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:
Correct
Answer: C. Anticipate a prescription for misoprostol.
Rationale: Misoprostol is a medication that helps to induce uterine contractions, which can help control postpartum bleeding due to uterine atony. It is a common pharmacological intervention for this situation.
Incorrect
Choices:
A: Administering betamethasone IM is not indicated for postpartum hemorrhage due to uterine atony. This medication is typically used for fetal lung maturation in preterm labor.
B: Avoiding performing sterile vaginal examinations does not address the primary concern of uterine atony and postpartum bleeding. Assessing the uterus and bleeding are crucial in this situation.
D: Obtaining a specimen for a Kleihauer-Betke test is used to determine the amount of fetal-maternal hemorrhage in Rh-negative women. While important in some situations, it is not the priority in managing postpartum hemorrhage.
Question 2 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, subtracting 3 months, and adding 1 year. In this case, August 10 + 7 days = August 17, subtracting 3 months gives May 17. This calculation estimates the date of delivery.
Choice A (May 13) is incorrect as it doesn't account for the full calculation process.
Choice C (May 3) is incorrect as it doesn't consider adding 7 days.
Choice D (May 20) is incorrect as it doesn't involve subtracting 3 months.
Question 3 of 5
A nurse is caring for a client who is at 36 weeks of gestation and has methicillin-resistant Staphylococcus aureus. Which of the following types of isolation precautions should the nurse initiate?
Correct Answer: B
Rationale: The correct answer is B: Contact precautions. Methicillin-resistant Staphylococcus aureus (MRS
A) is typically spread through direct contact with an infected person or contaminated surfaces.
Therefore, initiating contact precautions is essential to prevent the spread of the infection to other individuals. This includes wearing gloves and gowns when providing care to the client, ensuring proper hand hygiene, and properly cleaning and disinfecting the environment.
The other choices are incorrect:
A: Droplet precautions are used for infections spread through respiratory droplets (e.g., influenza, pertussis), not MRSA.
C: Protective environment precautions are used for clients with compromised immune systems to protect them from environmental pathogens, not for MRSA.
D: Airborne precautions are used for infections spread through airborne particles (e.g., tuberculosis, chickenpox), not MRSA.
Question 4 of 5
A nurse is caring for a client immediately following the delivery of a stillborn fetus. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Provide the client with photos of the fetus. This action allows the client to have tangible memories of their stillborn child, which can aid in the grieving process and provide closure. Providing photos is a sensitive and compassionate gesture that acknowledges the significance of the loss. It also respects the client's autonomy in choosing how they wish to remember their child.
The other choices are not appropriate in this situation:
A: Limiting the time the fetus is in the room may not consider the emotional needs of the client.
C: Instructing the client about an autopsy may be insensitive and distressing without discussing it first with the client.
D: Informing the client about naming the fetus is not a legal requirement and could add unnecessary pressure during a difficult time.
Question 5 of 5
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D. Labor induction with oxytocin can lead to uterine hyperstimulation, increasing the risk of postpartum hemorrhage. Vacuum-assisted delivery can cause trauma to the birth canal and uterus, also increasing the risk. History of uterine atony indicates a previous inability of the uterus to contract effectively after delivery, predisposing the client to postpartum hemorrhage.
Incorrect answers:
B: Newborn weight is not directly related to the risk of postpartum hemorrhage.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
In summary, choices A, C, and D are directly linked to postpartum hemorrhage risk due to their impact on uterine contraction and trauma during delivery, while choices B and E are not causative factors.