ATI RN
ATI RN Maternal Newborn 2023/24 1st Attempt & Retake Questions
Extract:
Question 1 of 5
A nurse in a provider’s office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?
Correct Answer: B
Rationale: The correct response is B: This procedure determines if your baby has genetic or congenital disorders. The rationale behind this is that amniocentesis is a prenatal test that is used to detect genetic conditions, chromosomal abnormalities, and neural tube defects in the fetus. It is not typically done solely to determine the sex of the baby. A is incorrect because there is no age requirement for amniocentesis. C is incorrect because chorionic villus sampling is a different procedure used to detect genetic abnormalities and is not typically done to determine the sex of the baby. D is incorrect because scheduling the procedure without discussing the risks and benefits with the client first is not appropriate.
Extract:
A nurse is caring for a newborn who is 70 hr old. Exhibit 1
Medical History
Newborn delivered by repeat cesarean birth at 40 weeks of gestation.
Birth weight 3,515 g (7 lb 12 oz)
Apgar scores 8 at 1 min and 9 at 5 min
Maternal history of methadone use during pregnancy.
Exhibit 2
Vital Signs
0700:
Heart rate 156/min
Respiratory rate 58/min
Temperature 37.2° C (98.9° F)
Oxygen saturation 98% on room air
1100:
Heart rate 160/min
Respiratory rate 60/min
Temperature 37.3° C (99.2° F)
Oxygen saturation 96% on room air
Exhibit 3
Physical Examination
1100:
Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but
breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle
tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several
loose stools today.
Exhibit 4
Diagnostic Results
Maternal urine toxicology screen positive for opiates (negative)
Newborn urine toxicology screen positive for opiates (negative)
Question 2 of 5
Which of the following findings should the nurse report to the provider? Select all that apply.
Correct Answer: C,D
Rationale: The nurse should report central nervous system (CNS) and gastrointestinal (GI) findings to the provider as they may indicate significant health issues. CNS findings can suggest neurological problems, such as changes in mental status or weakness, requiring immediate attention. GI findings, like abdominal pain or bleeding, can indicate potential digestive system issues needing prompt evaluation. Reporting respiratory findings and oxygen saturation is important too but typically not as urgent as CNS and GI issues. It is essential to prioritize CNS and GI findings for timely intervention.
Extract:
Question 3 of 5
A nurse is administering a hepatitis B vaccine to a newborn. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Administer the injection into the vastus lateralis muscle. In newborns, the vastus lateralis muscle is the preferred site for intramuscular injections due to its size and relatively lower risk of hitting nerves or blood vessels. This muscle is located on the anterior lateral aspect of the thigh and is recommended for vaccines in infants. Administering the hepatitis B vaccine in this muscle ensures proper absorption and effectiveness of the vaccine.
Choices B, C, and D are incorrect. Massaging the site vigorously can cause discomfort and potential tissue damage. Inserting the needle at a 45° angle may result in subcutaneous rather than intramuscular injection. Using a 21-gauge needle, though commonly used, may not be the most appropriate size for newborns and can cause unnecessary pain.
Question 4 of 5
A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take?
Correct Answer: D
Rationale:
Correct Answer: D - Report the client’s condition to the local health department.
Rationale: Reporting the client's HIV positive status to the local health department is crucial for public health surveillance and monitoring. This action helps to prevent the spread of HIV to others and ensures appropriate follow-up care and support for the client. It also allows for contact tracing and identification of potential exposure risks. Additionally, notifying the health department enables them to provide resources and interventions to support the client's health and well-being.
Incorrect
Choices:
A: Administering penicillin G is not the appropriate action for an HIV-positive client at 22 weeks of gestation. Penicillin G is typically used to treat bacterial infections, not HIV.
B: Instructing the client to schedule an annual pelvic examination is important for general health maintenance but is not directly related to the client's HIV status and gestational age.
C: Waiting to start HIV medication until after delivery is not recommended as timely initiation of antiretrov
Question 5 of 5
A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer?
Correct Answer: A
Rationale: The correct answer is A: 8 tablets.
To calculate the number of tablets needed, divide the total dose by the dose per tablet: 2000 mg / 250 mg = 8 tablets. The nurse should administer 8 tablets to achieve the prescribed 2 g dose. Option B (4 tablets) is incorrect as it would only provide half the required dose. Option C (2 tablets) and D (1 tablet) are also incorrect as they would provide even less than half the required dose.