ATI RN
ATI RN Maternal Newborn 2023 II Questions
Extract:
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid.
Question 1 of 5
Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Administer broad-spectrum antibiotics. This action is appropriate for preventing or treating infection at the site. Povidone-iodine cleansing (
A) may be too harsh for the wound. Surgical closure (
C) should be based on wound assessment, not a fixed time frame. Monitoring rectal temperature (
D) is not directly related to wound care. The nurse should focus on infection prevention and treatment, making administering antibiotics the most appropriate choice.
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 monitor for which of the following findings as an adverse effect of the medication?
Correct Answer: B
Rationale: The correct answer is B: Hypotension. Hypotension is a common adverse effect of many medications, especially those that affect blood pressure or circulation. The nurse should monitor for signs such as dizziness, lightheadedness, or low blood pressure readings. Polyuria (
A) is excessive urination, not typically an adverse effect of medications. Bilateral crackles (
C) indicate fluid in the lungs, not a common adverse effect of medications. Hyperglycemia (
D) is high blood sugar, often seen with certain medications like steroids or glucose-lowering drugs.
Extract:
A nurse is caring for a client who has bladder distention following a vaginal birth.
Question 3 of 5
Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Assist the client to the bathroom. This is the first action the nurse should take because it addresses the most immediate need of the client, which is to relieve themselves. It ensures the client's comfort and promotes their dignity. Option B, offering a sitz bath, can be considered later for comfort but does not address the urgent need. Option C, pouring warm water over the client's perineum, may provide relief but does not address the primary need. Option D, inserting a urinary catheter, is an invasive procedure and should only be considered after other non-invasive interventions have been attempted.
Question 4 of 5
Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Escort the client to the bathroom. This action should be taken first to address the immediate need of the client for toileting. It promotes the client's comfort, maintains their dignity, and prevents potential complications like urinary retention. Option B (Offer the client a sitz bath) and C (Pour warm water over the client's perineum) are not priorities as they do not address the client's urgent need for toileting. Option D (Insert a urinary catheter) is an invasive procedure and should not be the first action unless indicated for a specific medical reason. Options E and F (None) are not appropriate as there is a clear immediate need that requires action.
Extract:
A nurse is discussing fertility treatment options with a client and their partner.
Question 5 of 5
Which of the following nonpharmacological treatments should the nurse suggest?
Correct Answer: C
Rationale: The correct answer is C: Maintain a healthy weight. This is because maintaining a healthy weight can have a significant impact on overall health and can help manage various health conditions, including improving symptoms related to certain diseases. Obesity can exacerbate health issues, so suggesting weight management is crucial. Hot baths (
A) may provide temporary relief but do not address the root cause. Using a lubricant during intercourse (
B) may help with comfort but does not address nonpharmacological treatment. Drinking herbal tea (
D) may have some benefits but is not a primary treatment for most conditions.