ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take?
Correct Answer: C
Rationale:
Correct Answer: C - Initiate seizure precautions.
Rationale:
1. Neonatal abstinence syndrome can lead to neurological complications, including seizures.
2. Initiating seizure precautions involves creating a safe environment to prevent injury during a seizure.
3. This action prioritizes the infant's safety and well-being.
4. Monitoring blood glucose level every hour (
A) is not typically indicated for neonatal abstinence syndrome.
5. Placing the infant on his back with legs extended (
B) is a basic positioning technique but not directly related to managing seizures.
6. Providing a stimulating environment (
D) can exacerbate symptoms in an infant with neonatal abstinence syndrome.
Question 2 of 5
A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?
Correct Answer: D
Rationale:
Correct Answer: D - Postpartum hemorrhage
Rationale: The client being 80% effaced and 8 cm dilated indicates she is in active labor and close to giving birth. This progression puts her at higher risk for postpartum hemorrhage due to the increased likelihood of excessive bleeding after delivery. The cervix being fully dilated means the client is close to delivering the baby, and the risk of postpartum hemorrhage is highest during and immediately after childbirth. This is why the nurse should be vigilant for signs of excessive bleeding and be prepared to intervene promptly.
Summary of other choices:
A: Ectopic pregnancy - Not relevant as the client is admitted to the birthing unit and already in active labor.
B: Hyperemesis gravidarum - Not relevant as this is a condition of severe nausea and vomiting in pregnancy, not associated with the client's current situation.
C: Incompetent cervix - Not relevant as the client is already 8 cm dil
Question 3 of 5
A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching?
Correct Answer: B
Rationale: The correct answer is B: Transmission can occur via the saliva and urine of the newborn. Maternal cytomegalovirus (CMV) is commonly transmitted to the newborn through infected bodily fluids such as saliva and urine. This is important for the newly licensed nurses to understand as it highlights the need for strict infection control practices to prevent transmission to vulnerable infants.
Choice A is incorrect because acyclovir is not used for prophylactic treatment of CMV.
Choice C is incorrect as CMV typically does not present with visible lesions on the mother's genitalia.
Choice D is incorrect as airborne precautions are not necessary for newborns with CMV. It is crucial for nurses to focus on understanding the modes of transmission and prevention strategies for CMV to provide optimal care for both the mother and the newborn.
Question 4 of 5
A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum. Which of the following actions should the nurse take?
Correct Answer: A
Rationale:
Correct Answer: A - Apply a moist, warm compress to the perineum.
Rationale: Applying a moist, warm compress helps to reduce swelling, promote healing, and provide comfort to the client with a fourth-degree laceration. The warmth improves blood circulation to the area, aiding in the healing process. It also helps to relieve pain and discomfort.
Summary of other choices:
B: Providing a cool sitz bath may be too cold and uncomfortable for the client with a fourth-degree laceration.
C: Administering methylergonovine is not indicated for a perineal laceration and may cause adverse effects such as hypertension.
D: Applying povidone-iodine to the perineum can be too harsh and may delay healing of the laceration. It is not recommended for this situation.
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.
A: Labor induction with oxytocin can lead to uterine atony, increasing the risk of postpartum hemorrhage.
C: Vacuum-assisted delivery can cause uterine atony and trauma, contributing to postpartum hemorrhage.
D: History of uterine atony indicates a previous issue with uterine contractions, making the client more susceptible to postpartum hemorrhage.
B: Newborn weight is not directly related to postpartum hemorrhage risk.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
In summary, labor induction with oxytocin, vacuum-assisted delivery, and a history of uterine atony are factors that place the client at risk for postpartum hemorrhage.