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 answer is A, D, and E. The nurse should report respiratory, central nervous system, and gastrointestinal findings to the provider in a newborn at 70 hours old. Respiratory findings could indicate potential respiratory distress, CNS findings could signal neurological issues, and gastrointestinal findings could suggest feeding or digestion problems. Reporting these findings promptly allows the provider to assess and intervene if necessary, ensuring the newborn's well-being.
Choices B and C are typically monitored but are not the top priority in this scenario.
Extract:
Exhibit1 Graphic Record: Blood pressure 130/78 mm Hg Respiratory rate 20/min Heart rate 90/min
Exhibit2:Diagnostic Results Hemoglobin 12 g/dL (11 to 16 g/dL) Hematocrit 34% (33% (0 47%) 1-hr glucose tolerance test 120 mg/dL (less than 180-190 mg/dL)
Exhibit3 Progress Notes FundalFundal height 30 cm Good fetal movement Not experiencing headache, dizziness, blurred vision, or vaginal bleedingFetal heart rate 110/min
Question 2 of 5
A nurse in an antepartum clinic is providing weeks of gestation. Upon reviewing the following findings should the nurse report to the provider? (Click on the 'Exhibit' button for additional information about the client. There are three tabs that contain separate categories of data.)
Correct Answer: D
Rationale: The correct answer is D: Fetal heart rate (FHR). The nurse should report any abnormal fetal heart rate findings to the provider as it could indicate fetal distress or other complications. Monitoring FHR is crucial for assessing fetal well-being.
A: 1-hr glucose tolerance test is not relevant to the assessment of fetal well-being in this scenario.
B: Hematocrit is important for assessing the mother's blood volume but does not directly relate to fetal well-being.
C: Fundal height measurement helps estimate fetal growth but would not necessarily indicate an immediate concern that needs to be reported to the provider.
In summary, monitoring the FHR is essential for assessing fetal well-being and any abnormalities should be promptly reported for further evaluation and management.
Extract:
Question 3 of 5
A nurse who is caring for a client who is at 15 weeks of gestation, is Rh-negative, and has just had an amniocentesis. Which of the following interventions is the nurse's priority following the procedure?
Correct Answer: C
Rationale: The correct answer is C: Administer Rh(0) Immune globulin. After an amniocentesis, there is a risk of Rh sensitization due to potential mixing of maternal and fetal blood. Administering Rh(0) Immune globulin helps prevent the mother from developing antibodies against Rh-positive blood cells of the fetus. This intervention is crucial to prevent hemolytic disease of the newborn in subsequent pregnancies. Checking the client's temperature (
A) is important, but not the priority immediately after amniocentesis. Observing for uterine contractions (
B) is important but not the priority in this scenario. Monitoring the fetal heart rate (
D) is also important but not the priority post-amniocentesis.
Question 4 of 5
A nurse is assessing a client who gave birth vaginally 12 hr ago and palpates their uterus to the right above the umbilicus. Which of the following interventions should the nurse perform?
Correct Answer: C
Rationale: The correct answer is C: Assist the client to empty their bladder. Palpating the uterus above the umbilicus indicates uterine atony, which can be caused by a distended bladder pressing on the uterus. Emptying the bladder helps the uterus contract effectively, preventing postpartum hemorrhage.
Choice A is incorrect as immediate intervention is needed.
Choice B (administering simethicone) is irrelevant to the situation.
Choice D (instructing the client to lie on their right side) does not address the underlying issue.
Question 5 of 5
A nurse is assessing a newborn who was born at 26 weeks of gestation using the New Ballard Score. Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Minimal arm recoil. In premature newborns born at 26 weeks, they typically exhibit minimal arm recoil due to muscle tone immaturity. This is a key characteristic assessed through the New Ballard Score to determine gestational age accurately. The other choices are incorrect because: B: A popliteal angle of 90° is more indicative of full-term infants. C: Creases over the entire foot sole are typically seen in term infants. D: Raised areolas with 3 to 4 mm buds are also more common in full-term infants. E, F, G: These options are not relevant to the assessment of gestational age in newborns.