ATI RN
Caring for a Newborn who is Experiencing Complications ATI Questions
Question 1 of 5
The nurse is providing care for a neonate born to a mother with preexisting diabetes mellitus. Which neonatal assessment findings do the nurse expect? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Macrosomia. This is expected in neonates born to mothers with preexisting diabetes mellitus due to excessive glucose crossing the placenta, leading to increased fetal growth. Hyperglycemia (choice B) is not a neonatal assessment finding but rather a maternal condition. Hypocalcemia (choice C) and jaundice (choice D) are not directly associated with maternal diabetes mellitus in neonates.
Question 2 of 5
A newborn born 72 hours ago was diagnosed with jaundice, requiring phototherapy. Which is most important to educate the family on at this time?
Correct Answer: B
Rationale: The correct answer is B: Covering the newborn’s eyes during phototherapy. This is important because exposure to the bright lights used in phototherapy can harm the newborn’s eyes. Covering the eyes with a protective mask or eye patches helps prevent damage. Incorrect choices: A: Anticipatory guidance regarding immunization schedules is important but not the most immediate concern in this scenario. C: Proper clothing for the newborn during seasonal changes is important for general care but not as critical as protecting the eyes during phototherapy. D: How to accurately measure the newborn’s temperature is essential but not as urgent as ensuring eye protection during phototherapy. In summary, educating the family on covering the newborn’s eyes during phototherapy is crucial to prevent eye damage, making it the most important consideration in this situation.
Question 3 of 5
As the newborn nursery nurse, you are assessing your patients. Which assessment warrants further investigation?
Correct Answer: B
Rationale: The correct answer is B: Periodic episodes of grunting during expiration. This warrants further investigation as grunting during expiration is a sign of respiratory distress in newborns, indicating potential respiratory compromise. It can be a sign of underlying lung pathology or inadequate oxygenation. It is important to assess and address this promptly to prevent further deterioration. Incorrect choices: A: Irregular patterns of breathing with periods of apnea lasting 5 seconds - While apnea can be concerning, it is common in newborns. This alone may not warrant immediate further investigation. C: Breathing at a rate of 45 breaths per minute - A respiratory rate of 45 breaths per minute can be within normal range for a newborn. It may not be abnormal unless accompanied by other signs of distress. D: Mild sternal retractions - Sternal retractions can be a sign of increased work of breathing, but mild retractions alone may not be as concerning as grunting during expiration.
Question 4 of 5
Which are risk factors for a newborn developing hypoglycemia? Select all that apply.
Correct Answer: D
Rationale: The correct answer is D: Breastfeeding. Newborns exclusively breastfed are at risk of hypoglycemia due to delayed milk production, inadequate feeding, and poor latching. Prematurity (A) and being large for gestational age (B) can increase the risk, but they are not primary causes. Cold stress (C) can contribute, but it's not a direct risk factor for hypoglycemia in newborns. By process of elimination and understanding the physiological effects of breastfeeding on newborn glucose levels, choice D is the most relevant risk factor.
Question 5 of 5
The RN in the newborn nursery is reviewing the newborn’s chart and notices that the bilirubin levels are elevated. What intervention should the nurse perform next?
Correct Answer: D
Rationale: The correct answer is D because elevated bilirubin levels in newborns indicate jaundice, which can lead to complications if not treated promptly. Phototherapy helps break down bilirubin and is the first-line treatment for neonatal jaundice. Applying phototherapy as per hospital protocol is essential to decrease bilirubin levels. Notifying the physician is also crucial for ongoing monitoring and management. Choice A (Place the patient NPO and notify a physician) is incorrect because NPO status is not necessary for managing neonatal jaundice, and phototherapy is the primary intervention. Choice B (Weigh the patient to see if weight loss has occurred) is incorrect because weight loss is not directly related to elevated bilirubin levels in newborns. Choice C (Take the newborn’s vital signs and report to the physician) is incorrect because while vital signs are important, the immediate intervention for elevated bilirubin levels is phototherapy to prevent complications.