ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for a client who becomes unresponsive upon delivery of the placenta. 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 determine respiratory function (
Choice
A). This is crucial in an unresponsive client to assess airway patency, breathing, and circulation, which are the priorities in any emergency situation. Ensuring adequate oxygenation and ventilation is essential for the client's survival. Increasing IV fluid rate (
Choice
B) may be necessary later but is not the priority at this moment. Accessing emergency medications (
Choice
C) is important but assessing respiratory function takes precedence. Collecting a blood sample for coagulopathy studies (
Choice
D) can wait until the client's immediate needs are addressed.
Question 2 of 5
A nurse is caring for a client who is in labor and reports increasing rectal pressure. They are experiencing contractions 2 to 3 min apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that their cervix is dilated to 9 cm. The nurse should identify that the client is in which of the following phases of labor?
Correct Answer: D
Rationale: The correct answer is D: Descent. At 9 cm dilation, the client is in the second stage of labor, which consists of the descent and birth of the baby. Increasing rectal pressure indicates the baby is descending into the birth canal. Contractions 2-3 min apart lasting 80-90 seconds are characteristic of the active phase of the second stage. Passive descent (choice
A) refers to the initial descent of the baby before the active pushing stage. Active (choice
B) and early (choice
C) phases are terms used for the first stage of labor, not the second stage. The client's dilation and symptoms clearly indicate they are in the descent phase of the second stage of labor.
Question 3 of 5
A nurse is performing a routine assessment on a client who is at 18 weeks of gestation. Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: The correct answer is D: FHR 152/min. At 18 weeks gestation, the fetus's heart rate is typically around 140-160 beats per minute. This finding indicates normal fetal well-being. Deep tendon reflexes being 4+ (choice
A) is not relevant to gestational age assessment. Fundal height of 14 cm (choice
B) is too low for 18 weeks gestation. A blood pressure of 142/94 mm Hg (choice
C) is elevated for pregnancy and indicates hypertension.
Therefore, the correct answer is D.
Extract:
A nurse is caring for a newborn who is 48 hr old.
Exhibit 1
Vital Signs
Day 2, 0900:
Heart rate 174/min
Respiratory rate 88/min
Temperature 36.1° C (97.0° F)
Oxygen saturation 97% on room air
Exhibit 2
Diagnostic Results
Day 1, 0800: Newborn results
Blood type: A+
Urine toxicology screen: positive marijuana
Day 2, 0800: Newborn results
Total bilirubin 10 mg/dL (1.0 to 12.0 mg/dL)
Day 2, 0915:
Blood glucose: 38 mg/dL (expected value greater than 40 to 45
gm/dL
Exhibit 3
Nurses Notes
Day 2, 0900:
Newborn awake, alert, and crying. Loosely wrapped in one
blanket. Mild tremors noted. Yellow discoloration of mucus
membranes and sclera noted. Respirations 88/min, no
retractions, grunting, or nasal flaring noted. Diaper changed for
small amount of urine and transitional stool. Exhibit 4
Medical History
Apgars: 7 at 1 min and 8 at 5 min of age
Birth weight: 3,515 g (7 lb 12 oz)
Maternal blood type: O+
Uncomplicated pregnancy. Maternal use of marijuana during
pregnancy
Client who gave birth plans to breastfeed.
Question 4 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, E.
Rationale: The correct answer is to place newborn skin to skin on birthing parent's chest and encourage breastfeeding to address potential condition of Cold stress. Parameters to monitor are temperature and bilirubin level. Skin-to-skin contact and breastfeeding help regulate newborn's temperature and decrease risk of hypothermia. Cold stress can lead to increased bilirubin levels, so monitoring temperature and bilirubin levels will help assess the baby's progress. Incorrect options: Option A focuses on phototherapy and neonatal abstinence system scoring, which are not indicated for cold stress. Option C includes stool output and lung sounds, which are not relevant for assessing cold stress.
Extract:
Question 5 of 5
A nurse is assessing four newborns. Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: The correct answer is B because not passing meconium within 24-48 hours after birth can indicate a possible bowel obstruction or other underlying issue that needs immediate attention. Erythema toxicum (choice
A) is a common benign newborn rash. Pink-tinged urine (choice
C) may be due to uric acid crystals, which is normal in newborns. An axillary temperature of 37.7°C (99.9°F) (choice
D) is slightly elevated, but not alarming in a newborn.