ATI RN
Caring for a Newborn who is Experiencing Complications ATI Questions
Question 1 of 5
The nurse is providing care for a premature neonate born at 28 weeks gestation who is experiencing respiratory distress syndrome (RDS). Which assessment finding indicates to the nurse that the neonate’s respiratory status is deteriorating?
Correct Answer: A
Rationale: The correct answer is A. A Pao2 of 48 and Paco2 of 55 mm Hg on 90% oxygen indicates severe hypoxemia and hypercapnia, suggesting worsening respiratory status in a neonate with RDS. Here's a step-by-step rationale: 1. Hypoxemia (low Pao2) indicates inadequate oxygenation, which can lead to tissue hypoxia and organ damage. 2. Hypercapnia (high Paco2) is a sign of inadequate ventilation and respiratory acidosis. 3. High oxygen requirement (90%) despite low Pao2 suggests poor oxygen exchange. 4. Overall, these findings point to respiratory failure and deterioration in the neonate's condition. Summary: B is incorrect because an elevated respiratory rate is a compensatory mechanism for respiratory distress. C is incorrect as decreased breath sounds can be expected in RDS. D is incorrect as an elevated heart rate can be a compensatory response to hypoxemia
Question 2 of 5
The nurse is preparing for the discharge of a premature neonate to home with the parents. The nurse explains the neonate must be able to pass the infant car seat challenge before discharge. For which reason would the neonate be considered unsafe in a car seat?
Correct Answer: C
Rationale: The correct answer is C because the infant car seat challenge is used to assess if the neonate can maintain adequate oxygenation, heart rate, and respiratory rate in a seated position. This is crucial as infants who are unable to maintain these vital signs while in a car seat are at risk of oxygen desaturation and apnea, which can lead to serious complications such as suffocation or sudden infant death syndrome. Therefore, if the neonate is unable to maintain adequate oxygenation, heart rate, and respiratory rate during the trial, it would be unsafe for them to travel in a car seat. Choices A, B, and D are incorrect because they do not directly relate to the safety concerns associated with the infant car seat challenge. Choice A refers to the angle at which the neonate should be positioned in the car seat, which is important for proper positioning but not the primary concern during the car seat challenge. Choice B focuses on parental attitudes towards using the car seat, which is not a physiological
Question 3 of 5
The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, “I don’t believe this is happening to us. We were so careful during pregnancy.” The nurse associates the parents’ comments with which stage of grief?
Correct Answer: A
Rationale: The correct answer is A: Disbelief. In the context of the scenario, the parents' statements indicate a sense of shock and difficulty accepting the reality of their situation, which aligns with the stage of disbelief in the grief process. During this stage, individuals may struggle to comprehend the situation and may question how it could have happened despite their efforts. This initial stage typically involves denial and confusion. Choice B: Depression, is incorrect because the parents' statements do not reflect feelings of sadness or hopelessness, which are typical of the depression stage of grief. Choice C: Denial of reality, is incorrect as the parents' statements are more about disbelief and questioning rather than outright denial of the situation. Choice D: Anger with each other, is incorrect as there is no mention of the parents expressing anger towards each other in the scenario.
Question 4 of 5
The premature neonate is more susceptible to skin breakdown than a term neonate. Which skin care interventions will the nurse implement for the premature neonate? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C: Perform daily skin assessment to identify problems early. Premature neonates have fragile skin due to their immature epidermal barrier, making them more susceptible to skin breakdown. Daily skin assessments help in early detection of any skin issues, allowing prompt intervention to prevent complications. A: Using a neutral pH cleanser and sterile water for bathing is important, but it is not specific to premature neonates. B: Gently applying emollients is beneficial, but it does not address the need for regular skin assessments. D: Using water, air, or gel mattresses is more related to pressure ulcer prevention rather than general skin care for premature neonates.
Question 5 of 5
The nurse is preparing for the discharge of a neonate diagnosed with a congenital breathing disorder. Which health team members does the nurse include in discharge planning? Select all that apply.
Correct Answer: D
Rationale: The correct answer is D: Home health agency nurse. The nurse includes the home health agency nurse in discharge planning as they will provide ongoing care and support for the neonate with a congenital breathing disorder at home. The home health agency nurse can assess the home environment, educate the family on care techniques, monitor the neonate's condition, and provide necessary interventions. A: Respiratory therapist may be involved in managing acute respiratory issues but may not provide ongoing care at home. B: Community agency manager may help with connecting to community resources but may not provide direct care. C: Social worker may assist with psychosocial support but may not have the expertise in managing the neonate's medical needs at home.