require immediate reporting. Heart rate (
C) and temperature (
D) are vital signs that should be monitored but don't specifically indicate a need for immediate reporting. Condom usage (F) is important for sexual health discussions but does not require reporting to the provider.
Extract:
A nurse in a clinic is caring for a 16-year-old adolescent.
Exhibit 1
History and Physical
Adolescent is sexually active with two current partners.
IUD in place
Reports not using condoms during sexual activity.
History of type 1 diabetes mellitus”
Question 4 of 5
Which of the following conditions should the nurse identify as being consistent with the adolescent's assessment findings? For each finding click to specify if the assessment findings are consistent with trichomoniasis, gonorrhea, or candidiasis. Each finding may support more than one disease process.
| Assessment Findings | Trichomoniasis | Gonorrhea | Candidiasis |
|---|---|---|---|
| Abdominal pain. | |||
| Greenish discharge. | |||
| Diabetes. | |||
| Pain on urination. | |||
| Absence of condom. |
Correct Answer: B, D
Rationale:
To determine the correct answer, we look at the assessment findings. For "Greenish discharge," this is consistent with both trichomoniasis and gonorrhea. Trichomoniasis typically presents with a frothy, yellow-green discharge, while gonorrhea can cause a greenish or yellow discharge. "Pain on urination" is also a common symptom of both gonorrhea and trichomoniasis.
Therefore, the correct answer is B, D. Abdominal pain is not specific to any of the mentioned conditions and is not a defining symptom. Diabetes is not directly related to the assessment findings provided. The absence of a condom is not a symptom but rather a risk factor for sexually transmitted infections.
Extract:
The nurse is reviewing laboratory results in the adolescent's medical record.
Exhibit 1
Vital Signs
1300: Blood pressure 118/72 mm Hg, Heart rate 100/min ,Respiratory rate 20/min ,Temperature 38.3° C
(101° F)
Exhibit 2:
Provider Prescriptions 1300: Standing prescriptions for clients who present with abdominal pain: Obtain
laboratory tests: Urinalysis Cervical culture C-reactive protein Beta hCG
Exhibit 3:
Nurses' Notes 1300: Admitted adolescent reporting "cramping in my stomach." Reports pain as a 4 on 0
to 10 pain scale and describes pain as constant and dull. Reports nausea and vomiting over past 24
hours. Reports painful urination and pain during sexual intercourse with minimal vaginal itching-
Tenderness with palpation to lower abdomen, guarding abdomen observed. Greenish vaginal discharge
observed. Reports last menstrual period was 3 weeks ago as normal period lasted 4 days. “
Question 5 of 5
Which of the following conditions is the client most likely developing?
| Pelvic inflammatory. |
| Ectopic pregnancy. |
| Pyclonephritis. |
| C-reactive protein. |
| Beta hCG. |
| Urinalysis. |
Correct Answer: A
Rationale: [1, 0, 0, 0, 0, 0]
The correct answer is A: Pelvic inflammatory. Pelvic inflammatory disease is an infection of the female reproductive organs, often caused by sexually transmitted infections. It presents with symptoms like pelvic pain, abnormal vaginal discharge, and fever. Ectopic pregnancy (
B) is the implantation of a fertilized egg outside the uterus and presents with abdominal pain and vaginal bleeding. Pyelonephritis (
C) is a kidney infection, typically causing fever and flank pain. C-reactive protein (
D) is a marker for inflammation and infection, not a specific condition. Beta hCG (E) is a hormone produced in pregnancy. Urinalysis (F) is a test to analyze urine composition, not a condition.