ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
Order the Items
Source Container
Correct Answer: B, C, D, A
Rationale: The correct order for performing Leopold maneuvers is B, C, D, A. Firstly, palpating the fundus (
B) helps determine the fetal part. Next, determining the location of the fetal back (
C) guides the nurse to find the fetal back. Palpating for the fetal part at the inlet (
D) helps identify its presentation. Lastly, identifying the attitude of the head (
A) completes the assessment. Other choices are not relevant to the sequential assessment in Leopold maneuvers.
Extract:
A nurse is caring for a newborn.
Exhibit1
Vital Signs
8 hr of age:
Temperature: 37.1° C (98.8° F) Axillary
Pulse rate: 132/min
Respiratory rate: 52/min
36 hr of age:
Temperature: 36.1° C (97" F) Axillary
Pulse rate: 160/min
Respiratory rate: 78/min”
Question 2 of 5
For each assessment finding, click to specify if the finding is consistent with hypoglycemia, hyperbilirubinemia, or sepsis.
| Assessment Findings | Hypoglycemia | Hyperbilirubinemia | Sepsis | |
|---|---|---|---|---|
| Ecchymotic caput Succedaneum. | ||||
| Decreased temperature. | ||||
| Lethargy. | ||||
| Poor feeding. | ||||
| Respiratory distress. | ||||
| Yellow sclera and oral mucosa. |
Correct Answer: B, C, D, E, F
Rationale: The correct answer is because decreased temperature (
B), lethargy (
C), poor feeding (
D), respiratory distress (E), and yellow sclera and oral mucosa (F) are consistent with hypoglycemia, hyperbilirubinemia, and sepsis. Decreased temperature can indicate hypoglycemia, lethargy and poor feeding can be seen in hypoglycemia and sepsis, respiratory distress can be a sign of sepsis, and yellow sclera and oral mucosa can be indicative of hyperbilirubinemia. Ecchymotic caput succedaneum is more related to birth trauma and is not specific to these conditions.
Extract:
Question 3 of 5
A nurse is assessing a client who is in active labor. Which of the following findings should the nurse report to the provider?
Correct Answer: D
Rationale: The correct answer is D: PHR baseline 170/min. A baseline fetal heart rate (FHR) of 170/min is considered tachycardia in labor, which may indicate fetal distress. The nurse should report this finding to the provider promptly for further evaluation and intervention. Contractions lasting 80 seconds (choice
A) are within the normal range. Early decelerations (choice
B) are typically benign and do not require immediate intervention. A temperature of 37.4° C (choice
C) is slightly elevated but not a critical finding in active labor.
Therefore, choice D is the most concerning and requires immediate attention.
Extract:
A nurse is caring for a postpartum client in an outpatient setting
Exhibit1:
History and Physical
G1P1, spontaneous vaginal delivery with median episiotomy at 39 weeks of gestation.
Newborn 4,508 g (9 lb 15 oz), APGARs: 8 at 1 min, 9 at 5 min
group B streptococcus 8-hemolytic: positive (negative)
Received 2 doses of Intravenous penicillin G while in labor”
Question 4 of 5
complete the following sentence by using the lists of options. The client is at highest risk for developing ---evidenced by the client's ---
| Endometritis. |
| Mastitis. |
| Postpartum hemorrhage. |
| Group B streptococcus positive status. |
| Spontaneous vaginal delivery. |
| Median episiotomy. |
Correct Answer: A
Rationale:
Correct
Answer: A
Rationale:
1. Endometritis is an infection of the uterine lining, commonly occurring post-delivery.
2. The client's risk for endometritis increases due to factors like prolonged labor, multiple vaginal exams, and retained placental fragments.
3. The client's condition or symptoms may include fever, uterine tenderness, foul-smelling lochia.
4. The other options (B-F) are not directly related to the highest risk for developing endometritis post-delivery.
Extract:
A nurse is caring for a newborn who is 48 hr old.
Exhibit 1
Vital Signs
Day 2, 0900:
Heart rate 174/min
Respiratory rate 88/min
Temperature 36.1° C (97.0° F)
Oxygen saturation 97% on room air
Exhibit 2
Diagnostic Results
Day 1, 0800: Newborn results
Blood type: A+
Urine toxicology screen: positive marijuana
Day 2, 0800: Newborn results
Total bilirubin 10 mg/dL (1.0 to 12.0 mg/dL)
Day 2, 0915:
Blood glucose: 38 mg/dL (expected value greater than 40 to 45
gm/dL
Exhibit 3
Nurses Notes
Day 2, 0900:
Newborn awake, alert, and crying. Loosely wrapped in one
blanket. Mild tremors noted. Yellow discoloration of mucus
membranes and sclera noted. Respirations 88/min, no
retractions, grunting, or nasal flaring noted. Diaper changed for
small amount of urine and transitional stool. Exhibit 4
Medical History
Apgars: 7 at 1 min and 8 at 5 min of age
Birth weight: 3,515 g (7 lb 12 oz)
Maternal blood type: O+
Uncomplicated pregnancy. Maternal use of marijuana during
pregnancy
Client who gave birth plans to breastfeed.
Question 5 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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale:
The correct answer is to place the newborn skin to skin on the birthing parent's chest and encourage breastfeeding to address Cold stress, a potential condition the client is most likely experiencing. These actions help regulate the newborn's temperature and provide essential warmth and nutrition. Parameters to monitor would include temperature (to assess for hypothermia) and bilirubin level (to monitor for jaundice, a common issue in newborns). Monitoring these parameters will help the nurse assess the client's progress and ensure appropriate interventions are implemented.