ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse on an antepartum unit is caring for four clients. Which of the following clients should the nurse identify as the priority?
Correct Answer: B
Rationale: The correct answer is B. Epigastric pain in a pregnant woman at 34 weeks could indicate a serious condition like pre-eclampsia, which requires immediate attention to prevent complications for both the mother and the baby. Gestational diabetes with a fasting blood glucose level of 120 mg/dL, as in choice A, is concerning but can be managed with appropriate interventions and monitoring.
Choice C's client with an Hgb of 10.4 g/dL is below the normal range but not an immediate priority unless there are symptoms of severe anemia.
Choice D's client at 39 weeks with urinary symptoms may indicate a urinary tract infection, which is important but not as urgent as potential pre-eclampsia.
Question 2 of 5
A nurse is assessing a client who is in active labor. Which of the following findings should the nurse report to the provider?
Correct Answer: D
Rationale: The correct answer is D: PHR baseline 170/min. A baseline fetal heart rate (FHR) of 170/min is high and may indicate fetal distress or other complications. The nurse should report this finding to the provider for further evaluation and intervention. Contractions lasting 80 seconds (choice
A) are within the normal range for active labor. Early decelerations in the FHR (choice
B) are also normal and not concerning. A temperature of 37.4° C (99.3° F) (choice
C) is slightly elevated but not a critical finding in active labor.
Therefore, the nurse should focus on the abnormal FHR baseline of 170/min and report it promptly for appropriate management.
Extract:
Exhibit1 Medical History Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (71b 12 0z) Apgar scores 8 at 1 min and 9 at 5 min Maternal history of methadone use during
pregnancy.
Exhibit2 vital signs 0700: Heart rate 156/min Respiratory rate 58/min Temperature 37.2° C (98.9° F) Oxygen saturation 98% on room air .1100: Heart rate 160/min Respiratory rate 60/min Temperature 37.3° C (99.2° F) Oxygen saturation 96%
on room air
Exhibit3 Physical Examination 1100: Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorouslyon pacifier but breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today.Exhibit4 (image)
Apgars: 7 at 1 min and 8 at 5 min of age Birth weight: 3,515 (7 1b 12 02) Maternal blood type: O+ Uncomplicated pregnancy. Maternal use of marijuana during pregnancy Client who gave birth plans to breastfeed
Question 3 of 5
A nurse is caring for a newborn who is 70 hr old. Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A, D, E
Rationale: The correct answer is A, D, and E. The nurse should report respiratory, central nervous system, and gastrointestinal findings to the provider in a newborn at 70 hours old. Respiratory findings could indicate potential respiratory distress, CNS findings could signal neurological issues, and gastrointestinal findings could suggest feeding or digestion problems. Reporting these findings promptly allows the provider to assess and intervene if necessary, ensuring the newborn's well-being.
Choices B and C are typically monitored but are not the top priority in this scenario.
Extract:
Question 4 of 5
A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? (Select all that apply.)
Correct Answer: A, C
Rationale: The correct answers are A and C. A flaccid uterus and excess vaginal bleeding are indications for administering oxytocin postpartum. Oxytocin helps to prevent postpartum hemorrhage by inducing uterine contractions to promote uterine tone, reducing bleeding. If the uterus is flaccid, it may not contract effectively, leading to excessive bleeding. Excess vaginal bleeding is also a sign of inadequate uterine contraction.
Choices B, D, and E are incorrect. Cervical laceration and increased afterbirth cramping do not specifically indicate the need for oxytocin administration. Increased maternal temperature is not related to oxytocin administration but may indicate infection.
Extract:
“A nurse is caring tor a newborn.
Exhibit1:
Medical History. Apgar score 9 at 1 min and 9 at 5 min Birth weight 4,706 g (10 lb 6 oz)| Gestational age
40 weeks Difficult vaginal birth with shoulder dystocia.
EXHIBIT2:
Nurses: Notes 1700: Newborn is active and moves all extremities except for right arm. No spontaneous
movement of the right arm noted, Right arm remains at side during Moro reflex.
Exhibit3:
Physical examination 1830: Absent Moro reflex noted in right arm. Right shoulder and arm are internally
rotated and adducted. Elbow extended. Forearm pronated with wrist and fingers flexed. Diagnosis.
brachial prexus injury resulting in trot Duchenne (Erb's palsy) paralysis
Question 5 of 5
Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is Indicated or contraindicated for the newborn
| Potential Nursing Action | Indicated | Contraindicated | |
|---|---|---|---|
| Educate the parents to begin range of motion exercises on the affected arm after 1 week. | |||
| Assess for grasp reflex in the affected extremity. | |||
| Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt. | |||
| Instruct parents to limit physical handling for 2 weeks. |
Correct Answer: B
Rationale: [0, 1, 0, 0]
The correct answer is B: Assess for grasp reflex in the affected extremity. This is indicated to evaluate neurological function. Educating parents on range of motion exercises after 1 week, immobilizing the arm, and limiting physical handling are contraindicated as they can lead to complications and hinder recovery in a newborn with a possible neurological issue.