ATI RN
ATI RN Maternal Newborn 2023 Questions
Extract:
A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10.
Question 1 of 5
Using Nägele’s Rule, which of the following is the client's estimated date of delivery?
Correct Answer: D
Rationale: Using Nägele's Rule, we add 7 days to the first day of the last menstrual period and count forward 3 months. For D: 17-May, the first day would be February 10th (17 - 3 months = February 10th). Adding 7 days gives February 17th. Thus, the estimated delivery date is May 17th.
Choice A (3-May) is too early, B (20-May) is too late, and C (13-May) is also too early based on the calculation method.
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 2 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 immediately following the delivery of a stillborn fetus.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Provide the client with photos of the fetus. This action is appropriate as it allows the client to have a tangible memory of their loss, which can aid in the grieving process. Providing photos shows empathy and support for the client during a difficult time.
Choice A is incorrect because the decision to perform an autopsy should be discussed with the client based on their wishes and not imposed within a specific timeframe.
Choice B is incorrect as there is no law requiring the naming of a fetus.
Choice D is incorrect as the client should be given the autonomy to decide how long they wish to spend with the fetus in their room.
Extract:
A nurse is planning care for a client who is 1 hr postpartum and has peripartum cardiomyopathy.
Question 4 of 5
Which of the following actions should the nurse plan to take?
Correct Answer: D
Rationale: The correct answer is D: Restrict daily oral fluid intake. This action is important for patients with heart failure to prevent fluid overload. Administering an IV bolus of lactated Ringer's (
A) can exacerbate fluid overload. Obtaining misoprostol (
B) is not relevant to managing heart failure. Assessing blood pressure twice daily (
C) is important but not the priority.
Extract:
A nurse is caring for a client who is 48 hr postpartum and has a deep vein thrombosis. Vital Signs: Blood Pressure 130/72 mm Hg, Heart rate 90/min, Respiratory rate 18/min, Temperature 37°C (98.6°F).
Question 5 of 5
The nurse is assessing the client 24 hr later. How should the nurse interpret the findings? (Select one representative finding)
Correct Answer: B
Rationale: The correct answer is B: Redness in the extremity. This finding could indicate a possible infection, specifically cellulitis, which is a common complication post-operatively. Redness is a sign of inflammation and can be associated with warmth, tenderness, and swelling. It is important for the nurse to recognize this early to prevent further complications. Leukocytosis (
A) may be a nonspecific finding and can be present for various reasons. Scant lochia rubra (
C) is a normal finding in the postpartum period. Increased warmth in the extremity (
D) can be concerning for infection or deep vein thrombosis. Tachycardia (E) can be a sign of various conditions, not specifically related to post-operative complications. Decreased extremity edema (F) is a positive finding indicating improved circulation.