ATI RN
ATI RN Maternal Newborn 2023 III Questions
Extract:
The client's laboratory results show signs consistent with dehydration and electrolyte imbalances, such as a low potassium level (3.3 mEq/L) and an elevated blood urea nitrogen (BUN) level (28 mg/dL).
Question 1 of 5
Complete the following statement: The client is at risk of developing __ due to the client's __
Correct Answer: A
Rationale: Hyperemesis gravidarum is characterized by severe nausea, vomiting, weight loss, and dehydration during pregnancy. The client's laboratory results, including low potassium (3.3 mEq/L) and elevated BUN (28 mg/dL), indicate dehydration and electrolyte imbalances, which are consistent with this condition.
Extract:
A nurse is caring for a 32-year-old female client who is at 28 weeks of gestation,
Nurses Notes
• The client is a gravida 4, para 3. The client was admitted to the labor and delivery unit with a history of vaginal bleeding for 2 hours. The client states, “I started bleeding a couple of hours ago, but now I am saturating pads with bright red blood. I am so scared something is going to happen to my baby.” The abdomen is soft and nontender to palpation. The client reports no abdominal pain. The perineal pad is saturated with bright red vaginal bleeding, and blood is trickling down the client’s legs. Fundal height is at 27 cm. An electronic fetal monitor placed on the client shows FHR with minimal variability and no decelerations. No uterine contractions or uterine irritability noted. Blood was drawn for type and cross-match.
• 0600: Client admitted with a history of vaginal bleeding for 2 hours. Client reports saturating pads with bright red blood. Abdomen soft and nontender. No abdominal pain reported. Perineal pad saturated with bright red blood, blood trickling down legs. Fundal height at 27 cm. FHR with minimal variability, no decelerations. No uterine contractions or irritability noted. Blood drawn for type and cross-match.
Diagnostic Results
• Blood type and cross-match pending.
• Complete blood count (CBC): Hemoglobin 10.5 g/dL, Hematocrit 32%, Platelets 150,000/mm³.
Medical History
• Gravida 4, para 3.
• Previous pregnancies: 1 full-term vaginal delivery, 1 preterm delivery at 34 weeks, 1 miscarriage at 10 weeks.
• No known allergies.
• No history of hypertension or diabetes.
Vital Signs
• Temperature: 37°C (98.6°F)
• Heart rate: 88/min
• Respiratory rate: 18/min
• Blood pressure: 120/80 mmHg
• Oxygen saturation: 98% on room air
Physical Examination Results
• Abdomen: Soft, nontender, fundal height at 27 cm.
• Perineal area: Saturated pad with bright red blood, blood trickling down legs.
• Fetal heart rate: Minimal variability, no decelerations.
• No uterine contractions or irritability noted.
Provider’s Prescriptions
• Bed rest with bathroom privileges.
• Continuous electronic fetal monitoring.
• Administer Rho(D) immune globulin if the client is Rh-negative.
• IV access with normal saline at 125 mL/hr.
• Prepare for possible ultrasound to assess placental location and fetal well-being.
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.
Correct Answer:
Rationale: Hematocrit 27%, vaginal bleeding, and FHR 174/min require immediate follow-up due to potential anemia, ongoing hemorrhage, and fetal distress in placenta previa.
Extract:
A nurse is assessing the results of a nonstress test for an antepartal client at 35 weeks of gestation.
Question 3 of 5
Which of the following findings should indicate to the nurse the need for further diagnostic testing?
Correct Answer: A
Rationale: Irregular contractions not felt by the client may suggest preterm labor, warranting further testing, unlike reactive NST findings which are normal.
Extract:
A nurse is caring for a newborn with jaundice who has a new prescription for phototherapy.
Question 4 of 5
What actions should the nurse take?
Correct Answer: D
Rationale: Closing the newborn's eyes before applying eyepatches protects them from phototherapy light, preventing potential eye damage.
Extract:
A nurse is caring for a newborn immediately following birth.
Nurse’s Notes (0700 hrs):
• The newborn is a male, born at 38 weeks gestation via vacuum-assisted vaginal birth. The mother has a history of positive group B streptococcus B-hemolytic and received two doses of ampicillin IV bolus during labor.
• The newborn is placed under a radiant warmer.
• Initial assessment shows the newborn is crying weakly.
• The newborn’s skin color is consistent with genetic background but has acrocyanosis.
• Muscle tone is flaccid.
• Reflex irritability is present with a weak cry.
• The newborn’s temperature is 36.3°C (97.4°F).
Vital Signs (0700 hrs):
• Heart rate: 140/min
• Respiratory rate: 60/min
• Axillary temperature: 36.3°C (97.4°F)
• Oxygen saturation: 92%
Laboratory Findings (0700 hrs):
• WBC count: 15,000/mm³ (9,000 to 30,000/mm³)
• Hgb: 19 g/dL (15 to 24 g/dL)
• Hct: 57% (44 to 70%)
• Blood glucose: 44 mg/dL (40 to 60 mg/dL)
Medications (0700 hrs):
• Erythromycin ophthalmic ointment once 1 to 2 hr after birth
• Hepatitis B vaccine 10 mcg/0.5 mL IM once within 24 hr after birth
• Phytonadione 1 mg IM once 1 to 2 hr after birth
Question 5 of 5
A nurse is assessing the newborn 24 hours later. Based on the exhibits provided, which findings indicate that the newborn’s condition is improving, worsening, or unrelated to the diagnosis?
| Findings | condition improving | condition worsening | unrelated to the diagnosis |
|---|---|---|---|
| WBC count 18,000/mm³ | |||
| Hgb 18 g/dL | |||
| Hct 55% | |||
| Blood glucose 50 mg/dL | |||
| . Axillary temperature 36.8°C | |||
| Heart rate 130/min |
Correct Answer:
Rationale: Regurgitation, mottling, RR 70/min, high-pitched cry worsening (NAS symptoms); strabismus unrelated (normal newborn finding).