ATI RN
RN Maternal Nursing OB Newborn 2023 2024 Exam 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 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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale:
Extract:
A nurse is caring for a postpartum client who gave birth 3 days ago.
Exhibit 1
Vital Signs
Temperature 38.4° C (101.1° F)
Heart rate 108/min
Respiratory rate 20/min
Blood pressure 118/72 mm Hg
Question 2 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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale:
Extract:
A nurse is caring for a newborn who is 4 hr old
Exhibit 1
Vital Signs
Newborn vital signs:
Axillary temperature 36° C (96.8° F)
Heart rate 132/min
Respiratory rate 72/min
Weight 4,366 g (9 lb 10 oz)
Question 3 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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale:
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 4 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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale:
Extract:
A nurse is caring for a newborn.
Exhibit1
Vital Signs
8 hr of age:
Temperature: 37.1° C (98.8° F) Axillary
Pulse rate: 132/min
Respiratory rate: 52/min
36 hr of age:
Temperature: 36.1° C (97" F) Axillary
Pulse rate: 160/min
Respiratory rate: 78/min”
Question 5 of 5
For each assessment finding, click to specify if the finding is consistent with hypoglycemia, hyperbilirubinemia, or sepsis.
| Assessment Findings | Hypoglycemia | Hyperbilirubinemia | Sepsis |
|---|---|---|---|
| Ecchymotic caput Succedaneum. | |||
| Decreased temperature. | |||
| Lethargy. | |||
| Poor feeding. | |||
| Respiratory distress. | |||
| Yellow sclera and oral mucosa. |
Correct Answer: B, C, D, E, F
Rationale: Decreased temperature, lethargy, poor feeding, and respiratory distress are consistent with sepsis. Yellow sclera and oral mucosa are consistent with hyperbilirubinemia.