ATI RN
ATI RN Maternal Newborn 2023 Exam 4 Questions
Extract:
A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis.
Question 1 of 5
How should the nurse interpret the findings 24 hr later?
Correct Answer: A
Rationale: The correct answer is A: Decreased extremity edema. This indicates improved circulation and reduced fluid retention, a positive response to treatment. Redness (
B) may indicate infection, leukocytosis (
C) suggests inflammation or infection, and tachycardia (
D) could be a sign of distress. Monitoring for improvement in edema is crucial in assessing the effectiveness of treatment.
Extract:
A nurse is caring for a newborn who is 4 hours old. The newborn is lying in a bassinet, lightly swaddled. The newborn is noted to be jittery with a weak cry when disturbed. Extremities are mottled with acrocyanosis. Respirations are rapid and unlabored.
Question 2 of 5
What condition is the newborn most likely experiencing?
Correct Answer: A
Rationale: The symptoms of jitteriness, weak cry, and mottled extremities with acrocyanosis are indicative of hypoglycemia.
Extract:
A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation.
Question 3 of 5
Identify the sequence of actions the nurse should take.
Order the Items
Source Container
Correct Answer: A, B, C, D, E
Rationale: The correct order is A, B, C, D, E. Firstly, instructing the client to empty their bladder ensures a clearer assessment. Positioning the client supine with knees flexed and a rolled towel under the hip promotes comfort and relaxation. Palpating the fetal part in the fundus helps determine the presenting part. Palpating the fetal parts along both sides of the uterus allows for identification of the position and engagement. Lastly, palpating the fetal part above the symphysis pubis helps ascertain the descent and engagement of the presenting part. The other choices are incorrect as they do not follow a logical sequence for a comprehensive fetal assessment.
Extract:
A nurse is assessing a postpartum client during a follow-up visit.
Question 4 of 5
What was the client's score on the Edinburgh Postnatal Depression Screen?
Correct Answer: B
Rationale: A score of 11 on the EPDS on postpartum day 30 is above the clinical cutoff score of 10, indicating a high risk of postpartum depression.
Extract:
A nurse is assessing a newborn who has neonatal abstinence syndrome.
Question 5 of 5
Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Excessive crying. Excessive crying is a common finding in infants with colic, which is a self-limiting condition characterized by prolonged and inconsolable crying. Diminished deep tendon reflexes (
A), absent Moro reflex (
B), and decreased muscle tone (
D) are not typically associated with colic. It is important for the nurse to recognize these findings to differentiate them from colic and provide appropriate care.