ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is obtaining a 2-hr postprandial blood glucose from a client. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Select the lateral side of the finger for puncture. This is because the lateral side of the finger has fewer nerve endings, making it less painful for the client. Puncturing the finger while it is still damp with antiseptic solution (choice
A) can dilute the blood sample. Smearing the blood onto the reagent strip (choice
B) can lead to inaccurate results. Holding the finger above the heart prior to puncture (choice
C) can affect blood flow and glucose levels.
Therefore, selecting the lateral side of the finger for puncture ensures a less painful and accurate blood glucose reading.
Question 2 of 5
A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Assist the client in pulling their knees toward their abdomen. This maneuver helps to widen the pelvic outlet, reducing the angle between the sacrum and the pubic symphysis, thus allowing for easier delivery of the baby's shoulder. By bringing the knees closer to the abdomen, the nurse can help facilitate the rotation of the baby's shoulder, aiding in the resolution of shoulder dystocia.
Applying pressure to the client's fundus (
Choice
A) would not directly address the shoulder dystocia. Pressing firmly on the client’s suprapubic area (
Choice
B) may not be effective in resolving shoulder dystocia. Moving the client onto their hands and knees (
Choice
C) could potentially worsen the situation by further obstructing the baby's passage.
In summary, the McRoberts maneuver, which involves assisting the client in pulling their knees toward their abdomen, is the most appropriate action in managing shoulder dystocia during the second stage of
Extract:
A nurse is assessing a postpartum client who delivered vaginally 8 hr ago.
Exhibit 1 - Nurses' Notes: 0700
Breasts soft, nipples intact. Uterus palpated firm, midline, and at the level of the umbilicus.
Moderate amount of lochia rubra. Episiotomy site well approximated with mild edema and
ecchymosis. Client reports pain as 2 on a scale of 0 to 10. Able to void spontaneously; no bladder
distention. Deep tendon reflexes 1+. Peripheral edema 2+ in bilateral lower extremities.
Exhibit 2 - Nurses' Notes: 1100
Breasts soft, nipples intact. Uterus palpated soft with lateral deviation and 1 cm above the
umbilicus. Large amount of lochia rubra. Episiotomy site well approximated with mild edema
and ecchymosis. Client reports pain as 3 on a scale of 0 to 10. Deep tendon reflexes 1+.
Peripheral edema 2+ in bilateral lower extremities.
Question 3 of 5
Select the 3 findings that require immediate follow-up.
Correct Answer: A,B,C
Rationale: The correct findings that require immediate follow-up are A, B, and C.
A: Lateral deviation of the uterus indicates a potential complication like uterine atony or retained placental fragments.
B: Deep tendon reflexes of 1+ could indicate hyporeflexia, which may be a sign of neurological issues.
C: Pain rating of 3 on a scale of 0 to 10 (increased) suggests escalating pain that needs prompt assessment.
Other choices are incorrect:
D: Peripheral edema 2+ bilateral lower extremities could be expected postpartum due to fluid shifts.
E: Uterine tone soft is normal postpartum as the uterus involutes.
F: Large amount of lochia rubra is expected in the early postpartum period.
G: Blood pressure of 136/86 mm Hg is within normal limits postpartum.
Extract:
Question 4 of 5
A nurse is caring for a newborn who has jaundice and a new prescription for phototherapy. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Close the newborn's eyes before applying eyepatches. During phototherapy for jaundice, the baby's eyes should be protected from the light to prevent damage. Closing the newborn's eyes with eyepatches is crucial to shield them. Providing glucose water (
A), turning every 4 hours (
B), and applying hydrating lotion (
C) are not directly related to the phototherapy treatment. These actions could be unnecessary or even harmful. By selecting answer D, the nurse ensures the safety and well-being of the newborn during the phototherapy session.
Question 5 of 5
A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale:
Correct Answer: A
Rationale: The correct answer is A because a woman's body changes after giving birth, affecting the fit of the diaphragm. Getting refitted ensures proper sizing for effective contraception.
Choice B is incorrect because oil-based lubricants can damage latex diaphragms.
Choice C is incorrect as diaphragms should be kept in place for 6-8 hours, not 4.
Choice D is incorrect as diaphragms should be stored in a cool, dry place, not sterile water.