ATI RN
ATI Maternal Newborn Proctored Exam Latest Update Questions
Extract:
Question 1 of 5
A nurse is assessing a newborn following a circumcision. Which of the following should the nurse identify as an indication that the newborn is experiencing pain?
Correct Answer: B
Rationale: The correct answer is B: Chin quivering. This is because chin quivering is a common sign of pain in newborns following circumcision. It indicates discomfort or distress. Decreased heart rate (
A), pinpoint pupils (
C), and slowed respirations (
D) are not typical indicators of pain in newborns. A decrease in heart rate and slowed respirations may suggest relaxation or a calming response, while pinpoint pupils may indicate a different issue such as opioid overdose.
Question 2 of 5
A nurse is performing a physical assessment of a newborn. Which of the following clinical findings should the nurse expect? (Select all that apply).
Correct Answer: A,B,C,D
Rationale: The correct answer includes options A, B, C, and D. A newborn's normal heart rate ranges from 120 to 160 beats per minute, so a heart rate of 154/min (option
A) is within the expected range. A normal axillary temperature for a newborn is 97.7-99.5 F, so a temperature of 96.8 F (option
B) is slightly lower but still within the normal range. A newborn's normal respiratory rate is 30-60 breaths per minute, so a rate of 58/min (option
C) falls within the expected range. The average length of a full-term newborn is around 50 cm, so a length of 43 cm (option
D) is within the typical range for a newborn. Options E, F, and G are incorrect as they are not within the expected clinical findings for a newborn.
Question 3 of 5
A nurse is caring for a client who is in active labor and has had no cervical change in the last 4 hr. Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct answer is D. The nurse should inform the client that the provider will insert an intrauterine pressure catheter to monitor the strength of contractions. This is important because lack of cervical change in active labor could indicate ineffective contractions, which can lead to prolonged labor or fetal distress. Monitoring the strength of contractions with an intrauterine pressure catheter will help the healthcare team assess the effectiveness of contractions and make informed decisions on the next steps of labor management.
Other choices are incorrect:
A: Pushing without effective contractions can lead to exhaustion and fetal distress.
B: Medication to ripen the cervix is not indicated in this situation.
C: IV pain medicine does not address the issue of ineffective contractions.
E, F, G: No additional information provided.
Question 4 of 5
A nurse is caring for a 23-month-old child with iron-deficiency anemia.
Correct Answer: D
Rationale: Rationale for Correct Answer (
D): Giving liquid iron through a straw placed in the back of the mouth minimizes contact with teeth, reducing the risk of staining. This method also helps prevent aspiration and ensures proper administration. Summary of Incorrect
Choices: A: Cow's milk inhibits iron absorption; B: Citrus fruits aid iron absorption; C: While true, it is not the most immediate concern; E, F, G: No relevance to the scenario.
Question 5 of 5
A client is in the latent stage of labor. Which nursing intervention is most appropriate?
Correct Answer: A
Rationale: The correct answer is A: Encourage the client to walk in the hall until membranes rupture. In the latent stage of labor, it is essential to promote physical activity to help facilitate the progression of labor. Walking can help gravity assist in the descent of the fetus. It also helps in the dilation and effacement of the cervix. Additionally, walking can help distract the client from the discomfort of contractions. Encouraging walking until the membranes rupture can help maintain the client's energy levels and promote a more efficient labor process.
Choice B is incorrect as it describes the Valsalva maneuver, which is not appropriate during labor.
Choice C refers to a breathing technique that is not specifically indicated for the latent stage of labor.
Choice D is not recommended as eating a light meal during labor may lead to nausea or vomiting.