ATI RN
ATI Custom PNU Maternity Fall 2023 Questions
Extract:
A nurse is admitting a full-term baby boy delivered 12 hours ago to the nursery following a cesarean birth. The nurse observes that the newborn's skin is slightly yellow.
Question 1 of 5
This finding indicates the newborn is experiencing a complication related to which of the following?
Correct Answer: B
Rationale: The correct answer is B: Physiologic jaundice. Physiologic jaundice is common in newborns due to the breakdown of red blood cells and immature liver function. This leads to an increase in bilirubin levels, causing yellowing of the skin and eyes. Maternal/newborn blood group incompatibility (
A) would present with hemolytic disease of the newborn. Maternal cocaine abuse (
C) can lead to various complications but is not directly related to jaundice. Absence of vitamin K (
D) can cause bleeding issues but is not typically associated with jaundice in newborns.
Extract:
A nurse is caring for a client who is postpartum.
Question 2 of 5
Which of the following findings is an indication for the nurse to administer Rho(D) immune globulin?
Correct Answer: A
Rationale: The correct answer is A. Rho(
D) immune globulin is administered to Rh-negative mothers who give birth to Rh-positive babies to prevent sensitization of the mother's immune system. If the mother's blood is exposed to Rh-positive blood during birth, she may develop antibodies that can harm future Rh-positive pregnancies.
Choices B, C, and D do not involve the Rh incompatibility issue, so Rho(
D) immune globulin is not indicated.
Extract:
Duplicate of Question 13: A nurse is caring for a client who is postpartum.
Question 3 of 5
Which of the following findings is an indication for the nurse to administer Rho(D) immune globulin?
Correct Answer: A
Rationale: The correct answer is A. Rho(
D) immune globulin is administered to Rh-negative mothers when the newborn is Rh-positive to prevent Rh incompatibility reactions. Rh incompatibility can occur if fetal blood enters the maternal circulation during pregnancy or delivery, causing the mother to develop antibodies against the Rh antigen. This can lead to hemolytic disease of the newborn in subsequent pregnancies.
Choices B, C, and D do not present a risk for Rh incompatibility as there is no exposure to Rh-positive blood for an Rh-negative mother.
Therefore, administering Rho(
D) immune globulin in those situations would not be necessary to prevent Rh sensitization.
Extract:
Vital Signs: 0800: Temperature 36.6°C (97.9°F), Pulse 88/min, Respirations 20/min, BP 179/99 mm Hg. 0815: Pulse 82/min, Respirations 16/min, BP 168/104 mm Hg. 0830: Pulse 81/min, Respirations 16/min, BP 170/101 mm Hg. Medical History: Gravida 3 Para 2, 32 weeks gestation, Allergies: Penicillin, Height 5'4, Weight 80.7 kg (178 lb), BMI 30.6, 6 lb weight gain in 2 weeks. Client reports 5-day headache, blurred vision, dizziness, unrelieved by Tylenol, swelling of feet/fingers, 2+ pitting edema, DTR 3+, FHT 148.
Question 4 of 5
Which of the following findings should the nurse report to the provider?
Correct Answer: C,D,E
Rationale: The nurse should report weight, visual disturbances, and blood pressure to the provider as they indicate potential health issues. Weight changes can signal fluid retention or malnutrition. Visual disturbances may signify neurological or ocular problems. Abnormal blood pressure levels can indicate cardiovascular issues or preeclampsia. Respirations, fetal heart rate, and deep tendon reflexes are typically monitored during routine assessments and don't necessarily require immediate reporting unless significantly abnormal.
Extract:
A nurse is reinforcing teaching with a new mother about the purpose of administering vitamin K to her newborn following delivery.
Question 5 of 5
The nurse should explain that the purpose of administering vitamin K is to prevent which of the following complications?
Correct Answer: A
Rationale: The correct answer is A: Bleeding. Vitamin K is essential for the production of clotting factors in the liver, which helps prevent bleeding disorders like hemorrhage in newborns. Hyperbilirubinemia is managed with phototherapy, not vitamin K. Potassium deficiency is unrelated to vitamin K administration. Infection prevention is not a primary purpose of vitamin K administration.