ATI RN
ATI Maternal Newborn Proctored Exam Latest Update Questions
Extract:
Question 1 of 5
An hour after delivery, a 4000 gram infant exhibits pallor, jitteriness, a blood sugar level of 40 gm/dL, irritability and periodic apnea. Which maternal condition could be the cause of the newborn's symptoms?
Correct Answer: D
Rationale: The correct answer is D: Gestational diabetes. The symptoms described in the infant, such as hypoglycemia (blood sugar level of 40 gm/dL), jitteriness, irritability, and pallor, are indicative of neonatal hypoglycemia. Gestational diabetes can lead to fetal hyperinsulinemia, causing the infant to have low blood sugar levels after birth. This is because the fetus becomes accustomed to high glucose levels in utero and continues to produce excessive insulin after delivery. The other choices are less likely to cause neonatal hypoglycemia: A (drug addiction) typically presents with withdrawal symptoms but not hypoglycemia, B (pregnancy-induced hypertension) may lead to intrauterine growth restriction but not directly cause hypoglycemia, and C (TORCH infections) can cause various congenital anomalies but not typically result in neonatal hypoglycemia.
Question 2 of 5
A woman enters the birthing center in active labor. She tells the nurse that her membranes ruptured 26 hours ago. The nurse immediately takes the client's vital signs. Which is the rationale for the nurse's actions?
Correct Answer: D
Rationale: The correct answer is D. Prolonged rupture of membranes increases the risk of infection. When the amniotic sac has been ruptured for an extended period, bacteria can enter the uterus, potentially leading to chorioamnionitis, a serious infection that can harm both the mother and the baby. The nurse is taking vital signs to monitor for signs of infection, such as an elevated temperature or an increased heart rate.
Choices A, B, and C are incorrect because they do not directly relate to the potential complications of prolonged rupture of membranes. Pulse rates may increase with infection, but not solely due to the length of time of ruptured membranes. Respiratory rates are not typically impacted by ruptured membranes, and transient hypertension is not a common complication of this situation.
Question 3 of 5
A nurse is reinforcing teaching with the parent of an infant who has club feet with bilateral casts.
Correct Answer: A
Rationale: The correct answer is A: "Check the toes for any swelling or discoloration." This is correct because it is crucial to monitor for signs of complications such as impaired circulation in the toes due to the cast. Swelling or discoloration could indicate a problem that needs immediate attention.
Choice B is incorrect because monthly recasting is not the standard treatment for club feet with bilateral casts.
Choice C is incorrect because using a heated fan or dryer can cause burns or skin irritation to the infant's delicate skin under the cast.
Choice D is incorrect because giving Tylenol every 4 hours without consulting a healthcare provider may not be necessary or safe for the infant.
Overall, choice A is the most appropriate as it focuses on monitoring the infant's toes for any potential issues and taking appropriate action if needed.
Question 4 of 5
A nurse is assessing a newborn 12 hr after birth. Which of the following manifestations should the nurse report to the provider?
Correct Answer: C
Rationale: The correct answer is C: Jaundice. Jaundice in a newborn at 12 hours after birth can indicate hyperbilirubinemia, which if left untreated, can lead to kernicterus and neurological damage. The nurse should report this to the provider for further evaluation and management. Acrocyanosis (choice
A) is a common finding in newborns and resolves on its own. Transient strabismus (choice
B) is also common and typically resolves within a few months. Caput succedaneum (choice
D) is swelling on the newborn's head due to pressure during delivery and is considered a normal finding.
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:
Correct Answer: B - Have you noticed any bloody show or fluid coming from your vagina?
Rationale: Bloody show or fluid leakage can indicate rupture of membranes, a sign of true labor. This suggests the onset of cervical changes and progression towards delivery. It distinguishes true labor from false labor, which typically does not involve such physical signs.
Summary of other choices:
A: "When did your contractions begin?" - This question may provide a timeline for contractions but does not specifically differentiate between true and false labor.
C: "What happens to your contractions when you move about?" - Contractions can vary in intensity based on movement, but this does not definitively differentiate between true and false labor.
D: "Have you felt fetal movement over the last 24 hours?" - Fetal movement is important for assessing fetal well-being but does not directly help in distinguishing true labor from false labor.