ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is providing teaching to the parents of a newborn about the Plastibell circumcision technique. Which of the following information should the nurse include?
Correct Answer: D
Rationale:
Correct Answer: D - Notify the provider if the end of your baby’s penis appears dark red.
Rationale: Dark red color at the end of the penis could indicate infection or poor circulation, which are serious complications requiring immediate medical attention to prevent further complications. It is crucial for the parents to monitor the circumcision site regularly and report any concerning changes to the healthcare provider promptly.
Incorrect
Choices:
A: The Plastibell will not be removed after 4 hours; it typically falls off on its own within 5-8 days.
B: Ensuring a snug diaper is important for comfort but not specifically related to the Plastibell circumcision technique.
C: Yellow exudate is normal post-circumcision, usually appearing within 24-48 hours, and does not necessarily indicate a problem. Reporting dark red color is more critical.
Question 2 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.
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 assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Single palmar creases. This finding may indicate Down Syndrome. Reporting it is crucial for further evaluation and appropriate care. Single palmar creases are a physical characteristic associated with Down Syndrome, making it essential to inform the provider for thorough assessment and potential early intervention. The other choices are not indicative of immediate concern for a full-term newborn. Down Syndrome (
B) may be associated with single palmar creases, but it is not the clinical finding that should be reported. Rust-stained urine (
C), transient circumoral cyanosis (
D), and subconjunctival hemorrhage (E) are common and usually benign in newborns, requiring monitoring but not immediate reporting.
Question 5 of 5
A nurse is caring for a client who is 1 day postpartum and breastfeeding her newborn. The client reports sore nipples. Which of the following actions should the nurse take?
Correct Answer: B
Rationale:
Correct Answer: B - Assess the newborn's latch while breastfeeding.
Rationale: Sore nipples in breastfeeding may indicate improper latch, leading to discomfort. By assessing the newborn's latch, the nurse can identify any issues causing the soreness and provide guidance to improve latch technique, ultimately alleviating the discomfort for the client. This step is crucial in promoting successful breastfeeding and preventing further nipple soreness.
Summary of Incorrect
Choices:
A: Instructing the client to wait 4 hr between daytime feedings may lead to engorgement and decreased milk supply, worsening the issue.
C: Limiting breastfeeding time to 5 min per breast may not address the root cause of sore nipples and can impact milk production.
D: Offering supplemental formula may interfere with establishing a successful breastfeeding routine and addressing latch issues, which is essential for long-term breastfeeding success.