ATI RN
ATI RN Maternal Newborn 2023 IV Questions
Extract:
A nurse is caring for a client at the next prenatal visit. Vital Signs:
Initial visit, 1330:
• Heart rate 110/min
• Respiratory rate 18/min
• Blood pressure 104/66 mm Hg
• Temperature 36.6° C (97.9° F)
• Oxygen saturation 99% on room air
9-week visit, 0955:
• Heart rate 116/min
• Respiratory rate 20/min
• Blood pressure 92/50 mm Hg
• Temperature 36.5° C (97.7° F)
• Oxygen saturation 97% on room air
Nurses' Notes
29-year-old gravida 2, para 0 client presents with report of a positive home pregnancy test from 2 weeks ago. Last menstrual period was 7 weeks ago. Urine human chorionic gonadotropin (hCG) test positive. Client reports vomiting several times a day over the last 2 weeks and states, "I'm a vegetarian and I don't usually eat a lot of protein, but it's still hard to keep anything down." Decreased skin turgor noted, oral mucous membranes moist. Weight 79.4 kg (175 lb).
9-week visit, 1000:
Client returned to clinic for follow-up visit after initial prenatal appointment 2 weeks ago. Client reports continued nausea and recurrent episodes of vomiting every day. Has been unable to complete work or sleep well at night due to nausea and vomiting.
Poor skin turgor with tenting noted. Oral mucous membranes dry. Urine reagent strip results of large amount of ketones. Client tearful, reassurance provided. Weight today is 77.6 kg
Laboratory Results
• WBC count 7,500/mm3 (5,000 to 10,000/miny Hgb 10.2 g/dL (11 to 16 g/dL)
• Hct 45% (33% to 47%)
• Platelets 360,000/mm3 (150,000 to 400,000/mm3)
• Sodium 136 mEq/L (136 to 145 mEq/L)
• Potassium 3.3 mEq/L (3.5 to 5 mEq/L)
• BUN 28 mg/dL (10 to 20 mg/dL)
Urinalysis:
• Appearance clear (clear)
• Color dark amber yellow (pale yellow amber)
• pH 7.9 (4.6 to 8)
• Protein 4 mg/dL (0 to 8 mg/dL)
• Specific gravity 1.045 (1.005 to 1.03)
• Leukocyte esterase negative (negative)
• Nitrites none (none)
• Ketones large (none)
• Bilirubin none (none)
• Glucose none (none)
History and Physical
9-week visit, 1030:
Client is primigravida at 9 weeks of gestation. No significant medical or surgical history. Now reports continued vomiting, has lost 1.8 kg (4 lb) since prior visit. Mucous membranes dry, poor skin turgor, and ketonuria noted. FHR 156/min via Doppler ultrasound. Recommended admission to antepartum unit for treatment of hyperemesis gravidarum.
Question 1 of 5
After reviewing the assessment findings, which of the following complications is the client at an increased risk for developing? Select the 3 complications.
Correct Answer: B, C, F
Rationale: Persistent vomiting and dehydration (implied) risk electrolyte imbalance (
B), fetal growth restriction (
C) from poor nutrition, and spontaneous abortion (F) from maternal compromise.
Extract:
A nurse is planning care for a client who is 12 hr postpartum and has a third-degree perineal laceration.
Question 2 of 5
Which of the following interventions should the nurse include in the plan?
Correct Answer: D
Rationale: Witch hazel pads reduce swelling and discomfort, aiding healing in third-degree lacerations. Warm packs may worsen swelling, and nerve blocks or hydrogels are not routine.
Extract:
A nurse is caring for a client. Nurses' Notes: Initial visit, 1340: 29-year-old G2P0, positive hCG 2 weeks ago, LMP 7 weeks ago, vomiting daily for 2 weeks, vegetarian, poor protein intake, decreased skin turgor, moist mucous membranes, weight 79.4 kg. Vital Signs: HR 110/min, RR 18/min, BP 104/66 mmHg, Temp 36.6°C, SpO2 99%. Labs: WBC 7,500/mm³, Hgb 10.2 g/dL, Hct 45%, Platelets 360,000/mm³, Na 136 mEq/L, K 3.3 mEq/L, BUN 28 mg/dL, UA: dark amber, SG 1.045.
Question 3 of 5
Click to highlight the findings that require follow-up.
Correct Answer: A, B, C, D, E, F
Rationale: Vomiting (
A), decreased turgor (
B), low Hgb (
C), low potassium (
D), high BUN (E), and dark amber urine with high SG (F) indicate dehydration, anemia, and electrolyte imbalance needing follow-up.
Extract:
A nurse is caring for a client who is in labor. The nurse observes late decelerations of the fetal heart rate on the external fetal monitor. After placing the client in a side-lying position.
Question 4 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Late decelerations suggest uteroplacental insufficiency. Administering oxygen via face mask increases maternal oxygen levels, improving fetal oxygenation, and is the priority after repositioning.
Extract:
A nurse is caring for a newborn who was born at 39 weeks of gestation and is 36 hr old.
Nurses' Notes
Term newborn birthed via spontaneous vaginal delivery at 39 weeks of gestation. Apgar 9/9 at 5-minute score. Breastfeeding 3 to 4 times per day. Newborn has voided once since birth and has not passed meconium stool since birth.
Physical Examination
• Fontanels soft and flat
• Head molded with caput succedaneum
• Eyes symmetric, no discharge, sclera yellow
• Mucous membranes dry
• Abdomen soft and rounded, bowel sounds present x 4 quadrants
Vital Signs
• Heart rate 154/min
• Respiratory rate 44/min
• Temperature 36.9° C (98.4° F)
Diagnostic Results
• Coombs positive (negative)
• Glucose 50 mg/dL (40 to 60 mg/dL)
Question 5 of 5
Which finding(s) from the assessment should be reported to the provider for further evaluation or intervention? Select all that apply.
Correct Answer: A, B, D
Rationale: Dry mucous membranes (
A) and low output (
D) suggest dehydration from inadequate feeding (3-4 times/day vs. 8-12). Yellow sclera (
B) indicates jaundice, needing bilirubin checks.