ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Exhibit1 Medical History Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (71b 12 0z) Apgar scores 8 at 1 min and 9 at 5 min Maternal history of methadone use during
pregnancy.
Exhibit2 vital signs 0700: Heart rate 156/min Respiratory rate 58/min Temperature 37.2° C (98.9° F) Oxygen saturation 98% on room air .1100: Heart rate 160/min Respiratory rate 60/min Temperature 37.3° C (99.2° F) Oxygen saturation 96%
on room air
Exhibit3 Physical Examination 1100: Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorouslyon pacifier but breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today.Exhibit4 (image)
Apgars: 7 at 1 min and 8 at 5 min of age Birth weight: 3,515 (7 1b 12 02) Maternal blood type: O+ Uncomplicated pregnancy. Maternal use of marijuana during pregnancy Client who gave birth plans to breastfeed
Question 1 of 5
A nurse is caring for a newborn who is 70 hr old. Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A, D, E
Rationale: The correct answers are A (Respiratory findings), D (Central nervous system findings), and E (Gastrointestinal findings). These are crucial areas to monitor in a newborn to ensure their well-being. Respiratory findings are important as newborns are prone to respiratory distress. Central nervous system findings are vital for assessing neurological status. Gastrointestinal findings are necessary to monitor feeding tolerance and bowel movements. Temperature, oxygen saturation, and other choices are also important but may not be as critical in this case. It is essential to focus on the key areas that can indicate potential issues and require immediate attention.
Extract:
Question 2 of 5
A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Report the client's condition to the local health department. This is important to ensure proper monitoring, follow-up, and infection control measures. Reporting is necessary for contact tracing, prevention of transmission, and accessing appropriate support services. Administering penicillin G (
A) is not indicated for HIV; the client needs antiretroviral therapy. Scheduling annual pelvic exams (
B) is important for general health but not specific to HIV care. Waiting until after delivery to start HIV medication (
C) is not recommended as timely treatment is crucial.
Question 3 of 5
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A. Frequent vomiting with weight loss of 3 lb in 1 week can indicate hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy that can lead to dehydration and electrolyte imbalances. This finding is concerning and requires immediate medical attention to prevent complications. Reporting this to the provider allows for timely intervention.
Other choices are incorrect:
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for immediate concern.
C: Nosebleeds occurring approximately 3 times per week can be due to increased blood flow during pregnancy and are usually not a significant concern unless severe or persistent.
D: Increased vaginal discharge is a common symptom in early pregnancy due to hormonal changes and increased blood flow to the pelvic area. It is not typically an urgent issue unless accompanied by other symptoms like itching or foul odor.
Question 4 of 5
A nurse is assessing a newborn who is 16 hr old. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Substernal retractions. Substernal retractions indicate respiratory distress in a newborn, which can be a serious issue requiring immediate medical attention. Acrocyanosis (choice
B) is a common finding in newborns and is not concerning. Overlapping suture lines (choice
C) can be normal in newborns and typically resolve on their own. A head circumference of 33 cm (13 in) (choice
D) is within the normal range for a newborn.
Question 5 of 5
A nurse is assessing a late preterm newborn. Which of the following manifestations is an indication of hypoglycemia?
Correct Answer: D
Rationale: The correct answer is D: Respiratory distress. Hypoglycemia in a late preterm newborn can lead to respiratory distress due to decreased glucose levels affecting cellular function and energy production. Hypertonia (choice
A) is not typically associated with hypoglycemia in newborns. Increased feeding (choice
B) may be a response to hypoglycemia but is not a direct manifestation. Hyperthermia (choice
C) is not a common sign of hypoglycemia.
Therefore, the correct choice is D as it directly reflects the impact of low glucose levels on respiratory function.