ATI RN
ATI Pediatrics Final Exam Questions
Extract:
A client who is at 40 weeks of gestation and is in labor
Question 1 of 5
A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?
Correct Answer: D
Rationale: The correct answer is D: Variable decelerations. Variable decelerations are abrupt and visually apparent decreases in the fetal heart rate that vary in duration, depth, and timing. They are caused by cord compression, which can result in decreased blood flow to the fetus. The nurse should suspect a problem with the umbilical cord when observing variable decelerations because they indicate potential compromise to fetal oxygenation. Early decelerations (choice
A) are typically caused by head compression during contractions and are not concerning. Accelerations (choice
B) are indicative of fetal well-being. Late decelerations (choice
C) are associated with uteroplacental insufficiency. The presence of variable decelerations (choice
D) suggests umbilical cord compression and requires further assessment and intervention.
Extract:
Newborn who is 30 min old. Newborn placed on the birth parent's abdomen immediately following birth. Mouth and nose suctioned with bulb syringe. Dried and stimulated. Strong cry noted. Moving all extremities. Flexed tone noted. Acrocyanosis present. Newborn is alert and active. Respirations rapid and shallow with occasional expiratory grunting, Fine crackles auscultated throughout lung fields. Small amount of green-stained vernix present in skin folds. Fingernails stained green. Molding of skull and generalized soft occipital swelling noted. Vital Signs: Axillary temperature 36.9° C (98.4° F), Heart rate 170/min, Respiratory rate 72/min, Birth weight 4,025 gm (8 lb 14 oz) (Appropriate for Gestational Age), Axillary temperature 36.7° C (97.8° F), Heart rate 162/min, Respiratory rate 80/min
Question 2 of 5
After reviewing the information in the newborn's medical record, which of the following complications should the nurse identify as posing the greatest risk?
Correct Answer: A
Rationale: The correct answer is A: Meconium aspiration syndrome. This poses the greatest risk as it can lead to severe respiratory distress and potential long-term complications like pneumonia and respiratory failure. Meconium ileus, cold stress, hypoglycemia, and jaundice are common complications in newborns but do not typically carry as high a risk for immediate life-threatening consequences as meconium aspiration syndrome. Meconium ileus is a bowel obstruction, cold stress can be managed with warmth, hypoglycemia can be treated with glucose, and jaundice is common and usually benign. By prioritizing the risk of complications, the nurse should focus on addressing meconium aspiration syndrome promptly to prevent serious respiratory compromise.
Extract:
A client who is 4 hr postpartum following a vaginal delivery
Question 3 of 5
A nurse is assessing a client who is 4 hr postpartum following a vaginal delivery. Which of the following findings should the nurse identify as the priority?
Correct Answer: D
Rationale: The correct answer is D: Deep tendon reflexes 4+. This finding indicates hyperreflexia, which can be a sign of preeclampsia or eclampsia, potentially life-threatening conditions postpartum. The nurse should prioritize assessing for signs of these conditions to ensure the client's safety.
A: Fundus at the level of the umbilicus is expected within 4 hours postpartum, representing normal involution.
B: Saturated perineal pad in 30 minutes could indicate excessive bleeding, but hyperreflexia poses a more immediate risk.
C: Approximated edges of episiotomy indicate proper wound healing, a lower priority than assessing for potential hypertensive disorders.
Extract:
A client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling 'down' and sad, having no energy, and wanting to cry
Question 4 of 5
A nurse in a clinic is caring for a client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling 'down' and sad, having no energy, and wanting to cry. Which of the following is a priority action by the nurse?
Correct Answer: B
Rationale: The correct answer is B: Ask the client if she has considered harming her newborn. This is the priority action because the client is displaying symptoms of postpartum depression, which can lead to harmful thoughts or actions towards the newborn. By asking this question, the nurse can assess the client's risk for harm and provide necessary interventions to ensure the safety of both the client and the newborn. Anticipating antidepressant prescription (
A) is not the priority at this moment as immediate safety concerns need to be addressed first. Reinforcing postpartum and newborn care teaching (
C) and assisting the family to identify positive coping skills (
D) are important but not as urgent as addressing potential harm.
Extract:
Newborn immediately following birth
Question 5 of 5
A nurse is caring for a newborn immediately following birth. After assuring a patent airway, what is the priority nursing action?
Correct Answer: D
Rationale: The priority nursing action after ensuring a patent airway for a newborn is to dry the skin. This helps prevent heat loss and maintain the newborn's body temperature, reducing the risk of hypothermia. Administering vitamin K and eye prophylaxis are important but not immediate priorities. Placing an identification bracelet can be done later and does not impact the newborn's immediate well-being. Drying the skin is crucial for the newborn's physiological stability and should be the initial focus of care.