ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Question 1 of 5
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
Correct Answer: B
Rationale: The correct answer is B: Cover the umbilical cord with a sterile saline-saturated towel. This action is important to prevent compression of the umbilical cord, which can lead to decreased blood flow to the fetus resulting in fetal distress or demise. By covering the protruding cord with a sterile saline-saturated towel, the nurse can protect the cord and maintain adequate blood flow until further interventions can be performed by the healthcare team. Performing a vaginal examination by applying upward pressure on the presenting part (choice
A) can further compress the cord and worsen the situation. Administering oxygen via nonrebreather mask (choice
C) and initiating an infusion of IV fluids (choice
D) are important interventions but should be done after addressing the umbilical cord protrusion to ensure adequate oxygenation and perfusion to the fetus.
Question 2 of 5
A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?
Correct Answer: D
Rationale: The correct answer is D: Postpartum hemorrhage. The client being 80% effaced and 8 cm dilated indicates she is in active labor, not experiencing an ectopic pregnancy, hyperemesis gravidarum, or incompetent cervix. Postpartum hemorrhage is a potential risk due to the advanced stage of labor, increasing the likelihood of excessive bleeding post-delivery. It is crucial for the nurse to monitor the client closely for signs of hemorrhage and be prepared to intervene promptly to prevent complications.
Question 3 of 5
A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin. Which of the following actions should the nurse take to best evaluate the client’s medication adherence?
Correct Answer: D
Rationale: The correct answer is D: Check the client’s serum medication level. This is the best way to evaluate medication adherence for a client taking digoxin during pregnancy. Digoxin has a narrow therapeutic range, and monitoring the serum level helps ensure the client is taking the medication as prescribed. Option A is not as reliable as self-reporting may not be accurate. Option B, assessing kidney function, is important but not directly related to medication adherence. Option C, determining the apical pulse rate, may indicate the medication's effectiveness but does not confirm adherence. Checking the serum medication level directly assesses the actual drug concentration in the body, providing concrete evidence of adherence.
Question 4 of 5
A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?
Correct Answer: C
Rationale:
Correct
Answer: C - The car seat should be positioned in the car at a 45-degree angle.
Rationale: Placing the car seat at a 45-degree angle helps protect a newborn's airway and prevents slumping, ensuring optimal safety during travel. This position aligns the baby's head with the neck and spine, reducing the risk of suffocation and injury in the event of sudden stops or accidents. A 45-degree angle also supports proper breathing and oxygenation for the newborn.
Therefore, this statement indicates the parent understands the importance of correctly positioning the car seat for their baby's safety.
Summary of Incorrect
Choices:
A: Incorrect - Using a sleep sack in the car seat can lead to overheating and compromise the baby's safety by interfering with the car seat's harness system.
B: Incorrect - A car seat challenge test is typically done for premature infants, not a newborn delivered at 38 weeks of gestation.
D: Incorrect - Turning a baby's car seat forward-facing
Question 5 of 5
A nurse is assessing a client who is 1 hr postpartum following a vaginal birth. The nurse notes that the client has excessive vaginal bleeding. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct action for the nurse to take first is to massage the client's fundus. This is because excessive vaginal bleeding postpartum could indicate uterine atony, which is a common cause of postpartum hemorrhage. By massaging the fundus, the nurse can help stimulate uterine contractions and reduce bleeding. Administering oxytocin (choice
B) may be necessary but massaging the fundus should be done first. Emptying the client's bladder (choice
C) can also help, but addressing uterine atony is the priority. Providing oxygen (choice
D) is not the immediate action needed for excessive vaginal bleeding.