ATI RN
ATI RN Maternal Newborn 2023 Questions
Extract:
A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a new prescription for misoprostol. Medication Administration Record: Misoprostol 800 mcg rectally x 1 dose now, Nifedipine 20 mg PO twice daily, Ketorolac 30 mg IV every 6 hr.
Question 1 of 5
The nurse is assessing the client 30 min later. How should the nurse interpret the findings? (Select one representative finding)
Correct Answer: D
Rationale: The correct answer is D: Fundus firm to palpation. This indicates that the uterus is contracting well, which is important for preventing postpartum hemorrhage. A firm fundus at this time indicates good involution of the uterus.
Choices A, B, and C are indicative of potential issues that would require further assessment and intervention.
Choice A suggests hypotension, B may indicate a urinary tract infection, and C suggests excessive bleeding.
Choice E indicates a higher-than-expected fundal height, which could indicate uterine atony.
Extract:
A nurse is caring for a client who is receiving an epidural block with an opioid analgesic.
Question 2 of 5
The nurse should identify which findings as an adverse effect of the medication?
Correct Answer: D
Rationale: The correct answer is D: Hypotension. This is an adverse effect of the medication because hypotension indicates low blood pressure, which can lead to dizziness, weakness, and fainting. It is important for the nurse to monitor and address hypotension promptly. Polyuria (
A) is increased urination, not typically an adverse effect. Bilateral crackles (
B) indicate fluid in the lungs, not directly related to medication adverse effects. Hyperglycemia (
C) is high blood sugar, more commonly associated with diabetes or corticosteroid use.
Extract:
A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception.
Question 3 of 5
Which of the following instructions should the nurse include?
Correct Answer: C
Rationale:
Correct Answer: C - "You should have your provider refit you for a new diaphragm."
Rationale: It is important for the nurse to instruct the patient to have their provider refit them for a new diaphragm because diaphragms need to be properly fitted to ensure effectiveness in contraception. Over time, the size and shape of the cervix can change, which may affect the fit of the diaphragm. It is recommended to have the diaphragm refitted after significant weight change, pregnancy, childbirth, or every 2-3 years. This ensures that the diaphragm continues to provide optimal protection against pregnancy.
Summary of Incorrect
Choices:
A: Using an oil-based lubricant can damage the diaphragm. Water-based lubricants are recommended.
B: The diaphragm should be kept in place for at least 6 hours, not 4 hours, after intercourse.
D: Diaphragms should be stored in a cool, dry place, not sterile
Extract:
A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding.
Question 4 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Anticipate a prescription for misoprostol. This is the correct action because misoprostol is commonly used in obstetrics to induce labor or manage postpartum hemorrhage. The nurse should anticipate this prescription to be prepared to administer it as needed.
Choice A is incorrect as sterile vaginal examinations may be necessary for assessment and care.
Choice C is incorrect as a Kleihauer-Betke test is used to detect fetal-maternal hemorrhage, not typically indicated in this scenario.
Choice D is incorrect as betamethasone is a corticosteroid used for fetal lung maturity, not indicated in this situation.
Extract:
Nurses Notes 0700: Breasts soft nipples intact. Uterus palpated firm, midline, and at level of umbilicus. Moderate amount of lochia rubra. Episiotomy site well approximated with mild edema and ecchymosis. Client reports pain as 2 on a scale of 0 to 10. Able to void spontaneously, no bladder distention. Deep tendon reflexes 1+. Peripheral edema 2+ in bilateral lower extremities. 1100: Breasts soft, nipples intact. Uterus palpated soft with lateral deviation and 1 cm above the umbilicus. Large amount of lochia rubra. Episiotomy site well approximated with mild edema and ecchymosis. Client reports pain as 3 on a scale of 0 to 10. Deep tendon reflexes 1+ Peripheral edema 2+ in bilateral lower extremities.
Question 5 of 5
Select the 3 findings that require immediate follow-up.
Correct Answer: C, F,G
Rationale: The correct answer is C, F, and G.
C: Lateral deviation of the uterus indicates a possible uterine abnormality that needs immediate follow-up to prevent complications.
F: Soft breasts could be a sign of inadequate lactation or mastitis, requiring prompt intervention.
G: Large amount of lochia rubra suggests excessive postpartum bleeding, which is concerning and necessitates immediate attention.
Other choices are less urgent:
A: Peripheral edema and blood pressure within normal range are common postpartum findings.
D: Pain rating of 3 is mild and does not necessitate immediate follow-up.
E: Uterine tone being soft can be normal in the early postpartum period.