ATI RN
ATI Maternal NewBorn Proctored Exam 2023 with NGN All 70 Questions With Answers Questions
Extract:
A nurse is caring for a newborn who is 70 hr old. Exhibit 1
Medical History
Newborn delivered by repeat cesarean birth at 40 weeks of gestation.
Birth weight 3,515 g (7 lb 12 oz)
Apgar scores 8 at 1 min and 9 at 5 min
Maternal history of methadone use during pregnancy.
Exhibit 2
Vital Signs
0700:
Heart rate 156/min
Respiratory rate 58/min
Temperature 37.2° C (98.9° F)
Oxygen saturation 98% on room air
1100:
Heart rate 160/min
Respiratory rate 60/min
Temperature 37.3° C (99.2° F)
Oxygen saturation 96% on room air
Exhibit 3
Physical Examination
1100:
Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but
breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle
tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several
loose stools today.
Exhibit 4
Diagnostic Results
Maternal urine toxicology screen positive for opiates (negative)
Newborn urine toxicology screen positive for opiates (negative)
Question 1 of 5
Which of the following findings should the nurse report to the provider? Select all that apply.
Correct Answer: C,D
Rationale: The nurse should report central nervous system (CNS) and gastrointestinal (GI) findings to the provider as they can indicate potential serious issues. CNS findings like altered mental status or neurological deficits may signal neurological problems. GI findings such as abdominal pain or bleeding may indicate gastrointestinal issues that require immediate attention. Respiratory findings (choice
A) and oxygen saturation (choice
B) are important but may not always require immediate reporting unless they are significantly abnormal. The other choices are not directly related to urgent medical concerns. Reporting CNS and GI findings ensures prompt evaluation and appropriate intervention.
Extract:
Question 2 of 5
A nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura (ITP). Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Decreased platelet count. In idiopathic thrombocytopenia purpura (ITP), there is a decrease in platelet count due to immune-mediated destruction of platelets. This can lead to an increased risk of bleeding.
Explanation for other choices:
B: Increased erythrocyte sedimentation rate (ESR) is not typically associated with ITP.
C: Decreased megakaryocytes may be seen in some cases of ITP but is not a consistent finding.
D: Increased WBC is not a characteristic finding in ITP.
Therefore, the most relevant finding in a client with ITP would be a decreased platelet count due to the underlying pathophysiology of the condition.
Question 3 of 5
A nurse is caring for a client who is in labor and receiving oxytocin. Which of the following findings indicates that the nurse should increase the rate of infusion?
Correct Answer: A
Rationale: The correct answer is A because contractions every 5 minutes that last 30 seconds indicate increased frequency and duration, which may not be sufficient for effective labor progress. Increasing the rate of oxytocin can help strengthen contractions for more efficient labor.
Choices B, C, and D do not indicate the need to increase the rate of infusion. Montevideo units measure the strength of contractions, urine output reflects renal perfusion, and absent variability in fetal heart rate suggests fetal distress, not the need for increased oxytocin.
Question 4 of 5
A nurse in a clinic is caring for a 16-year-old adolescent. Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A,B,D,E,F
Rationale: The correct answers to report to the provider are A, B, D, E, and F. A: Abdominal assessment is crucial to identify any potential underlying issues. B: Vaginal discharge in an adolescent may indicate infection or hormonal imbalance. D: Temperature abnormalities could signal infection. E: Dyspareunia (pain during intercourse) may indicate reproductive health concerns. F: Condom usage is important for safe sex practices.
Choices C and G are not specifically related to the adolescent's care needs and do not require immediate reporting.
Question 5 of 5
A nurse is assessing four newborns. Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: The correct answer is B. A newborn who is 32 hr old and has not passed a meconium stool should be reported to the provider. Meconium should be passed within the first 24-48 hours of life, so the delay could indicate an obstruction or other issue.
Choices A, C, and D are all within normal ranges for newborn assessments and do not require immediate reporting to the provider. E, F, and G are not provided as options.