ATI RN
ATI RN Maternal Newborn 2023/24 1st Attempt & Retake Questions
Extract:
Question 1 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 for the nurse to take first is to massage the client's fundus. This is because excessive vaginal bleeding postpartum could indicate uterine atony, where the uterus fails to contract effectively, leading to hemorrhage. Massaging the fundus helps stimulate uterine contractions, which can help control bleeding. Administering oxytocin (choice
B) can also help with uterine contractions, but massaging the fundus is the initial intervention. Emptying the client's bladder (choice
C) can alleviate pressure on the uterus but is not the priority in this situation. Providing oxygen (choice
D) is not directly related to managing postpartum bleeding.
Question 2 of 5
A nurse is caring for a client who is at 15 weeks of gestation, is Rh-negative, and has just had an amniocentesis. Which of the following interventions is the nurse's priority following the procedure?
Correct Answer: C
Rationale: The correct answer is C: Administer Rho(
D) immune globulin. This is the priority intervention because the client is Rh-negative, and an amniocentesis can lead to fetal-maternal blood incompatibility. Administration of Rho(
D) immune globulin helps prevent the mother from developing antibodies against Rh-positive fetal blood cells, reducing the risk of hemolytic disease in the fetus. Checking the client's temperature (
A) is important but not the priority immediately following an amniocentesis. Observing for uterine contractions (
B) is not the priority unless there are signs of preterm labor. Monitoring the FHR (
D) is essential but not the priority immediately post-amniocentesis.
Question 3 of 5
A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?
Correct Answer: C
Rationale: The correct answer is C: Hypotension. Epidural opioids can cause vasodilation, leading to a drop in blood pressure. This can result in hypotension, which the nurse should monitor for due to the risk of complications. Hyperglycemia (
A), bilateral crackles (
B), and polyuria (
D) are not typically associated with epidural opioids. Hyperglycemia is more commonly linked to stress or certain medications. Bilateral crackles suggest pulmonary issues, not related to epidural opioids. Polyuria is excessive urine production, not a common adverse effect of epidural opioids.
Extract:
A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a new prescription for misoprostol.
Exhibit 2: Medical History
Preeclampsia
Cesarean birth of viable twin male newborns
Question 4 of 5
The nurse is assessing the client 30 min later. How should the nurse interpret the findings? For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication of potential improvement, or an indication of potential worsening condition.
| Findings 30 min later | Unrelated to diagnosis | Indication Of potential improvement | Indication of Potential worsening condition |
|---|---|---|---|
| Fundus at level of umbilicus | |||
| Cloudy urine | |||
| Blood pressure 80/50 mm Hg | |||
| Moderate lochia rubra | |||
| Thready pulse | |||
| Fundus firm to palpation |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Fundus at the level of the umbilicus is an indication of potential improvement as it indicates proper involution of the uterus.
- Cloudy urine is unrelated to the diagnosis and may indicate other issues like urinary tract infection.
- Blood pressure of 80/50 mm Hg is an indication of potential worsening condition as it is hypotensive.
- Moderate lochia rubra is also an indication of potential worsening condition as it may indicate excessive bleeding.
- Thready pulse is unrelated to the diagnosis.
- Fundus firm to palpation is an indication of potential improvement as it indicates proper uterine contraction and involution.
Extract:
Question 5 of 5
A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Uterine tenderness. Postpartum endometritis is an infection of the uterine lining, causing inflammation and tenderness. This is a common complication seen in women after childbirth. The other options are incorrect because: A: A slightly elevated temperature of 37.4°C is not specific to endometritis. B: WBC count of 9,000/mm3 is within the normal range and may not indicate infection. D: Scant lochia refers to minimal vaginal discharge, which is not a typical finding in endometritis.