ATI RN
ATI RN Custom 2023 Fall Exam 3 Questions
Extract:
A nurse is completing the admission assessment of a client who is at 38 weeks of gestation and has severe preeclampsia.
Question 1 of 5
Which of the following is an expected finding?
Correct Answer: A
Rationale: The correct answer is A: Report of headache. This is an expected finding because headaches are a common symptom that can indicate various underlying conditions. It is important to investigate the cause of the headache further to determine the appropriate management. Absence of clonus (
B), polyuria (
C), and tachycardia (
D) are not necessarily expected findings in every situation and may indicate different issues. Headache is a more specific and common symptom that requires attention.
Extract:
In an effort to decrease complications for the infant right after birth, the nurse would expect to administer which medication for prophylaxis of potential eye conditions?
Question 2 of 5
In an effort to decrease complications for the infant right after birth, the nurse would expect to administer which medication for prophylaxis of potential eye conditions?
Correct Answer: B
Rationale: The correct answer is B: Erythromycin ophthalmic ointment. This medication is administered to prevent ophthalmia neonatorum, an eye infection that can occur in newborns due to exposure to maternal gonorrhea or chlamydia during birth. Erythromycin ointment is effective in preventing this infection and reducing the risk of complications such as conjunctivitis or corneal ulceration. Vitamin K (choice
A) is given to prevent bleeding disorders in newborns. Gentamicin ointment (choice
C) is not typically used for prophylaxis in newborns. Silver nitrate solution (choice
D) used to be commonly used for prophylaxis but has been replaced by erythromycin due to concerns about its efficacy and potential side effects.
Extract:
A nurse is caring for a client who is postpartum and has a prescription for Rho (D) immunoglobulin.
Question 3 of 5
The nurse should verify which of the following prior to administration?
Correct Answer: D
Rationale: The correct answer is D because the Rh factor is inherited. If the mother is Rh negative and the newborn is Rh positive, it can lead to Rh incompatibility issues. The mother's immune system may produce antibodies against the baby's Rh-positive blood, causing hemolytic disease of the newborn. This can result in severe anemia and jaundice in the baby.
Therefore, it is crucial to verify the mother's Rh status and the newborn's Rh status to prevent complications.
Choices A, B, and C are incorrect because they do not address the risk of Rh incompatibility.
Extract:
At what time is the laboring client encouraged to push?
Question 4 of 5
At what time is the laboring client encouraged to push?
Correct Answer: D
Rationale: The correct answer is D: When the cervix is fully dilated. This is because pushing before full dilation of the cervix can lead to ineffective pushing and potential complications. When the cervix is fully dilated, it indicates that the baby is in the right position and the birth canal is open enough for the baby to pass through. Pushing at this stage helps in the efficient delivery of the baby.
Choices A, B, and C are incorrect because they do not consider the physiological readiness of the mother and baby for pushing.
Choice A depends on the healthcare provider's arrival, which may not align with the mother's natural labor progress.
Choice B focuses on the visibility of the fetal head, which may not necessarily indicate full cervical dilation.
Choice C is based on the nurse's preference rather than the mother's and baby's readiness for pushing.
Extract:
The client is being rushed into the labor and delivery unit.
Question 5 of 5
At which station would the nurse document the fetus immediately prior to birth? (Enter a numerical value)
Correct Answer: B
Rationale: The nurse would document the fetus immediately prior to birth at station 0. Station 0 corresponds to the level of the ischial spines, indicating the fetus is at the level of the maternal ischial spines and is ready to be born. Station -1 means the fetus is above the ischial spines, not yet engaged in the pelvis. Station 1 indicates the fetus is 1 cm below the ischial spines, not immediately prior to birth. Station 2 indicates the fetus is 2 cm below the ischial spines, also not immediately prior to birth.
Therefore, station 0 is the correct choice for documenting the fetus immediately prior to birth.