ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Anticipate a prescription for misoprostol. Misoprostol is a medication commonly used to manage postpartum hemorrhage due to uterine atony. It works by causing uterine contractions, which can help stop the bleeding. Administering betamethasone (choice
A) is not indicated in this situation as it is a steroid used to promote fetal lung maturation in preterm labor. Avoiding sterile vaginal examinations (choice
B) may delay necessary interventions. Obtaining a specimen for a Kleihauer-Betke test (choice
D) is used to determine the amount of fetal-maternal hemorrhage, but it does not directly address the immediate issue of uterine atony and bleeding.
Extract:
A nurse is assessing a postpartum client who delivered vaginally 8 hr ago.
Exhibit 1 - Nurses' Notes: 0700
Breasts soft, nipples intact. Uterus palpated firm, midline, and at the level of the umbilicus.
Moderate amount of lochia rubra. Episiotomy site well approximated with mild edema and
ecchymosis. Client reports pain as 2 on a scale of 0 to 10. Able to void spontaneously; no bladder
distention. Deep tendon reflexes 1+. Peripheral edema 2+ in bilateral lower extremities.
Exhibit 2 - Nurses' Notes: 1100
Breasts soft, nipples intact. Uterus palpated soft with lateral deviation and 1 cm above the
umbilicus. Large amount of lochia rubra. Episiotomy site well approximated with mild edema
and ecchymosis. Client reports pain as 3 on a scale of 0 to 10. Deep tendon reflexes 1+.
Peripheral edema 2+ in bilateral lower extremities.
Question 2 of 5
Select the 3 findings that require immediate follow-up.
Correct Answer: A,B,C
Rationale: The correct findings that require immediate follow-up are A, B, and C.
A: Lateral deviation of the uterus indicates a potential complication like uterine atony or retained placental fragments.
B: Deep tendon reflexes of 1+ could indicate hyporeflexia, which may be a sign of neurological issues.
C: Pain rating of 3 on a scale of 0 to 10 (increased) suggests escalating pain that needs prompt assessment.
Other choices are incorrect:
D: Peripheral edema 2+ bilateral lower extremities could be expected postpartum due to fluid shifts.
E: Uterine tone soft is normal postpartum as the uterus involutes.
F: Large amount of lochia rubra is expected in the early postpartum period.
G: Blood pressure of 136/86 mm Hg is within normal limits postpartum.
Extract:
Question 3 of 5
A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching?
Correct Answer: B
Rationale: The correct answer is B: Transmission can occur via the saliva and urine of the newborn. Maternal cytomegalovirus (CMV) is commonly transmitted to the newborn through infected bodily fluids such as saliva and urine. This is important for the newly licensed nurses to understand as it highlights the need for strict infection control practices to prevent transmission to vulnerable infants.
Choice A is incorrect because acyclovir is not used for prophylactic treatment of CMV.
Choice C is incorrect as CMV typically does not present with visible lesions on the mother's genitalia.
Choice D is incorrect as airborne precautions are not necessary for newborns with CMV. It is crucial for nurses to focus on understanding the modes of transmission and prevention strategies for CMV to provide optimal care for both the mother and the newborn.
Question 4 of 5
A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, which of the following is the client’s estimated date of delivery?
Correct Answer: B
Rationale: The correct answer is B: May 17. Nägele's Rule involves adding 7 days to the first day of the last menstrual period (August 10), then subtracting 3 months, and finally adding 1 year. So, August 10 + 7 days = August 17. Subtracting 3 months gives May 17. This estimation is based on the assumption of a 28-day menstrual cycle.
Choice A (May 13) is incorrect because it does not account for the full 3 months.
Choice C (May 3) is incorrect as it miscalculates the 3 months and adds 7 days incorrectly.
Choice D (May 20) is wrong as it adds 7 days to the correct date but does not subtract the 3 months accurately.
Therefore, B is the correct choice based on the accurate application of Nägele's Rule.
Extract:
A nurse is caring for a newborn who was born at 39 weeks of gestation and is 36 hr old.
Physical Examination:
• Fontanels soft and flat
• Head molded with caput succedaneum
• Eyes symmetric, no discharge, sclera yellow
• Mucous membranes dry
• Abdomen soft and rounded, bowel sounds present x 4 quadrants
Question 5 of 5
Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A,B,C,G
Rationale: The nurse should report Coombs test result (
A) to the provider as it indicates potential hemolytic anemia. Mucous membrane assessment (
B) should be reported as changes can signify dehydration or infection. Intake and output (
C) should be reported to monitor fluid balance. Sclera color (G) should be reported as it can indicate liver dysfunction. The other choices, respiratory rate (
D), head assessment finding (E), heart rate (F), are important assessments but do not necessarily require immediate provider notification unless they are significantly abnormal and impacting the patient's condition.