ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is assessing the newborn of a client who took a selective serotonin reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI?
Correct Answer: D
Rationale: The correct answer is D: Vomiting. Newborns exposed to SSRIs in utero may experience withdrawal symptoms due to drug discontinuation at birth. Vomiting is a common withdrawal manifestation in newborns due to the sudden absence of the drug. Large for gestational age (choice
A) is not typically associated with SSRI withdrawal. Hyperglycemia (choice
B) and bradypnea (choice
C) are not typical withdrawal symptoms of SSRIs.
Therefore, the nurse should identify vomiting as an indication of withdrawal from an SSRI in the newborn.
Question 2 of 5
A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply.)
Correct Answer: A, B, D
Rationale: The correct answers are A, B, and D. Cholecystitis is a contraindication due to the risk of gallbladder disease. Hypertension is a contraindication because estrogen in oral contraceptives can exacerbate hypertension. Migraine headaches are a contraindication due to the increased risk of stroke. Human papillomavirus and anxiety disorder are not contraindications for oral contraceptives.
Question 3 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 assesses the well-being of the fetus immediately after the client's water breaking. Monitoring the fetal heart rate can provide crucial information on the baby's status and help identify any signs of distress. Performing Nitrazine testing (
A) or checking cervical dilation (
C) can be done after ensuring fetal well-being. Assessing the fluid (
B) can confirm if the amniotic sac has indeed ruptured but does not provide immediate information on fetal status.
Extract:
Exhibit1 Graphic Record: Blood pressure 130/78 mm Hg Respiratory rate 20/min Heart rate 90/min
Exhibit2:Diagnostic Results Hemoglobin 12 g/dL (11 to 16 g/dL) Hematocrit 34% (33% (0 47%) 1-hr glucose tolerance test 120 mg/dL (less than 180-190 mg/dL)
Exhibit3 Progress Notes FundalFundal height 30 cm Good fetal movement Not experiencing headache, dizziness, blurred vision, or vaginal bleedingFetal heart rate 110/min
Question 4 of 5
A nurse in an antepartum clinic is providing weeks of gestation. Upon reviewing the following findings should the nurse report to the provider? (Click on the 'Exhibit' button for additional information about the client. There are three tabs that contain separate categories of data.)
Correct Answer: D
Rationale: The correct answer is D: Fetal heart rate (FHR). The nurse should report any abnormal findings related to fetal well-being to the provider. Monitoring the FHR is crucial to assess the baby's status and can indicate potential issues such as fetal distress. In this scenario, if the FHR is abnormal (e.g., too high or too low), it could signal a problem that needs immediate attention.
A: 1-hr glucose tolerance test - This is typically done to screen for gestational diabetes and is not directly related to fetal well-being.
B: Hematocrit - This measures the volume percentage of red blood cells in blood and is more related to maternal health.
C: Fundal height measurement - This assesses fetal growth and position, but abnormal findings may not require immediate provider notification unless significant deviations are noted.
In summary, the other choices are not as time-sensitive or directly indicative of fetal distress as the FHR, making D the correct answer in this context.
Extract:
Exhibit1 Medical History Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (71b 12 0z) Apgar scores 8 at 1 min and 9 at 5 min Maternal history of methadone use during
pregnancy.
Exhibit2 vital signs 0700: Heart rate 156/min Respiratory rate 58/min Temperature 37.2° C (98.9° F) Oxygen saturation 98% on room air .1100: Heart rate 160/min Respiratory rate 60/min Temperature 37.3° C (99.2° F) Oxygen saturation 96%
on room air
Exhibit3 Physical Examination 1100: Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorouslyon pacifier but breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today.Exhibit4 (image)
Apgars: 7 at 1 min and 8 at 5 min of age Birth weight: 3,515 (7 1b 12 02) Maternal blood type: O+ Uncomplicated pregnancy. Maternal use of marijuana during pregnancy Client who gave birth plans to breastfeed
Question 5 of 5
A nurse is caring for a newborn who is 70 hr old. Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A, D, E
Rationale: The correct answers are A (Respiratory findings), D (Central nervous system findings), and E (Gastrointestinal findings). These are crucial areas to monitor in a newborn to ensure their well-being. Respiratory findings are important as newborns are prone to respiratory distress. Central nervous system findings are vital for assessing neurological status. Gastrointestinal findings are necessary to monitor feeding tolerance and bowel movements. Temperature, oxygen saturation, and other choices are also important but may not be as critical in this case. It is essential to focus on the key areas that can indicate potential issues and require immediate attention.