ATI RN
ATI Maternal Newborn Proctored Exam Latest Update Questions
Extract:
Question 1 of 5
A nurse monitors fetal well-being by means of an external monitor. At the peak of the contractions, the fetal heart rate has repeatedly dropped 30 beats/min below the baseline. Late decelerations are suspected and the nurse notifies the physician. Which is the rationale for this action?
Correct Answer: D
Rationale: The correct answer is D because late decelerations are associated with uteroplacental insufficiency, resulting in fetal hypoxia. This is a sign of fetal distress, as indicated by the repeated drops in fetal heart rate during contractions. Late decelerations occur after the peak of the contraction, reflecting the delayed recovery of the fetal heart rate due to inadequate oxygen supply from the placenta. This prompts the nurse to notify the physician for further evaluation and intervention to address the underlying cause of fetal distress.
Choices A, B, and C are incorrect because they do not accurately describe the characteristics and causes of late decelerations in fetal monitoring.
Question 2 of 5
Which preoperative nursing interventions should be included for a client who is scheduled to have an emergency cesarean birth?
Correct Answer: C
Rationale: The correct answer is C because in an emergency cesarean birth, surgery must be performed quickly to ensure the safety of the mother and baby. Inserting an indwelling catheter is crucial to keep the bladder empty and prevent injury during the incision. This intervention helps maintain a sterile field and reduces the risk of infection. Additionally, a full bladder can impede the progress of surgery. Monitoring O2 saturations and administering pain medications (
A) are postoperative interventions and not relevant in the preoperative phase. Taking vital signs every 15 minutes (
B) is more appropriate for the postoperative period. Assessing breath sounds (
D) is important but typically done by the anesthesiologist during surgery. Instructing the client about breathing exercises (
B) may not be effective in an emergency situation where immediate interventions are necessary.
Question 3 of 5
A nurse provided discharge teaching to new parents on how to care for their newborn following circumcision. Which of the following statements by the parents indicates the need for further clarification?
Correct Answer: D
Rationale: The correct answer is D. Giving the newborn a tub bath in two days after circumcision could increase the risk of infection as the circumcision wound needs time to heal. A sponge bath is recommended until the wound is completely healed.
Choice A is correct because yellow exudate is normal during the healing process.
Choice B is correct as keeping the area clean is important.
Choice C is correct as circumcision typically heals within a couple of weeks.
Question 4 of 5
A nurse is discussing the use of condoms with a female client. Which of the following statements by client represents a need for further teaching?
Correct Answer: B
Rationale: The correct answer is B because removing the condom 30 minutes after intercourse is incorrect. Condoms should be removed immediately after ejaculation to prevent leakage or spillage of semen. Leaving the condom on for too long increases the risk of pregnancy and STIs.
Choice A is correct as putting the condom on while the penis is erect is the proper way to ensure it fits securely.
Choice C is also correct as leaving a small space at the tip allows room for semen collection.
Choice D is incorrect because spermicidal gels or creams are not recommended with condoms as they can cause irritation and may not increase effectiveness.
Question 5 of 5
A client reports awaking from sleep by contractions that are occurring every five minutes and lasting 30-40 seconds. Which of the following questions should the nurse ask to assess for true labor versus false labor?
Correct Answer: B
Rationale: The correct answer is B. The presence of bloody show or fluid coming from the vagina can indicate ruptured membranes, which is a sign of true labor. This is important in determining whether the client is in active labor. Asking about the presence of bloody show or fluid helps differentiate between true and false labor.
Choice A is less relevant as the timing of contractions alone does not distinguish between true and false labor.
Choice C is related to assessing the effectiveness of contractions, not differentiating between true and false labor.
Choice D is important for assessing fetal well-being but does not help in distinguishing between true and false labor.