ATI RN
ATI RN Maternal Newborn 2023/24 1st Attempt & Retake Questions
Extract:
Question 1 of 5
A nurse is teaching a postpartum client about steps the nurses will take to promote the security and safety of the client's newborn. Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct answer is D because staff wearing photo identification badges ensures proper identification and security for the newborn. This measure helps prevent unauthorized individuals from accessing the baby.
Choice A is incorrect as it compromises the safety of the newborn by potentially exposing them to unnecessary risks during transport.
Choice B is irrelevant to the security and safety of the newborn.
Choice C is incorrect as it goes against safe sleep practices that recommend infants sleep in a separate crib to reduce the risk of Sudden Infant Death Syndrome (SIDS).
Question 2 of 5
A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take?
Correct Answer: D
Rationale:
Correct Answer: D - Report the client’s condition to the local health department.
Rationale: Reporting the client's HIV positive status to the local health department is crucial for public health surveillance and monitoring. This action helps to prevent the spread of HIV to others and ensures appropriate follow-up care and support for the client. It also allows for contact tracing and identification of potential exposure risks. Additionally, notifying the health department enables them to provide resources and interventions to support the client's health and well-being.
Incorrect
Choices:
A: Administering penicillin G is not the appropriate action for an HIV-positive client at 22 weeks of gestation. Penicillin G is typically used to treat bacterial infections, not HIV.
B: Instructing the client to schedule an annual pelvic examination is important for general health maintenance but is not directly related to the client's HIV status and gestational age.
C: Waiting to start HIV medication until after delivery is not recommended as timely initiation of antiretrov
Question 3 of 5
A nurse is admitting a client to the labor and delivery unit when the client states, 'My water just broke.' Which of the following interventions is the nurse's priority?
Correct Answer: D
Rationale: The correct answer is D: Begin FHR monitoring. This is the priority intervention because assessing the fetal heart rate (FHR) is crucial to ensuring the well-being of the fetus after the client's water has broken. Monitoring the FHR can help detect any signs of distress or complications that may arise. Performing Nitrazine testing (
A) and assessing the fluid (
B) can provide additional information, but monitoring the FHR takes precedence due to its direct impact on fetal well-being. Checking cervical dilation (
C) is important but not as urgent as monitoring the FHR in this situation.
Question 4 of 5
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A. Frequent vomiting with weight loss of 3 lb in 1 week is concerning as it may indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and electrolyte imbalance, posing risks to both the mother and fetus. The nurse should report this finding to the provider for further evaluation and intervention.
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for concern at this gestational age.
C: Nosebleeds occurring approximately 3 times per week are common in pregnancy due to increased blood volume and nasal congestion and do not typically require immediate provider notification.
D: Increased vaginal discharge is a normal finding in pregnancy due to hormonal changes and increased blood flow to the pelvic area and does not typically necessitate immediate provider notification.
Question 5 of 5
A nurse is assessing a newborn following a circumcision. Which of the following findings should the nurse identify as an indication that the newborn is experiencing pain?
Correct Answer: B
Rationale: The correct answer is B: Chin quivering. Chin quivering is a common sign of pain in newborns. It indicates discomfort and distress. Decreased heart rate (
A), pinpoint pupils (
C), and slowed respirations (
D) are not reliable indicators of pain in newborns. Heart rate may decrease as a response to pain, but it can also be affected by other factors. Pinpoint pupils are more indicative of drug use or neurological issues. Slowed respirations may be a sign of relaxation, not necessarily pain. Chin quivering, on the other hand, is a direct physical manifestation of pain and should be recognized by the nurse as a sign to address the newborn's discomfort.