ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A school nurse is providing teaching to an adolescent about levonorgestrel contraception. Which of the following information should the nurse include in the teaching?
Correct Answer: A
Rationale: The correct answer is A: You should take the medication within 72 hours following unprotected sexual intercourse. Levonorgestrel is most effective when taken within 72 hours of unprotected sex to prevent pregnancy. It works by preventing ovulation or fertilization.
Choice B is incorrect because levonorgestrel can be used even if the individual is on oral contraceptives.
Choice C is incorrect because a missed period does not necessarily indicate pregnancy.
Choice D is incorrect because levonorgestrel is only effective for a short period after taking it.
Question 2 of 5
A nurse is assessing a newborn who is 16 hr old. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A. Substernal retractions in a 16-hour-old newborn indicate respiratory distress and may be a sign of an underlying issue such as respiratory distress syndrome. This finding requires immediate attention from the healthcare provider to assess and manage the newborn's respiratory status.
Choices B, C, and D are not as concerning in a newborn of this age. Acrocyanosis is a common finding in newborns due to immature circulation. Overlapping suture lines can be normal due to the molding process during birth. A head circumference of 33 cm falls within the normal range for a newborn.
Therefore, these findings do not require immediate reporting to the provider.
Question 3 of 5
A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: The correct answer is C because continuing to take insulin even during nausea and vomiting is crucial to prevent complications of hyperglycemia. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia without insulin.
Choice A is incorrect as insulin needs may decrease in the first trimester.
Choice B is incorrect as moderate exercise is not recommended if blood glucose is 250 or greater.
Choice D is incorrect as a bedtime snack high in refined sugar can lead to unstable blood sugar levels.
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 because frequent vomiting with significant weight loss in a short period can indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and malnutrition, posing risks to both the mother and fetus. Weight loss of 3 lb in 1 week is concerning and requires immediate medical attention to prevent complications.
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for immediate concern.
C: Nosebleeds occurring 3 times per week are often due to increased blood volume and hormonal changes during pregnancy and are usually not a serious issue unless severe or persistent.
D: Increased vaginal discharge is a common symptom during pregnancy due to hormonal changes and increased blood flow to the pelvic area, typically not a cause for immediate concern unless accompanied by other symptoms like itching or foul odor.
Extract:
A nurse is caring for a newborn who is 48 hr old.
Exhibit 1
Vital Signs
Day 2, 0900:
Heart rate 174/min
Respiratory rate 88/min
Temperature 36.1° C (97.0° F)
Oxygen saturation 97% on room air
Exhibit 2
Diagnostic Results
Day 1, 0800: Newborn results
Blood type: A+
Urine toxicology screen: positive marijuana
Day 2, 0800: Newborn results
Total bilirubin 10 mg/dL (1.0 to 12.0 mg/dL)
Day 2, 0915:
Blood glucose: 38 mg/dL (expected value greater than 40 to 45
gm/dL
Exhibit 3
Nurses Notes
Day 2, 0900:
Newborn awake, alert, and crying. Loosely wrapped in one
blanket. Mild tremors noted. Yellow discoloration of mucus
membranes and sclera noted. Respirations 88/min, no
retractions, grunting, or nasal flaring noted. Diaper changed for
small amount of urine and transitional stool. Exhibit 4
Medical History
Apgars: 7 at 1 min and 8 at 5 min of age
Birth weight: 3,515 g (7 lb 12 oz)
Maternal blood type: O+
Uncomplicated pregnancy. Maternal use of marijuana during
pregnancy
Client who gave birth plans to breastfeed.
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.
Correct Answer:
Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale: The correct answer is to place newborn skin to skin on birthing parent's chest and encourage breastfeeding to address potential condition of Cold stress. Parameters to monitor are temperature and bilirubin level. Skin-to-skin contact and breastfeeding help regulate newborn's temperature and decrease risk of hypothermia. Cold stress can lead to increased bilirubin levels, so monitoring temperature and bilirubin levels will help assess the baby's progress. Incorrect options: Option A focuses on phototherapy and neonatal abstinence system scoring, which are not indicated for cold stress. Option C includes stool output and lung sounds, which are not relevant for assessing cold stress.