ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery and reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository?
Correct Answer: D
Rationale: The correct answer is D: Third-degree perineal laceration. This type of laceration extends through the vaginal mucosa, perineal muscles, and anal sphincter, making the use of a suppository contraindicated due to the risk of infection and increased pain. Vaginal candidiasis (choice
A) does not directly impact the use of a suppository. Abdominal distention (choice
B) can be addressed by using a suppository. Afterpains (choice
C) are normal postpartum contractions and do not contraindicate the use of a suppository. In summary, the presence of a third-degree perineal laceration poses a significant risk if a suppository is used, making it the correct answer.
Question 2 of 5
A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, which of the following is the client’s estimated date of delivery?
Correct Answer: B
Rationale: The correct answer is B: May 17. Nägele's Rule involves adding 7 days to the first day of the last menstrual period (August 10), then subtracting 3 months, and finally adding 1 year. So, August 10 + 7 days = August 17. Subtracting 3 months gives May 17. This estimation is based on the assumption of a 28-day menstrual cycle.
Choice A (May 13) is incorrect because it does not account for the full 3 months.
Choice C (May 3) is incorrect as it miscalculates the 3 months and adds 7 days incorrectly.
Choice D (May 20) is wrong as it adds 7 days to the correct date but does not subtract the 3 months accurately.
Therefore, B is the correct choice based on the accurate application of Nägele's Rule.
Question 3 of 5
A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?
Correct Answer: C
Rationale: The correct answer is C: Hypotension. Opioid analgesics can cause hypotension as a common adverse effect by decreasing systemic vascular resistance and cardiac output. The vasodilatory effects of opioids can lead to a drop in blood pressure, which can be more pronounced when combined with an epidural block. Monitoring for hypotension is crucial to prevent complications such as decreased perfusion to vital organs.
Other choices are incorrect because:
A: Hyperglycemia is not a common adverse effect of opioid analgesics.
B: Bilateral crackles are more indicative of fluid overload or pulmonary edema, not related to opioid analgesics.
D: Polyuria is not a typical adverse effect of opioids; they are more likely to cause urinary retention.
In summary, monitoring for hypotension is essential when a client is receiving an epidural block with an opioid analgesic to ensure hemodynamic stability.
Question 4 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.
Question 5 of 5
A nurse is assisting the provider to administer a dinoprostone insert to induce labor for a client. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Verify that informed consent is obtained prior to administration. This is crucial because obtaining informed consent ensures that the client understands the risks, benefits, and alternatives of the procedure. Without informed consent, the client's autonomy and right to make decisions about their care are not upheld.
A: Allowing the medication to reach room temperature is not necessary for the administration of dinoprostone insert.
B: Placing the client in a semi-Fowler's position is not a standard precaution after administering a dinoprostone insert.
C: Instructing the client to avoid urinary elimination is not necessary and can be harmful to the client's health.
E, F, G: No other choices are provided, but they would likely be incorrect as well since the correct answer focuses on obtaining informed consent, which is a fundamental principle in healthcare.