ATI RN
RN Maternal Nursing OB Newborn 2023 2024 Exam Questions
Extract:
Question 1 of 5
A nurse is admitting a client to the labor and delivery unit when the client states, 'My water just broke.' Which of the following interventions is the nurse's priority?
Correct Answer: D
Rationale: The correct answer is D: Begin FHR monitoring. This is the priority intervention because it allows the nurse to assess the baby's well-being and detect any signs of fetal distress. Monitoring the fetal heart rate is crucial in determining the baby's response to the water breaking. Performing Nitrazine testing (
A) and assessing the fluid (
B) can provide additional information but do not directly assess fetal well-being. Checking cervical dilation (
C) is important but not as urgent as monitoring the FHR in this situation.
Question 2 of 5
Which of the following is a potential complication of oligohydramnios?
Correct Answer: B
Rationale: The correct answer is B: Fetal growth restriction. Oligohydramnios refers to low amniotic fluid levels, which can restrict fetal movement and lead to poor circulation, resulting in inadequate fetal growth. Preterm labor can be associated with polyhydramnios (
Choice
C), not oligohydramnios.
Choice D is incorrect as preterm labor is not directly linked to oligohydramnios.
Question 3 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: Reporting the client's HIV status to the local health department is required by law to ensure proper public health monitoring and intervention.
Extract:
The nurse continues to care for the client who is at 30 weeks of
gestation.
Exhiont 2
Vital Signs
1000:
Temperature 37.4"C（99.3*F)
Heart rate 90/min
Respiratory rate 20/min
Blood pressure 148/94 mm Hg
Oxygen saturation 95% on room air
1100:
Temperature 37° C (98.6° F)
Heart rate 92/min
Respiratory rate 24/min
Blood pressure 156/96 mm Hg
Oxygen saturation 94% on room air
1400:
Temperature 37.2°C（98.9*F）
Heart rate 80/min
Respiratory rate 14/min
Blood pressure 170/112 mm Hg
oxygen saturation 92% on room air
Question 4 of 5
Complete the following sentence by using the list of options. Based on the client findings, the nurse should first admister-----------------and then prepare to administer-----------------------
Correct Answer: B,A
Rationale:
Rationale:
First administer hydralazine ✅
The client is experiencing severe hypertension (BP 170/112 mm Hg at 1400), which indicates preeclampsia with severe features.
Hydralazine is a fast-acting antihypertensive that helps lower blood pressure and reduce the risk of stroke, placental abruption, or fetal compromise.
Then prepare to administer calcium gluconate ✅
If the client is receiving magnesium sulfate for seizure prevention (common in severe preeclampsia), calcium gluconate is the antidote in case of magnesium toxicity (which can cause respiratory depression or cardiac arrest).
The nurse should have calcium gluconate readily available in case of toxicity signs like loss of deep tendon reflexes, respiratory depression, or cardiac arrhythmias.
Notify the provider 🚨
The severely elevated BP (170/112 mm Hg) and potential risk for eclampsia (seizures) require immediate provider notification for further management.
Extract:
Question 5 of 5
A nurse is assessing a newborn who is 16 hr old. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Substernal retractions. Substernal retractions in a 16-hour-old newborn indicate respiratory distress and require immediate attention from the provider to prevent further complications. Acrocyanosis (choice
B) is a common finding in newborns and is not concerning. Overlapping suture lines (choice
C) can be normal in a newborn as their skull bones are not fused yet. A head circumference of 33 cm (13 in) (choice
D) falls within the normal range for a newborn and does not require immediate reporting.