ATI RN
ATI RN Maternal Newborn 2023 III Questions
Extract:
A 28-year-old female at 12 weeks gestation admitted with excessive vomiting for 48 hours, lost 2.3 kg. Reports unable to keep food/fluids down. Dry mucous membranes, poor skin turgor, amber urine 20 mL/hr.
Question 1 of 5
The nurse is assessing the client 24 hours later. How should the nurse interpret the findings? Options: A. Urine pH 5.0, B. Urine specific gravity 1.050, C. 3+ ketones, D. Urinary output 40 mL/hr, E. HR 130/min, F. WBC 10,000/mm³
Correct Answer: A
Rationale: Urine pH 5.0 and output 40 mL/hr improving (hydration); specific gravity 1.050, 3+ ketones, HR 130/min worsening (dehydration); WBC 10,000/mm³ unrelated (normal range).
Extract:
A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B12.
Question 2 of 5
Which foods should the nurse recommend?
Correct Answer: C
Rationale: Fortified soy milk is a reliable vitamin B12 source for vegans, unlike plant foods like carrots, citrus fruits, or brown rice which lack it naturally.
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 3 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).
Extract:
A nurse is planning care for a patient who is 12 hours postpartum and has a third-degree perineal laceration.
Question 4 of 5
Which of the following interventions should the nurse include in the plan?
Correct Answer: D
Rationale: Witch hazel pads reduce inflammation and promote healing, suitable for a third-degree laceration postpartum.
Extract:
A 28-year-old female at 15 weeks gestation reports frequent nausea, vomiting, fatigue, weight loss, dizziness, no abdominal pain.
Question 5 of 5
Which of the following findings should the nurse identify as an indication of a potential complication of pregnancy? (Select all that apply)
Correct Answer: A, B, C, D, E
Rationale: Sodium 132 mEq/L, urine specific gravity 1.035, potassium 3.3 mEq/L, HR 106/min, and weight loss indicate hyperemesis gravidarum complications (electrolyte imbalance, dehydration), requiring monitoring.