ATI RN Maternal Newborn level 3 Final Exam 2023 (All Correct Answers). Maternal-Child Nursing -Nurselytic

Correct Answer: B

Rationale: The correct answer is B: Single palmar creases. This finding may indicate the presence of Down syndrome or other chromosomal abnormalities. It is important to report this to the provider for further evaluation and testing. Transient circumoral cyanosis is common in newborns and usually resolves on its own. Subconjunctival hemorrhage is also common and typically resolves without treatment. Rust-stained urine may result from urate crystals and is normal in newborns within the first few days of life. It is not a cause for concern and does not require immediate reporting to the provider.

Correct Answer: B

Rationale: The correct answer is B: A client who has gestational diabetes mellitus. Misoprostol is commonly used for labor induction in cases of gestational diabetes mellitus to prevent complications associated with prolonged pregnancy. It helps in ripening the cervix and initiating contractions. Clients with active genital herpes are not candidates for misoprostol due to the risk of exacerbating the infection. Clients with a previous uterine incision are at risk for uterine rupture with misoprostol. Clients with placenta previa should not undergo labor induction with misoprostol due to the risk of increasing bleeding.

Correct Answer: A

Rationale: The correct answer is A: Position a wedge under the client's left hip. Placing a wedge under the left hip helps to optimize the effectiveness of the epidural by promoting even distribution of the medication, ensuring proper pain management during labor. This position also helps to prevent nerve compression and potential complications.
B: Placing the client in the lithotomy position is not recommended as it can increase the risk of nerve compression and hinder the effectiveness of the epidural.
C: Assisting the client to a knee-chest position is not appropriate for a client with an epidural, as it can cause discomfort and compromise the effectiveness of the medication.
D: Elevating the head of the client's bed to 90% is unrelated to the management of an epidural and does not contribute to optimal pain relief.

Correct Answer: C

Rationale: The correct answer is C. The nurse should assess the client with hyperemesis gravidarum and a sodium level of 110 mEq/L first as this indicates severe dehydration and electrolyte imbalance, which can lead to serious complications like seizures and cardiac arrhythmias. Hydration and electrolyte balance are critical for both maternal and fetal well-being.


Choice A is not the priority as a client with diabetes mellitus and an HbA1c of 5.8% is within target range and does not require immediate assessment.
Choice B is not the priority as a creatinine level of 1.1 mg/dL is within normal limits for pregnancy and does not indicate an urgent situation.
Choice D is not the priority as a hematocrit of 36% in a client with placenta previa is not concerning unless there are signs of active bleeding.

Correct Answer: D

Rationale: The correct answer is D: Feed the newborn immediately. Newborns of mothers with diabetes are at risk for hypoglycemia due to increased insulin production in response to the mother's high blood glucose levels during pregnancy. Feeding the newborn helps increase blood glucose levels by providing essential nutrients. Administering IV dextrose solution (
A) is not necessary at this time as the glucose level is only slightly low and can be corrected with feeding. Obtaining a blood sample (
B) may delay necessary intervention. Reassessing blood glucose (
C) before feeding may further delay treatment.