ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D. Labor induction with oxytocin can lead to uterine hyperstimulation, increasing the risk of postpartum hemorrhage. Vacuum-assisted delivery can cause trauma to the birth canal and uterus, also increasing the risk. History of uterine atony indicates a previous inability of the uterus to contract effectively after delivery, predisposing the client to postpartum hemorrhage.
Incorrect answers:
B: Newborn weight is not directly related to the risk of postpartum hemorrhage.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
In summary, choices A, C, and D are directly linked to postpartum hemorrhage risk due to their impact on uterine contraction and trauma during delivery, while choices B and E are not causative factors.
Question 2 of 5
A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer?
Correct Answer: A
Rationale: The correct answer is A: 8 tablets.
To calculate the number of tablets needed, divide the total dose (2 g) by the dose per tablet (250 mg). First, convert 2 g to mg (2000 mg).
Then, divide 2000 mg by 250 mg per tablet, which equals 8 tablets. This ensures the client receives the correct total dose.
Choice B, 4 tablets, is incorrect as it does not provide the full 2 g dose.
Choice C, 2 tablets, is only half the required dose.
Choice D, 1 tablet, is too low and would not provide the necessary treatment for trichomoniasis.
Question 3 of 5
A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Assist the client in pulling their knees toward their abdomen. In shoulder dystocia, the McRoberts maneuver involves hyperflexing the mother's legs against her abdomen. This action helps to widen the pelvic outlet and reduce the angle of the pubic symphysis, facilitating the delivery of the infant's shoulder. Pressing on the fundus (
A) does not address the shoulder dystocia issue. Pressing on the suprapubic area (
B) may not provide the necessary assistance in this situation. Moving the client onto their hands and knees (
C) does not facilitate the specific maneuver required.
Therefore, assisting the client in pulling their knees toward their abdomen (
D) is the correct action in this scenario.
Question 4 of 5
A nurse is assessing a client who is 3 days postpartum. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Cool, clammy skin. This finding may indicate hypovolemic shock, a serious condition postpartum. The nurse should report this to the provider immediately for further evaluation and intervention.
Choice B, moderate lochia serosa, is a normal finding 3 days postpartum.
Choice C, heart rate 89/min, and choice D, BP 120/70 mm Hg, are within normal ranges for a postpartum client and do not require immediate reporting.
Extract:
A nurse is caring for a postpartum client who gave birth 3 days ago.
Exhibit 1
Vital Signs
Temperature 38.4° C (101.1° F)
Heart rate 108/min
Respiratory rate 20/min
Blood pressure 118/72 mm Hg
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:
Correct Answer: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale:
1. Potential Condition: Engorgement is a common condition postpartum characterized by breast fullness and tenderness.
2. Actions to Take: Initiate anticoagulant therapy to prevent deep vein thrombosis and administer an oxytocic medication to relieve engorgement.
3. Parameters to Monitor: Circumference of lower extremities (for DVT) and integrity of the nipples (for engorgement). These parameters will help assess the client's progress in managing these conditions effectively.