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.
A: Labor induction with oxytocin can lead to uterine atony, increasing the risk of postpartum hemorrhage.
C: Vacuum-assisted delivery can cause uterine atony and trauma, contributing to postpartum hemorrhage.
D: History of uterine atony indicates a previous issue with uterine contractions, making the client more susceptible to postpartum hemorrhage.
B: Newborn weight is not directly related to postpartum hemorrhage risk.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
In summary, labor induction with oxytocin, vacuum-assisted delivery, and a history of uterine atony are factors that place the client at risk for postpartum hemorrhage.
Question 2 of 5
A nurse is caring for a client who is in active labor with a fetus in the occipitoposterior position. The nurse assists the client into a hands-and-knees position. Which of the following questions should the nurse ask to evaluate the effectiveness of this intervention?
Correct Answer: D
Rationale:
Rationale: The correct answer is D because the occipitoposterior position can result in back labor due to pressure on the mother's sacrum. By asking if the back labor has improved, the nurse can assess the effectiveness of the hands-and-knees position in relieving this specific discomfort.
Incorrect options:
A: Suprapubic pain is not typically associated with occipitoposterior position, so this question is not directly related to the intervention.
B: Pelvic pressure may not be the main concern with occipitoposterior position, making this question less relevant.
C: Contractions feeling further apart may not be directly impacted by the hands-and-knees position in this scenario.
Summary: Option D is correct as it targets the specific issue of back labor associated with occipitoposterior position, while the other options do not address the primary concern or may not be influenced by the intervention.
Question 3 of 5
A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?
Correct Answer: D
Rationale: The correct answer is D: Jitteriness. Newborns of mothers with gestational diabetes are at risk for hypoglycemia due to the abrupt drop in glucose levels after birth. Jitteriness is a common manifestation of hypoglycemia in newborns as it is a sign of neurologic irritability caused by low blood sugar levels. Abdominal distention (
A) is not typically associated with hypoglycemia. Petechiae (
B) are small red or purple spots on the skin caused by bleeding under the skin and are not related to hypoglycemia. Increased muscle tone (
C) is not a typical sign of hypoglycemia in newborns.
Question 4 of 5
A nurse is assessing a client who is 1 hr postpartum following a vaginal birth. The nurse notes that the client has excessive vaginal bleeding. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct action for the nurse to take first in this situation is to massage the client's fundus. This is because excessive vaginal bleeding postpartum can be a sign of uterine atony, which is the most common cause of postpartum hemorrhage. Massaging the fundus helps to stimulate uterine contractions and can help control bleeding. Administering oxytocin (choice
B) can also help with uterine contractions, but massaging the fundus should be done first to assess the situation. Emptying the client's bladder (choice
C) can help relieve pressure on the uterus, but it is not the priority in this situation. Providing oxygen (choice
D) is not indicated for excessive vaginal bleeding unless the client is showing signs of hypoxia.
Question 5 of 5
A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Administer 500 mL lactated Ringer’s IV bolus. In this scenario, the steady trickle of vaginal bleeding after a cesarean birth could indicate postpartum hemorrhage. Administering a lactated Ringer's IV bolus helps to stabilize the client's hemodynamic status by replacing lost fluids and improving perfusion. This is crucial in managing postpartum hemorrhage and preventing complications.
Incorrect choices:
A: Replacing the surgical dressing does not address the underlying issue of postpartum hemorrhage.
B: Evaluating urinary output is important but not the priority when dealing with postpartum hemorrhage.
C: Applying an ice pack to the incision site is not appropriate for managing postpartum hemorrhage.