ATI RN
RN Maternal Nursing OB Newborn 2023 2024 Exam Questions
Extract:
Question 1 of 5
A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?
Correct Answer: D
Rationale: The correct answer is D: Postpartum hemorrhage. The nurse assessed the client to be 80% effaced and 8 cm dilated, indicating she is in active labor. This client is at risk for postpartum hemorrhage, which is excessive bleeding after childbirth due to the uterus not contracting adequately to control bleeding. The risk is higher in clients who have a rapid labor progression like this client. Ectopic pregnancy (
A) is not relevant in this scenario as the client is already in labor. Hyperemesis gravidarum (
B) is severe nausea and vomiting during pregnancy, not related to the client's current condition. Incompetent cervix (
C) is the premature dilation of the cervix, not applicable at this stage of labor.
Question 2 of 5
A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Assist the client in pulling their knees toward their abdomen. In shoulder dystocia, the baby's shoulder is stuck behind the mother's pubic bone. The McRoberts maneuver involves hyperflexing the mother's legs towards her abdomen to enlarge the pelvic outlet, which can help dislodge the shoulder and facilitate delivery. This action can help create more space for the baby to maneuver and be born. Applying pressure to the fundus (
A) does not address the mechanical issue of shoulder dystocia. Pressing on the suprapubic area (
B) may not provide the necessary space for the baby to be delivered. Moving the client onto their hands and knees (
C) may not be as effective as the McRoberts maneuver in this situation.
Question 3 of 5
A nurse is assessing a client who is 1 hr postpartum following a vaginal birth. The nurse notes that the client has excessive vaginal bleeding. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct action is to massage the client's fundus first. This helps to stimulate uterine contractions and control excessive bleeding, preventing postpartum hemorrhage. Massaging the fundus promotes the expulsion of clots and helps the uterus contract, decreasing the risk of further bleeding. Administering oxytocin (choice
B) can be done after fundal massage to enhance uterine contractions. Emptying the client's bladder (choice
C) can also aid in reducing uterine atony but is not the priority in this situation. Providing oxygen (choice
D) is not directly related to controlling postpartum bleeding.
Question 4 of 5
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
Correct Answer: B
Rationale: The correct answer is B: Cover the umbilical cord with a sterile saline-saturated towel. This action is crucial in preventing compression and desiccation of the umbilical cord, which could lead to decreased blood flow and oxygen delivery to the fetus. By covering the cord, the nurse can protect it from further damage while waiting for emergency intervention. Performing a vaginal examination (choice
A) could worsen the situation by causing more pressure on the cord. Administering oxygen (choice
C) may be important later but is not the immediate priority. Initiating IV fluids (choice
D) is not the most urgent action in this scenario.
Question 5 of 5
A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Excessive crying. Neonatal abstinence syndrome (NAS) occurs in newborns exposed to addictive substances in utero. The newborn may exhibit symptoms such as excessive crying due to neurologic irritability. Diminished deep tendon reflexes (
A) are not typically associated with NAS. Decreased muscle tone (
C) is not a common finding in NAS; infants may actually have increased muscle tone. An absent Moro reflex (
D) is not a typical finding in NAS, as hyperreflexia is more common.