ATI RN
ATI RN Maternal Newborn 2023/24 1st Attempt & Retake Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is at 41 weeks of gestation and has a positive contraction stress test. For which of the following diagnostic tests should the nurse prepare the client?
Correct Answer: C
Rationale: The correct answer is C: Biophysical profile (BPP). This test evaluates the fetus's well-being by assessing fetal heart rate, fetal breathing movements, fetal movement, fetal tone, and the volume of amniotic fluid. In a client at 41 weeks with a positive contraction stress test, a BPP helps determine if immediate delivery is necessary due to potential fetal distress.
Percutaneous umbilical blood sampling (
A) is used to directly sample fetal blood and assess fetal oxygenation but is not typically indicated in this scenario. Amnioinfusion (
B) is used to relieve variable decelerations during labor by infusing sterile fluid into the amniotic cavity, which is not relevant to a client at 41 weeks of gestation with a positive contraction stress test. Chorionic villus sampling (
D) is an invasive procedure to diagnose genetic abnormalities early in pregnancy and is not indicated for assessing fetal well-being at 41 weeks.
Question 2 of 5
A nurse is caring for a postpartum client who is receiving heparin via a continuous IV infusion for thrombophlebitis in their left calf. Which of the following actions should the nurse take?
Correct Answer: B
Rationale:
Rationale:
Choice B is correct because bed rest helps prevent further clot formation and reduces the risk of embolism. Movement can dislodge the clot. Aspirin (
Choice
A) can increase bleeding risk. Massaging (
Choice
C) can dislodge clots. Cold compresses (
Choice
D) can also increase bleeding risk and dislodge clots.
Question 3 of 5
A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse see first?
Correct Answer: A
Rationale: The correct answer is A: A client who is at 11 weeks of gestation and reports abdominal cramping. Abdominal cramping in early pregnancy can be a sign of ectopic pregnancy, miscarriage, or other complications requiring immediate attention. The nurse should see this client first to assess the situation and provide appropriate interventions.
Choice B is incorrect because tingling and numbness in the right hand is not typically an urgent issue in pregnancy.
Choice C is incorrect as constipation, while uncomfortable, is not an immediate concern that requires urgent attention.
Choice D is incorrect as bloody noses can be common in pregnancy due to increased blood volume and nasal congestion, but it does not require immediate attention unless severe or persistent.
Question 4 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, which can worsen with oxytocin administration due to increased uterine contractions. This can lead to fetal distress and hypoxia. Late decelerations are a sign to stop or decrease the oxytocin infusion and notify the provider. Moderate variability of the FHR (
B) is a reassuring sign of fetal well-being. Cessation of uterine dilation (
C) may indicate a stalled labor but is not a contraindication for initiating oxytocin. Prolonged active phase of labor (
D) may warrant oxytocin augmentation but is not a contraindication.
Question 5 of 5
A nurse is caring for a newborn who was transferred to the nursery 30 min after birth because of mild respiratory distress. Which of the following actions should the nurse take first?
Correct Answer: B
Rationale: The correct answer is B: Verify the newborn's identification. This should be the first action taken because ensuring the correct identification of the newborn is crucial for providing appropriate care. Incorrect identification could lead to serious consequences, such as administering medications or treatments to the wrong infant. Confirming the newborn's Apgar score (choice
A) or administering vitamin K (choice
C) can wait until the identification is verified. Determining obstetrical risk factors (choice
D) is important but not the immediate priority.