ATI RN
ATI Maternal Newborn Proctored Exam Latest Update Questions
Extract:
Question 1 of 5
A 38 week gestation newborn weighs 4020 grams, is sluggish, and has limp muscle tone. The baby experienced a broken clavicle during delivery. Based on this information, which can the nurse conclude about the baby?
Correct Answer: B
Rationale: The correct answer is B: Large for gestational age. A newborn weighing 4020 grams at 38 weeks is above the 90th percentile, indicating macrosomia or being large for gestational age. The sluggishness and limp muscle tone can be attributed to the baby's size. A broken clavicle during delivery is common in larger babies due to difficulty in passing through the birth canal. Neonatal abstinence symptoms (
A) are related to drug withdrawal, not indicated here. Congenital cardiac defects (
C) typically do not present with these symptoms. Respiratory depression (
D) is more likely in preterm infants or those with perinatal asphyxia.
Question 2 of 5
A nurse monitors fetal well-being by means of an external monitor. At the peak of the contractions, the fetal heart rate has repeatedly dropped 30 beats/min below the baseline. Late decelerations are suspected and the nurse notifies the physician. Which is the rationale for this action?
Correct Answer: D
Rationale: The correct answer is D. Late decelerations are associated with uteroplacental insufficiency, leading to fetal hypoxia. This occurs due to poor oxygen exchange at the placenta during contractions, resulting in a delayed recovery of the fetal heart rate after the contraction peaks. Repeated late decelerations indicate ongoing fetal distress and the need for immediate intervention to prevent further compromise.
Choices A and B are incorrect as they describe different types of decelerations.
Choice C is incorrect as late decelerations are indeed associated with hypoxia. However, they are related to uteroplacental insufficiency rather than the strength of maternal contractions.
Choice D provides the most accurate explanation of late decelerations and their significance in indicating fetal distress.
Question 3 of 5
A labor and delivery nurse suspects that a client is in the transition stage of labor. Which information supports this conclusion? The client is:
Correct Answer: B
Rationale: The correct answer is B: irritable and needs frequent repetition of directions. This behavior is indicative of the transition stage of labor, which is the most intense phase characterized by strong contractions and nearing full dilation. The client's irritability and need for repeated directions suggest she is experiencing intense pain and discomfort, typical of this stage.
Incorrect choices:
A: Walking around and talking may occur in early labor but not indicative of transition.
C: Expelling feces and fetal head crowning indicate the pushing stage, not transition.
D: Reading a magazine and talking on the phone are unlikely behaviors during transition due to the intensity of contractions.
Question 4 of 5
Which information is most important for the nurse to gather when a client is admitted to the unit in labor?
Correct Answer: B
Rationale: The correct answer is B: Medical problems or complications. This information is crucial for assessing potential risks during labor and ensuring appropriate care. Knowing the client's medical history helps the nurse anticipate and address any complications that may arise. Other choices like A, C, and D are important but not as critical as medical problems or complications. The support person's name (
A) is important for emotional support, fluid preferences (
C) can be addressed later, and weight gain during pregnancy (
D) is relevant but does not impact immediate care during labor.
Question 5 of 5
Which condition must occur in order for identical (monozygotic) twins to develop?
Correct Answer: C
Rationale: The correct answer is C: One sperm fertilizes one ovum. Identical twins develop from a single fertilized egg that splits into two embryos. This process results in monozygotic twins with identical genetic makeup. If one sperm fertilizes two ova (
A), it would result in fraternal (dizygotic) twins, not identical twins. Two sperm fertilizing two ova (
B) would also produce fraternal twins with different genetic compositions. If two sperm fertilize one ovum (
D), it would lead to chromosomal abnormalities, not identical twins.
Therefore, the only scenario that aligns with the development of identical twins is when one sperm fertilizes one ovum, leading to the formation of monozygotic twins.