ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
A nurse in the emergency department is caring for a 19-year-old client
who is at 18 weeks of gestation.
Exhibit 1
Nurses' Notes
Client presents with reports of nausea and vomiting for the past
several weeks, which has worsened in severity. Client states that
they have been unable to retain even clear fluids for the past 48
hr. Client reports no pain. Client reports a history of migraines
and asthma.
Question 1 of 4
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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale:
Correct
Answer: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale: The potential condition the client is most likely experiencing is ectopic pregnancy. The nurse should insert a peripher-all access device to administer medications and fluids, and perform daily fetal movement counts to monitor fetal well-being. The nurse should monitor urine ketones to assess for dehydration and Kleihauer-Betke values to evaluate for internal bleeding, which are common in ectopic pregnancies. Serum human chorionic gonadotropin (hCG) levels should also be monitored to track the progression of the pregnancy and ensure appropriate management.
Extract:
A nurse is caring for a newborn who was born at 39 weeks of gestation and is 36 hr old.
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
Question 2 of 4
Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A,B,C,G
Rationale: The correct answers to report to the provider are A, B, C, and G.
A: Coombs test result is crucial for diagnosing hemolytic anemia.
B: Mucous membrane assessment reflects hydration and oxygenation status.
C: Intake and output are vital for monitoring fluid balance.
G: Sclera color can indicate jaundice or liver dysfunction.
Other choices like D, E, and F are important assessments but not as critical for immediate provider notification. The respiratory rate (
D) and heart rate (F) are essential vital signs but can be monitored routinely. Head assessment findings (E) can be important but may not require immediate provider notification unless there is a significant change.
Extract:
A nurse is caring for a client who is at 33 weeks of gestation.
Diagnostic Results:
• Proteinuria 3+, straw-colored urine
• Platelet count 150,000/mm3 (150,000 to 400,000/mm3)
• BUN 18 mg/dL (10 to 20 mg/dL)
Question 3 of 4
The nurse is assessing the client 24 hr later. How should the nurse interpret the findings?
| Findings 24 hr later | Sign of potential worsening condition | Sign of potential improvement | Unrelated to diagnosis |
|---|---|---|---|
| Hematuria | |||
| Proteinuria 2+ | |||
| Leukorrhea | |||
| Positive clonus | |||
| BUN 40 mg/dL | |||
| Platelet count 110,000/mm3 |
Correct Answer:
Rationale:
Correct
Answer:
Rationale:
- Hematuria and Proteinuria 2+ are relevant findings that may indicate a potential worsening condition.
- Leukorrhea is unrelated to the diagnosis and should not be considered for interpretation.
- Positive clonus is a sign of potential improvement as it suggests a neurological response.
- BUN 40 mg/dL is a critical value that indicates potential renal impairment.
- Platelet count 110,000/mm3 is a concerning finding that suggests a potential worsening condition.
Extract:
A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis.
Medical History:
• Gravida 2 Para 2
• Cesarean birth
• Deep vein thrombosis with previous pregnancy
• Preeclampsia
• BMI of 32
Question 4 of 4
A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis.
| Findings 24 hr later | Indication of worsening condition | Indication of improving condition |
|---|---|---|
| Increased warmth in the extremity | ||
| Tachycardia | ||
| Leukocytosis | ||
| Scant lochia rubra | ||
| Decreased extremity edema |
Correct Answer:
Rationale:
Correct
Answer:
Rationale:
- Increased warmth in the extremity: Indicates clot progression or inflammation.
- Tachycardia: Can signify a pulmonary embolism or worsening condition.
- Leukocytosis: Suggests infection or inflammatory response.
- Scant lochia rubra: Not directly related to deep vein thrombosis, more common postpartum.
Extract:
A nurse is caring for a client who is at 32 weeks of gestation and has complete placenta previa Physical Examination
Funda height 33 cm
Fetal heart rate 174/min
Moderate amount of bright real vaginal bleeding
Abdomen soft palpation and without tenderness
Question 5 of 4
Which of the following assessment findings requires Immediate follow-up? Select all that apply,
Correct Answer: B,C,E,F
Rationale: The correct answers are B, C, E, and F. Vaginal bleeding requires immediate follow-up to assess for potential complications. HCT, HGB, and WBC count are crucial for evaluating maternal health. Fetal heart rate is essential for monitoring fetal well-being. Platelet count and RBC count are important but not as urgent as the other findings.