ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
A nurse is reviewing the provider's prescription in the adolescent's medical record
Exhibit 1
History and Physical, Adolescent is sexually active with two current partners.
IUD in place, Reports not using condoms during sexual activity.
History of type 1 diabetes mellitus
Question 1 of 5
The nurse suspects the adolescent is experiencing pelvic inflammatory disease and is planning care. Which of the following prescriptions should the nurse expect the provider to prescribe? Drag words from the choices below to fill in each blank in the following sentence. The nurse should anticipate a provider's prescription for---------------------- and ------------------
Correct Answer: A,E,F
Rationale: The correct answer is A, E, and F. The nurse should anticipate a prescription for doxycycline and ceftriaxone to treat the pelvic inflammatory disease. Doxycycline is a common antibiotic used to treat pelvic inflammatory disease caused by chlamydia or gonorrhea. Ceftriaxone is another antibiotic that may be prescribed in combination with doxycycline for broader coverage. Additionally, providing education on medications is crucial to ensure the adolescent understands the treatment plan and complies with the prescribed regimen.
Choices B, C, and D are incorrect as acyclovir is used to treat herpes infections, imiquimod is used for certain skin conditions like genital warts, and fluconazole is an antifungal medication not typically used for pelvic inflammatory disease.
Extract:
Exhibit1 Medical History Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (71b 12 0z) Apgar scores 8 at 1 min and 9 at 5 min Maternal history of methadone use during
pregnancy.
Exhibit2 vital signs 0700: Heart rate 156/min Respiratory rate 58/min Temperature 37.2° C (98.9° F) Oxygen saturation 98% on room air .1100: Heart rate 160/min Respiratory rate 60/min Temperature 37.3° C (99.2° F) Oxygen saturation 96%
on room air
Exhibit3 Physical Examination 1100: Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorouslyon pacifier but breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today.Exhibit4 (image)
Apgars: 7 at 1 min and 8 at 5 min of age Birth weight: 3,515 (7 1b 12 02) Maternal blood type: O+ Uncomplicated pregnancy. Maternal use of marijuana during pregnancy Client who gave birth plans to breastfeed
Question 2 of 5
A nurse is caring for a newborn who is 70 hr old. Which of the following findings should the nurse report to the provider? (Select all that apply.)
Correct Answer: A, D, E
Rationale: The correct answer is A, D, and E. The nurse should report respiratory, central nervous system, and gastrointestinal findings to the provider in a newborn at 70 hours old. Respiratory findings could indicate potential respiratory distress, CNS findings could signal neurological issues, and gastrointestinal findings could suggest feeding or digestion problems. Reporting these findings promptly allows the provider to assess and intervene if necessary, ensuring the newborn's well-being.
Choices B and C are typically monitored but are not the top priority in this scenario.
Extract:
“A nurse is caring tor a newborn.
Exhibit1:
Medical History. Apgar score 9 at 1 min and 9 at 5 min Birth weight 4,706 g (10 lb 6 oz)| Gestational age
40 weeks Difficult vaginal birth with shoulder dystocia.
EXHIBIT2:
Nurses: Notes 1700: Newborn is active and moves all extremities except for right arm. No spontaneous
movement of the right arm noted, Right arm remains at side during Moro reflex.
Exhibit3:
Physical examination 1830: Absent Moro reflex noted in right arm. Right shoulder and arm are internally
rotated and adducted. Elbow extended. Forearm pronated with wrist and fingers flexed. Diagnosis.
brachial prexus injury resulting in trot Duchenne (Erb's palsy) paralysis
Question 3 of 5
Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is Indicated or contraindicated for the newborn
| Potential Nursing Action | Indicated | Contraindicated | |
|---|---|---|---|
| Educate the parents to begin range of motion exercises on the affected arm after 1 week. | |||
| Assess for grasp reflex in the affected extremity. | |||
| Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt. | |||
| Instruct parents to limit physical handling for 2 weeks. |
Correct Answer: B
Rationale: [0, 1, 0, 0]
The correct answer is B: Assess for grasp reflex in the affected extremity. This is indicated to evaluate neurological function. Educating parents on range of motion exercises after 1 week, immobilizing the arm, and limiting physical handling are contraindicated as they can lead to complications and hinder recovery in a newborn with a possible neurological issue.
Extract:
A nurse is reviewing the provider's prescription in the adolescent's medical chart
Exhibit 1
History and Physical, Adolescent is sexually active with two current partners.
IUD in place, Reports not using condoms during sexual activity.
History of type 1 diabetes mellitus
Question 4 of 5
Which of the following indicates whether the adolescent understands the teaching on requires further education?
| client statements | Indicates understanding | Requires further education | |
|---|---|---|---|
| I should continue taking all my medications even if I don't show any symptoms. | |||
| If I continue to get this type of infection, it can affect my ability to have kids in the future. | |||
| I should go to the emergency department if my urine turns dark. | |||
| As long as I keep my IUD, I don't need to use condoms. | |||
| I'm more likely to get a sunburn while taking these medications. |
Correct Answer: D
Rationale: [_,1,0,1,0,0,0]
The correct answer is . This statement indicates a misunderstanding as using an IUD does not protect against sexually transmitted infections (STIs). The client requires further education on the importance of using condoms to prevent STIs. The other options do not directly relate to sexual health education or contraception.
Extract:
Question 5 of 5
A nurse is teaching a client who is at 35 weeks of gestation about manifestations of potential pregnancy complications to report to the provider. Which of the following manifestations should the nurse include?
Correct Answer: C
Rationale: The correct answer is C: Headache that is unrelieved by analgesia. This is a concerning symptom that could indicate a serious complication like preeclampsia. It is crucial to report this to the provider promptly to prevent potential harm to both the mother and the baby. Shortness of breath when climbing stairs (
A) can be a normal pregnancy symptom due to increased demand on the body, swelling of feet and ankles (
B) is common in pregnancy but not typically a sign of immediate concern, Braxton Hicks contractions (
D) are normal and can occur throughout pregnancy. By prioritizing the headache that is unrelieved by analgesia, the nurse is focusing on a symptom that requires urgent attention.