ATI RN
ATI RN Maternal Newborn 2023/24 1st Attempt & Retake Questions
Extract:
Question 1 of 5
A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Facial petechiae. A nuchal cord occurs when the umbilical cord is wrapped around the baby's neck. This can cause pressure on the blood vessels, leading to tiny red or purple spots called petechiae on the baby's face. This is due to the rupture of small blood vessels under the skin. Telangiectatic nevi (choice
A) are unrelated birthmarks. Periauricular papillomas (choice
C) are benign skin-colored growths near the ears. Erythema toxicum (choice
D) is a common rash in newborns not associated with a nuchal cord.
Question 2 of 5
A nurse is caring for a client who is at 36 weeks of gestation and has methicillin-resistant Staphylococcus aureus. Which of the following types of isolation precautions should the nurse initiate?
Correct Answer: B
Rationale: The correct answer is B: Contact precautions. Methicillin-resistant Staphylococcus aureus (MRS
A) is typically spread through direct contact with an infected person or contaminated surfaces.
Therefore, the nurse should implement contact precautions to prevent the transmission of the bacteria. This includes wearing gloves and gowns when entering the client's room, ensuring proper hand hygiene, and using dedicated patient care equipment. Droplet precautions (choice
A) are used for pathogens spread via respiratory droplets, such as influenza. Protective environment (choice
C) is used for immunocompromised clients to protect them from environmental pathogens. Airborne precautions (choice
D) are for pathogens that remain suspended in the air, like tuberculosis.
Question 3 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 late preterm newborns can present with signs such as respiratory distress due to inadequate glucose supply to the brain, leading to central nervous system dysfunction. Hypertonia (choice
A) is not a typical sign of hypoglycemia. Increased feeding (choice
B) is a compensatory mechanism to raise blood glucose levels. Hyperthermia (choice
C) is not directly related to hypoglycemia.
Therefore, choice D is the most indicative of hypoglycemia in this scenario.
Question 4 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: The correct answer is D: Postpartum hemorrhage. The client being 80% effaced and 8 cm dilated indicates she is in active labor, not pregnant with an ectopic pregnancy. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, which is not related to the client's current condition. Incompetent cervix would present earlier in pregnancy with painless cervical dilation, not during active labor. Postpartum hemorrhage is a risk due to the advanced dilation and effacement, making the uterus more prone to atony and excessive bleeding after delivery.
Question 5 of 5
A nurse is assessing four newborns. Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: The correct answer is B. Failure to pass meconium stool within 48 hours could indicate a bowel obstruction, so it must be reported to the provider for further evaluation. A: Erythema toxicum is a common benign rash in newborns. C: Pink-tinged urine in a newborn may be due to urate crystals and is considered normal. D: An axillary temperature of 37.7°C is within the normal range for newborns.