ATI RN
ATI Maternal Newborn Proctored Exam Latest Update Questions
Extract:
Question 1 of 5
The nurse conducting a physical assessment notes that a 1-day-old newborn with dark skin has a bluish-gray discoloration over the lower back, the buttocks, and the scrotum. How should this assessment finding be documented?
Correct Answer: B
Rationale: The correct answer is B: Mongolian spots. This is because Mongolian spots are common in newborns with dark skin and appear as bluish-gray discolorations over the lower back, buttocks, and sometimes the scrotum. They are benign and typically fade over time.
Choice A, extensive bruising, would present as red or purple discoloration from trauma, not bluish-gray.
Choice C, nevus flammeus, is a birthmark that appears as a pink or red patch, not bluish-gray.
Choice D, acrocyanosis, is a condition where the extremities have a bluish discoloration due to poor circulation, not localized to the lower back and buttocks.
Question 2 of 5
During the postpartum period, a hospitalized client complains of discomfort related to her episiotomy. The nurse assigns the diagnosis of 'pain related to perineal sutures.' Which nursing intervention is most appropriate during the first 24 hours following an episiotomy?
Correct Answer: D
Rationale: The correct answer is D: Apply ice packs to the perineum. This intervention helps reduce swelling, inflammation, and provides pain relief by numbing the area. Ice constricts blood vessels, reducing blood flow to the area, which can minimize pain and discomfort. Ice packs should be applied for short periods, typically 20 minutes on and 20 minutes off, to prevent skin damage. This intervention is most appropriate during the first 24 hours post-episiotomy as it helps manage acute pain and promotes healing.
Other choices are incorrect:
A: Using petroleum jelly can increase the risk of infection and hinder wound healing.
B: Kegel exercises focus on pelvic floor muscle strength and do not directly address pain related to perineal sutures.
C: Sitz baths are beneficial for promoting healing but may not provide immediate pain relief like ice packs.
Question 3 of 5
A woman in active labor receives a narcotic analgesic for pain control. If the narcotic is given a half an hour before delivery, which effect will the medication have on the infant?
Correct Answer: B
Rationale: The correct answer is B: It will cause the infant's respiratory rate to decrease. Narcotic analgesics can cross the placenta and affect the infant. These medications can cause respiratory depression in the newborn due to their central nervous system depressant effects. This effect is more pronounced when the narcotic is given close to delivery as the infant may still have the drug in its system after birth. Options A and C are incorrect as narcotics do not directly affect blood sugar or heart rate in infants. Option D is incorrect as narcotics typically cause sedation rather than hyperactivity.
Question 4 of 5
If a pregnant client diagnosed with gestational diabetes cannot maintain control of her blood sugar by diet alone, which medication will she receive?
Correct Answer: C
Rationale: The correct answer is C: Insulin. In gestational diabetes, insulin is the preferred medication as it does not cross the placenta and is safe for both the mother and the fetus. Insulin helps regulate blood sugar levels effectively and can be adjusted based on the client's needs during pregnancy. Metformin (choice
A) may not be recommended during pregnancy due to potential risks. Glucagon (choice
B) is not typically used for managing gestational diabetes. Glyburide (choice
D) may cross the placenta and pose risks to the fetus. It is essential to prioritize the safety and well-being of both the mother and the unborn child when selecting medications for gestational diabetes.
Question 5 of 5
A nurse is preparing a room for the admission of a client with sickle cell anemia who is in vasoocclusive crisis. Which type of equipment should the nurse place in the client's room?
Correct Answer: D
Rationale: The correct answer is D: Blood transfusion equipment. During a vasoocclusive crisis in sickle cell anemia, there is a blockage in blood vessels leading to severe pain and tissue damage. Blood transfusions may be necessary to improve oxygen delivery to tissues and alleviate symptoms. Having blood transfusion equipment readily available in the client's room allows for prompt intervention if needed.
A: Wheelchair with adjustable leg rests - Not directly related to managing vasoocclusive crisis.
B: A radio and age-appropriate reading materials - Entertainment items, not essential for crisis management.
C: Extra blankets and pillows - Provide comfort but do not address the underlying cause of the crisis.
In summary, the focus during a vasoocclusive crisis in sickle cell anemia should be on interventions that directly address the physiological needs of the client, such as blood transfusion equipment.