ATI RN
ATI Maternal NewBorn Proctored Exam 2023 with NGN All 70 Questions With Answers Questions
Extract:
Question 1 of 5
A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control. Which of the following actions should the nurse include in the plan of care?
Correct Answer: C
Rationale:
Correct Answer: C. Monitor the client's blood pressure every 5 minutes following the first dose of anesthetic solution.
Rationale: Continuous monitoring of the client's blood pressure is crucial after administering epidural anesthesia to detect any potential hypotension, a common side effect. By monitoring every 5 minutes, the nurse can promptly intervene if hypotension occurs, preventing maternal and fetal compromise.
Summary of other choices:
A: Placing the client in a supine position can lead to hypotension due to inferior vena cava compression. Incorrect.
B: Administering dextrose solution is unrelated to epidural anesthesia and not indicated for pain control. Incorrect.
D: NPO status is not directly related to epidural anesthesia administration. Incorrect.
Question 2 of 5
A nurse is providing teaching to a client who is breastfeeding and experiencing engorgement. Which of the following recommendations should the nurse include?
Correct Answer: A
Rationale: The correct answer is A: Apply warm compresses on the breasts before feedings. Warm compresses help to promote milk flow and relieve engorgement by increasing blood flow to the area. This can make it easier for the baby to latch and feed effectively. It is important to address engorgement promptly to prevent complications such as blocked ducts or mastitis.
Option B is incorrect because allowing the infant to nurse on one breast per feeding may not fully empty the breasts, leading to further engorgement. Option C is incorrect because aspirin is not recommended during breastfeeding due to potential risks to the infant. Option D is incorrect because wearing a tight-fitting underwire bra can constrict the breasts and worsen engorgement.
Question 3 of 5
A nurse is caring for a postpartum client who is receiving heparin via a continuous IV infusion for thrombophlebitis in their left calf. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Maintain the client on bed rest. In a client receiving heparin for thrombophlebitis, bed rest is essential to prevent dislodgment of the clot and avoid further complications. Moving around can increase the risk of embolism. Administering aspirin (choice
A) is not recommended as it can increase the risk of bleeding with heparin. Massaging the affected leg (choice
C) can dislodge the clot leading to embolism. Applying cold compresses (choice
D) can also increase the risk of dislodging the clot. The key is to promote circulation without dislodging the clot, which is achieved by keeping the client on bed rest.
Question 4 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 of gestation, they typically exhibit minimal arm recoil due to their immature neuromuscular development. This is a key characteristic assessed in the New Ballard Score to determine the gestational age of the newborn.
Choices B, C, and D are incorrect as they do not align with the expected findings in a premature newborn at 26 weeks of gestation. Popliteal angle of 90° (
Choice
B) is more typical in a term newborn. Creases over the entire foot sole (
Choice
C) are also more common in term newborns. Raised areolas with 3 to 4 mm buds (
Choice
D) are indicative of a more mature newborn and not typically seen in a premature newborn at 26 weeks of gestation.
Question 5 of 5
A nurse is performing a routine assessment on a client who is at 18 weeks of gestation. Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: The correct answer is D: FHR 152/min. At 18 weeks gestation, a normal fetal heart rate (FHR) ranges from 120-160/min. This is indicative of a healthy fetus. A: Deep tendon reflexes 4+ is not a typical finding during a routine assessment in pregnancy. B: Fundal height of 14 cm is more consistent with around 12-13 weeks gestation, not 18 weeks. C: Blood pressure of 142/94 mm Hg is elevated and may indicate hypertension, which is not expected at this stage of pregnancy.