ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following findings should the nurse report to the provider?
Correct Answer: C
Rationale: The correct answer is C: Urine output of 280 mL within 8 hr. In hyperemesis gravidarum, excessive vomiting leads to dehydration and electrolyte imbalance. Monitoring urine output is crucial for assessing renal perfusion. A urine output of 280 mL in 8 hours is low, indicating possible renal impairment. This finding should be reported to the provider for further evaluation and intervention.
Choices A, B, and D are within normal limits for a client with hyperemesis gravidarum and receiving IV fluids. Blood pressure of 105/64 mm Hg is acceptable, heart rate of 98/min is slightly elevated but not alarming, and urine negative for ketones indicates adequate fluid replacement.
Extract:
The nurse is reviewing laboratory results in the adolescent's medical record.
Exhibit 1
Vital Signs
1300: Blood pressure 118/72 mm Hg, Heart rate 100/min ,Respiratory rate 20/min ,Temperature 38.3° C
(101° F)
Exhibit 2:
Provider Prescriptions 1300: Standing prescriptions for clients who present with abdominal pain: Obtain
laboratory tests: Urinalysis Cervical culture C-reactive protein Beta hCG
Exhibit 3:
Nurses' Notes 1300: Admitted adolescent reporting "cramping in my stomach." Reports pain as a 4 on 0
to 10 pain scale and describes pain as constant and dull. Reports nausea and vomiting over past 24
hours. Reports painful urination and pain during sexual intercourse with minimal vaginal itching-
Tenderness with palpation to lower abdomen, guarding abdomen observed. Greenish vaginal discharge
observed. Reports last menstrual period was 3 weeks ago as normal period lasted 4 days. “
Question 2 of 5
Which of the following conditions is the client most likely developing?
| Pelvic inflammatory. |
| Ectopic pregnancy. |
| Pyclonephritis. |
| C-reactive protein. |
| Beta hCG. |
| Urinalysis. |
Correct Answer: A
Rationale: [1, 0, 0, 0, 0, 0]
The correct answer is A: Pelvic inflammatory. Pelvic inflammatory disease is an infection of the female reproductive organs, often caused by sexually transmitted infections. It presents with symptoms like pelvic pain, abnormal vaginal discharge, and fever. Ectopic pregnancy (
B) is the implantation of a fertilized egg outside the uterus and presents with abdominal pain and vaginal bleeding. Pyelonephritis (
C) is a kidney infection, typically causing fever and flank pain. C-reactive protein (
D) is a marker for inflammation and infection, not a specific condition. Beta hCG (E) is a hormone produced in pregnancy. Urinalysis (F) is a test to analyze urine composition, not a condition.
Extract:
Question 3 of 5
A nurse is caring for a client who is to receive oxytocin to augment their labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider?
Correct Answer: A
Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, meaning the baby is not getting enough oxygen during contractions. Administering oxytocin, which can further stress the baby by increasing contractions, can worsen the situation. Late decelerations are a sign of fetal distress and require immediate intervention.
B: Moderate variability of the FHR is a normal finding and does not contraindicate the initiation of oxytocin.
C: Cessation of uterine dilation would suggest a potential issue with labor progress but does not directly contraindicate oxytocin.
D: Prolonged active phase of labor may warrant oxytocin to augment contractions but is not a contraindication itself.
Question 4 of 5
A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? (Select all that apply.)
Correct Answer: A, C
Rationale: The correct choices for administering oxytocin are A (flaccid uterus) and C (excess vaginal bleeding). Oxytocin is indicated to help contract the uterus, reducing bleeding and preventing postpartum hemorrhage. A flaccid uterus indicates poor uterine tone, which can lead to increased bleeding. Excess vaginal bleeding also indicates the need for oxytocin to aid in uterine contraction.
Choices B, D, and E are incorrect. Cervical laceration does not directly impact the need for oxytocin administration. Increased afterbirth cramping is a normal postpartum finding and does not necessarily require oxytocin. Increased maternal temperature is not a direct indication for oxytocin administration.
Question 5 of 5
A nurse is assessing a client who is in active labor. Which of the following findings should the nurse report to the provider?
Correct Answer: D
Rationale: The correct answer is D: PHR baseline 170/min. A baseline fetal heart rate (FHR) of 170/min is considered tachycardia in labor, which may indicate fetal distress. The nurse should report this finding to the provider promptly for further evaluation and intervention. Contractions lasting 80 seconds (choice
A) are within the normal range. Early decelerations (choice
B) are typically benign and do not require immediate intervention. A temperature of 37.4° C (choice
C) is slightly elevated but not a critical finding in active labor.
Therefore, choice D is the most concerning and requires immediate attention.