ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Administer broad-spectrum antibiotics. This is crucial to prevent infection due to the exposed neural tissue. Administering antibiotics helps reduce the risk of meningitis, which can be life-threatening. Monitoring rectal temperature (
B) is important but not the priority. Cleansing the site with povidone-iodine (
C) can cause irritation and is not recommended. Surgical closure (
D) should be done as soon as possible to prevent complications, not after 72 hours.
Extract:
A nurse in the emergency department is caring for a 19-year-old client
who is at 18 weeks of gestation.
Exhibit 1
Nurses' Notes
Client presents with reports of nausea and vomiting for the past
several weeks, which has worsened in severity. Client states that
they have been unable to retain even clear fluids for the past 48
hr. Client reports no pain. Client reports a history of migraines
and asthma.
Question 2 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Correct Answer:
Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, D.
Rationale:
The correct actions to take for addressing hyperemesis gravidarum would be to insert a peripher-all access device for intravenous fluids and prepare the client for surgery if necessary. Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, which may require IV fluids and, in severe cases, surgical intervention. The nurse should monitor urine ketones to assess for dehydration and Kleihauer-Betke values to monitor for blood loss, both of which are important parameters to assess the client's progress in managing hyperemesis gravidarum.
Extract:
A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a new prescription for misoprostol.
Exhibit 2: Medical History
Preeclampsia
Cesarean birth of viable twin male newborns
Question 3 of 5
The nurse is assessing the client 30 min later. How should the nurse interpret the findings? For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication of potential improvement, or an indication of potential worsening condition.
| Findings 30 min later | Unrelated to diagnosis | Indication Of potential improvement | Indication of Potential worsening condition |
|---|---|---|---|
| Fundus at level of umbilicus | |||
| Cloudy urine | |||
| Blood pressure 80/50 mm Hg | |||
| Moderate lochia rubra | |||
| Thready pulse | |||
| Fundus firm to palpation |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
1. Fundus at level of umbilicus: (Indication of potential improvement) - This finding indicates the uterus is contracting well, which is a positive sign postpartum.
2. Cloudy urine: (Unrelated to diagnosis) - Cloudy urine is not typically associated with postpartum assessment and may be due to other factors like dehydration.
3. Blood pressure 80/50 mm Hg: (Indication of potential worsening condition) - This blood pressure reading is low and could indicate hypotension, which is concerning postpartum.
4. Moderate lochia rubra: (Unrelated to diagnosis) - Lochia rubra is expected postpartum and is not directly related to the assessment findings.
5. Thready pulse: (Indication of potential improvement) - A thready pulse may indicate dehydration or hypovolemia, but if it improves over
Extract:
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:
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 5 of 5
A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin. Which of the following actions should the nurse take to best evaluate the client’s medication adherence?
Correct Answer: D
Rationale: The correct answer is D: Check the client’s serum medication level. This is the best action to evaluate medication adherence for a client taking digoxin during pregnancy. Digoxin has a narrow therapeutic range, and monitoring serum levels helps ensure the medication is within the safe and effective range. Checking the medication level provides objective data on adherence compared to subjective responses from the client (choice
A). Assessing kidney function (choice
B) is important for digoxin dosing but does not directly evaluate adherence. Monitoring the apical pulse rate (choice
C) is essential for digoxin therapy but does not directly assess medication adherence. Checking the serum medication level is the most direct and reliable method to confirm if the client is taking the medication as prescribed.