ATI RN
RN Comprehensive Predictor 2023 Questions
Extract:
Nurses' Notes
Vital Signs
Laboratory results
Provider prescriptions
0900:
Client who is at 38 weeks of gestation presents to the antepartum unit with uterine contractions, dark red vaginal bleeding, and abdominal pain that started approximately 45 min prior to arrival. Rates abdominal pain a 7 on a scale of 0 to 10. Client reports, "My blood pressure has been high during the pregnancy."
Home Medications: prenatal multivitamin, methyldopa 250 mg PO twice daily
Physical Exam:
General: tearful, anxious
Cardiovascular: S1, S2, no murmur
Respiratory: bilateral breath sounds clear
Abdomen: Uterine hypertonicity with a board-like abdomen, tenderness noted upon palpation of left upper quadrant FHR: 116/min, minimal variability noted
Question 1 of 5
For each potential nursing action, click to specify if the nursing action is anticipated or contraindicated for the client.
| Options | Anticipated | Contraindicated |
|---|---|---|
| Obtain consent for cesarean birth | ||
| Provide intermittent fetal heart rate monitoring | ||
| Administer oxygen 10 L via face mask | ||
| Prepare the client for an amnioinfusion | ||
| Initiate IV bolus lactated Ringer's | ||
| Insert a urinary catheter |
Correct Answer: A,B,C,D
Rationale: Obtain consent: Anticipated - Potential need for cesarean due to complications. Provide monitoring: Anticipated - Essential for fetal well-being. Administer oxygen: Anticipated - Improves oxygenation. Prepare for amnioinfusion: Contraindicated - Increases risk in bleeding. Initiate IV bolus: Anticipated - Addresses hypovolemic shock. Insert catheter: Contraindicated - Not immediately necessary.
Extract:
Question 2 of 5
A nurse is caring for a client who has severe hypertension and is to receive nitroprusside via continuous IV infusion. Which of the following actions should the nurse plan to take?
Correct Answer: A
Rationale: Nitroprusside is light-sensitive and degrades when exposed to light, reducing its potency and effectiveness.
Question 3 of 5
A nurse is providing an in-service about client evacuation during a fire. Which of the following clients should the nurse instruct the staff to evacuate first?
Correct Answer: C
Rationale: A client who is ambulatory and receiving oxygen is at risk of immediate danger if the oxygen supply poses a fire hazard. They can be evacuated quickly and independently.
Question 4 of 5
Select words from the choices below to fill in each blank in the following sentence. The client is at greatest risk for developing ___ and ___ .
Correct Answer: A,E
Rationale: The client is at greatest risk for developing seizures and placental abruption. Preeclampsia and history increase risks.
Extract:
Nurses' Notes
Vital Signs
0900:
Contractions occurring every 3 to 4 min, lasting 80 to 90
seconds. Client rates pain with contractions as 10 on a scale of 0 to 10 and requests an epidural. Contractions approximately 4 min apart. Vaginal examination reveals cervix dilated 5 cm, 80% effaced, -1 station, vertex presentation. FHR baseline 142/min with moderate variability. IV fluid bolus initiated.
0930:
Epidural inserted by anesthesiology. Client reports pain as 2 on a scale of 0 to 10.
0950:
Spontaneous rupture of membranes with clear fluid.
Question 5 of 5
Select the 5 actions the nurse should take.
| Exert upward pressure on the presenting part. |
| Place the client in a Trendelenburg position. |
| Administer oxygen at 10 L/min via nonrebreather face mask. |
| Attempt to push the umbilical cord back into the cervix. |
| Have the charge nurse notify the provider. |
| Increase the flow rate of the maintenance IV fluid. |
Correct Answer: A,B,C,E,F
Rationale: Exert pressure: Relieves cord compression. Trendelenburg: Reduces cord pressure. Oxygen: Improves fetal oxygenation. Notify provider: Ensures timely intervention. Increase IV fluid: Supports maternal circulation.