ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
A nurse is caring for a postpartum client in an outpatient setting
Exhibit1:
History and Physical
G1P1, spontaneous vaginal delivery with median episiotomy at 39 weeks of gestation.
Newborn 4,508 g (9 lb 15 oz), APGARs: 8 at 1 min, 9 at 5 min
group B streptococcus 8-hemolytic: positive (negative)
Received 2 doses of Intravenous penicillin G while in labor”
Question 1 of 5
complete the following sentence by using the lists of options. The client is at highest risk for developing ---evidenced by the client's ---
| Endometritis. |
| Mastitis. |
| Postpartum hemorrhage. |
| Group B streptococcus positive status. |
| Spontaneous vaginal delivery. |
| Median episiotomy. |
Correct Answer: A
Rationale:
Correct
Answer: A
Rationale:
1. Endometritis is an infection of the uterine lining, commonly occurring post-delivery.
2. The client's risk for endometritis increases due to factors like prolonged labor, multiple vaginal exams, and retained placental fragments.
3. The client's condition or symptoms may include fever, uterine tenderness, foul-smelling lochia.
4. The other options (B-F) are not directly related to the highest risk for developing endometritis post-delivery.
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 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: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale:
The correct answer is to place the newborn skin to skin on the birthing parent's chest and encourage breastfeeding to address Cold stress, a potential condition the client is most likely experiencing. These actions help regulate the newborn's temperature and provide essential warmth and nutrition. Parameters to monitor would include temperature (to assess for hypothermia) and bilirubin level (to monitor for jaundice, a common issue in newborns). Monitoring these parameters will help the nurse assess the client's progress and ensure appropriate interventions are implemented.
Extract:
A nurse is reviewing the provider's prescription in the adolescent's medical record
Exhibit 1
History and Physical, Adolescent is sexually active with two current partners.
IUD in place, Reports not using condoms during sexual activity.
History of type 1 diabetes mellitus
Question 3 of 5
The nurse suspects the adolescent is experiencing pelvic inflammatory disease and is planning care. Which of the following prescriptions should the nurse expect the provider to prescribe? Drag words from the choices below to fill in each blank in the following sentence. The nurse should anticipate a provider's prescription for---------------------- and ------------------
Correct Answer: A,E,F
Rationale: The correct answer is A, E, and F. Pelvic inflammatory disease is commonly caused by sexually transmitted infections, such as Chlamydia and Gonorrhea. The recommended treatment involves antibiotics like doxycycline (
A) and ceftriaxone (E) to target these infections. Providing education on medications (F) is essential to ensure compliance and understanding of the treatment regimen. Acyclovir (
B) is used to treat herpes infections, not PID. Imiquimod (
C) is used for certain skin conditions, not PID. Fluconazole (
D) is an antifungal medication, not typically used for PID treatment.
Extract:
Question 4 of 5
A nurse is assessing the newborn of a client who took a selective serotonin reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI?
Correct Answer: D
Rationale: The correct answer is D: Vomiting. Newborns exposed to SSRIs in utero may experience withdrawal symptoms due to drug discontinuation at birth. Vomiting is a common withdrawal manifestation in newborns due to the sudden absence of the drug. Large for gestational age (choice
A) is not typically associated with SSRI withdrawal. Hyperglycemia (choice
B) and bradypnea (choice
C) are not typical withdrawal symptoms of SSRIs.
Therefore, the nurse should identify vomiting as an indication of withdrawal from an SSRI in the newborn.
Question 5 of 5
A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply.)
Correct Answer: A, B, D
Rationale: The correct answers are A, B, and D. Cholecystitis is a contraindication due to the risk of gallbladder disease. Hypertension is a contraindication because estrogen in oral contraceptives can exacerbate hypertension. Migraine headaches are a contraindication due to the increased risk of stroke. Human papillomavirus and anxiety disorder are not contraindications for oral contraceptives.