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 receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?
Correct Answer: C
Rationale: The correct answer is C: Hypotension. Opioid analgesics can cause hypotension as a common adverse effect by decreasing systemic vascular resistance and cardiac output. The vasodilatory effects of opioids can lead to a drop in blood pressure, which can be more pronounced when combined with an epidural block. Monitoring for hypotension is crucial to prevent complications such as decreased perfusion to vital organs.
Other choices are incorrect because:
A: Hyperglycemia is not a common adverse effect of opioid analgesics.
B: Bilateral crackles are more indicative of fluid overload or pulmonary edema, not related to opioid analgesics.
D: Polyuria is not a typical adverse effect of opioids; they are more likely to cause urinary retention.
In summary, monitoring for hypotension is essential when a client is receiving an epidural block with an opioid analgesic to ensure hemodynamic stability.
Extract:
A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis.
Medical History:
• Gravida 2 Para 2
• Cesarean birth
• Deep vein thrombosis with previous pregnancy
• Preeclampsia
• BMI of 32
Question 2 of 5
A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis.
| Findings 24 hr later | Indication of worsening condition | Indication of improving condition |
|---|---|---|
| Increased warmth in the extremity | ||
| Tachycardia | ||
| Leukocytosis | ||
| Scant lochia rubra | ||
| Decreased extremity edema |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Increased warmth in the extremity: Indicates worsening condition as it can be a sign of infection or inflammation in deep vein thrombosis.
- Tachycardia: Indicates worsening condition as it can be a sign of stress on the cardiovascular system due to the clot.
- Leukocytosis: Indicates worsening condition as it can be a sign of infection or inflammation.
- Scant lochia rubra: Indicates improving condition as it suggests reduced postpartum bleeding, which is a positive sign.
Extract:
Question 3 of 5
A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer?
Correct Answer: A
Rationale: The correct answer is A: 8 tablets.
To calculate the number of tablets needed, divide the total dosage (2g) by the dosage per tablet (250mg). 2g = 2000mg, so 2000mg ÷ 250mg = 8 tablets. This ensures the client receives the correct total dose for effective treatment. Option B: 4 tablets is incorrect as it does not match the calculated dosage. Option C: 2 tablets is incorrect as it is half of the required dosage. Option D: 1 tablet is incorrect as it is a quarter of the needed dosage.
Question 4 of 5
A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Single palmar creases. This finding may indicate Down Syndrome. Reporting it is crucial for further evaluation and appropriate care. Single palmar creases are a physical characteristic associated with Down Syndrome, making it essential to inform the provider for thorough assessment and potential early intervention. The other choices are not indicative of immediate concern for a full-term newborn. Down Syndrome (
B) may be associated with single palmar creases, but it is not the clinical finding that should be reported. Rust-stained urine (
C), transient circumoral cyanosis (
D), and subconjunctival hemorrhage (E) are common and usually benign in newborns, requiring monitoring but not immediate reporting.
Question 5 of 5
A nurse is caring for a client who is hypotensive following the administration of epidural anesthesia. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Turn the client to a side-lying position. This action helps improve venous return to the heart, increasing blood pressure in a hypotensive client. Gravity assists in redistributing blood volume, which can help stabilize the client's blood pressure. Turning the client to a side-lying position also helps prevent compression of the inferior vena cava, which can occur when the client is supine, contributing to hypotension.
Choices B, C, and D are incorrect in this scenario. Applying oxygen via nasal cannula may be needed in some cases, but it does not directly address hypotension caused by epidural anesthesia. Massaging the fundus is not relevant in this situation, as it is typically done postpartum to aid in uterine contraction. Assisting the client to empty their bladder may be important for overall comfort but does not directly address hypotension.