ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN 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 in this situation is to massage the client's fundus. This is because excessive vaginal bleeding postpartum can be a sign of uterine atony, which is the most common cause of postpartum hemorrhage. Massaging the fundus helps to stimulate uterine contractions and can help control bleeding. Administering oxytocin (choice
B) can also help with uterine contractions, but massaging the fundus should be done first to assess the situation. Emptying the client's bladder (choice
C) can help relieve pressure on the uterus, but it is not the priority in this situation. Providing oxygen (choice
D) is not indicated for excessive vaginal bleeding unless the client is showing signs of hypoxia.
Extract:
A nurse is caring for a postpartum client who gave birth 3 days ago.
Exhibit 1
Vital Signs
Temperature 38.4° C (101.1° F)
Heart rate 108/min
Respiratory rate 20/min
Blood pressure 118/72 mm Hg
Question 2 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Correct Answer:
Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, D.
Rationale: Engorgement is a common condition postpartum.
To address it, the nurse should initiate anticoagulant therapy to prevent deep vein thrombosis and administer an oxytocic medication to promote milk ejection. Monitoring the client's temperature for infection and the circumference of lower extremities for edema can help assess progress. Applying ice packs to the breasts is not necessary for engorgement, and monitoring the integrity of the nipples is not directly related to this condition.
Extract:
Question 3 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 dosage (2g) by the dosage per tablet (250mg). 2g = 2000mg, so 2000mg ÷ 250mg = 8 tablets. This ensures the client receives the correct total dose for effective treatment. Option B: 4 tablets is incorrect as it does not match the calculated dosage. Option C: 2 tablets is incorrect as it is half of the required dosage. Option D: 1 tablet is incorrect as it is a quarter of the needed dosage.
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:
1. Fundus at level of umbilicus: (Indication of potential improvement) - This finding indicates the uterus is contracting well, which is a positive sign postpartum.
2. Cloudy urine: (Unrelated to diagnosis) - Cloudy urine is not typically associated with postpartum assessment and may be due to other factors like dehydration.
3. Blood pressure 80/50 mm Hg: (Indication of potential worsening condition) - This blood pressure reading is low and could indicate hypotension, which is concerning postpartum.
4. Moderate lochia rubra: (Unrelated to diagnosis) - Lochia rubra is expected postpartum and is not directly related to the assessment findings.
5. Thready pulse: (Indication of potential improvement) - A thready pulse may indicate dehydration or hypovolemia, but if it improves over
Extract:
Question 5 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:
Correct Answer: D - Postpartum hemorrhage
Rationale: The client being 80% effaced and 8 cm dilated indicates she is in active labor and close to giving birth. This progression puts her at higher risk for postpartum hemorrhage due to the increased likelihood of excessive bleeding after delivery. The cervix being fully dilated means the client is close to delivering the baby, and the risk of postpartum hemorrhage is highest during and immediately after childbirth. This is why the nurse should be vigilant for signs of excessive bleeding and be prepared to intervene promptly.
Summary of other choices:
A: Ectopic pregnancy - Not relevant as the client is admitted to the birthing unit and already in active labor.
B: Hyperemesis gravidarum - Not relevant as this is a condition of severe nausea and vomiting in pregnancy, not associated with the client's current situation.
C: Incompetent cervix - Not relevant as the client is already 8 cm dil