ATI RN
ATI Maternal Newborn Proctored Exam Questions
Question 1 of 5
A client at 35 weeks' gestation reports mild vaginal bleeding and no pain. What condition should the nurse suspect?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Placenta previa. Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless vaginal bleeding, especially in the third trimester. This condition is associated with no uterine tenderness or contractions, which aligns with the client's presentation of mild vaginal bleeding and no pain at 35 weeks' gestation. Option A) Abruptio placentae involves the premature separation of the placenta from the uterine wall, leading to painful bleeding. This condition is usually associated with uterine tenderness and contractions, which are absent in the client's case. Option C) Preterm labor involves regular uterine contractions leading to cervical changes and can manifest with vaginal bleeding. However, in this case, the lack of pain and the absence of contractions make preterm labor less likely. Option D) Urinary tract infection is unrelated to the symptoms described by the client and does not present with vaginal bleeding in the absence of other complications. Educationally, understanding the differences between placenta previa, abruptio placentae, preterm labor, and unrelated conditions like urinary tract infections is crucial for nurses caring for pregnant clients. Recognizing the signs and symptoms of each condition is essential for prompt identification, intervention, and ensuring the best outcomes for both the mother and the baby.
Question 2 of 5
The nurse is monitoring a client with severe preeclampsia. What assessment finding indicates worsening condition?
Correct Answer: C
Rationale: In the context of pharmacology and maternal newborn care, understanding the assessment findings in severe preeclampsia is crucial for providing safe and effective care to pregnant patients. In this scenario, the correct answer is C) New-onset confusion and restlessness, indicating a worsening condition in a client with severe preeclampsia. New-onset confusion and restlessness are concerning signs in severe preeclampsia as they can be indicative of neurological involvement, such as eclampsia, which is a severe complication characterized by seizures. Prompt recognition of these symptoms is essential to prevent further progression to eclampsia and ensure the safety of both the mother and the fetus. Option A, proteinuria of +1, is a common finding in preeclampsia, but it is not the most concerning sign of worsening condition in this context. Option B, a respiratory rate of 16 breaths per minute, is within the normal range and does not directly indicate worsening of preeclampsia. Option D, a urine output of 40 mL/hr, is decreased but may not necessarily indicate immediate worsening of the condition compared to neurological symptoms like confusion and restlessness. Educationally, this question highlights the importance of recognizing subtle changes in a client's condition, especially in the context of a high-risk pregnancy complication like severe preeclampsia. Nurses and healthcare providers must be vigilant in monitoring and assessing pregnant patients for signs of deterioration to provide timely and appropriate interventions to prevent adverse outcomes for both the mother and the baby.
Question 3 of 5
The nurse is assessing a pregnant client with hyperemesis gravidarum. What is the priority nursing action?
Correct Answer: A
Rationale: In the context of pharmacology and maternal newborn care, the priority nursing action when assessing a pregnant client with hyperemesis gravidarum is to monitor for dehydration and electrolyte imbalances (Option A). This is crucial because hyperemesis gravidarum is characterized by severe nausea, vomiting, and electrolyte disturbances, which can lead to dehydration and pose risks to both the mother and the developing fetus. Monitoring for dehydration and electrolyte imbalances is essential to prevent complications such as hypovolemia, metabolic alkalosis, and ketosis. Dehydration can compromise maternal circulation, leading to reduced placental perfusion, which can negatively impact fetal well-being. Therefore, addressing fluid and electrolyte imbalances is the priority to ensure the health and safety of both the mother and the baby. Encouraging the client to eat small, frequent meals (Option B) may be beneficial in managing nausea and vomiting in some cases, but it is not the priority when the client is at risk of dehydration and electrolyte imbalances. Providing antiemetic medication (Option C) can help manage symptoms, but it does not address the underlying issue of fluid and electrolyte imbalances. Assessing for fetal growth restriction (Option D) is important in the long-term management of the client but is not the immediate priority when the client's physiological needs are compromised. In an educational context, understanding the priority nursing actions in managing complications like hyperemesis gravidarum during pregnancy is essential for providing safe and effective care to pregnant clients. Nurses need to prioritize interventions based on the urgency of the situation and the potential risks to both the mother and the fetus. Monitoring for dehydration and electrolyte imbalances is a fundamental aspect of maternal care in such situations and should be addressed promptly to optimize outcomes for both the mother and the baby.
Question 4 of 5
The nurse is monitoring a client in labor who is receiving oxytocin. What finding requires immediate intervention?
Correct Answer: C
Rationale: In the scenario of a laboring client receiving oxytocin, the finding that requires immediate intervention is a fetal heart rate of 100 beats/minute (Option C). This finding is concerning as a fetal heart rate of 100 beats/minute is indicative of fetal distress. Fetal distress can be a critical situation during labor and may necessitate prompt action to ensure the well-being of the fetus. Contractions lasting 90 seconds (Option A) may be intense but are not necessarily abnormal or an immediate cause for concern. Contractions every 2-3 minutes (Option B) are frequent but may be expected in active labor. Maternal heart rate of 85 beats/minute (Option D) falls within a normal range for an adult at rest and does not raise immediate alarm in the context of labor. Educationally, understanding the significance of fetal heart rate monitoring during labor is crucial for nurses caring for laboring clients. Sudden changes in fetal heart rate patterns can indicate fetal distress, prompting the need for quick assessment and intervention to optimize maternal and fetal outcomes. Monitoring and interpreting fetal heart rate patterns accurately are essential skills for nurses in obstetric care to ensure safe labor and delivery experiences.
Question 5 of 5
The nurse is teaching a client about signs of postpartum hemorrhage. What statement indicates understanding?
Correct Answer: B
Rationale: In the context of pharmacology in maternal newborn care, understanding the signs of postpartum hemorrhage is crucial for ensuring the well-being of both the mother and the newborn. The correct answer, option B ("Soaking one pad in an hour is concerning"), indicates understanding because it highlights a key indicator of postpartum hemorrhage, which is excessive bleeding. This statement reflects the importance of monitoring bleeding patterns closely after childbirth to promptly recognize and address any potential complications. Option A ("Passing a few clots is normal") is incorrect because while passing small clots can be normal in the immediate postpartum period, soaking a pad in an hour is a more significant and concerning amount of bleeding. Option C ("Heavy bleeding stops within 48 hours") is incorrect as it provides a misleading timeframe for the cessation of bleeding after childbirth. Postpartum bleeding can persist for several weeks, with the heaviest bleeding typically occurring within the first few days. Option D ("I should ignore mild cramping") is also incorrect as mild cramping can be a sign of uterine contractions, which are essential for postpartum recovery. However, if accompanied by soaking a pad in an hour, it could indicate a more serious issue like postpartum hemorrhage. Educationally, understanding the signs of postpartum hemorrhage is essential for nurses providing care to postpartum women. By recognizing these signs early, nurses can intervene promptly, potentially preventing serious complications associated with excessive postpartum bleeding. It underscores the importance of patient education and close monitoring in the postpartum period to ensure optimal outcomes for both the mother and the newborn.