ATI RN Maternal Newborn Updated 2023 | Nurselytic

Questions 53

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ATI RN Maternal Newborn Updated 2023 Questions

Extract:

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: D

Rationale: The correct answer is D: Administer broad-spectrum antibiotics. This is crucial in the plan of care to address potential infection post-injury. Antibiotics help prevent or treat infections that can develop in the wound site. Monitoring rectal temperature (
B) does not directly address wound care. Preparing for surgical closure (
A) can be important but addressing infection is a higher priority. Cleansing with povidone-iodine (
C) is a good practice, but antibiotics are necessary for systemic infection prevention.

Extract:

A postpartum client who recently had an indwelling urinary catheter removed.


Question 2 of 5

Which of the following findings indicates that the client is able to void effectively?

Correct Answer: A

Rationale: The correct answer is A because urinating 30 mL/hr indicates adequate urinary output, suggesting effective voiding. Option B is incorrect as lack of urge to urinate signifies potential urinary retention. Option C is unrelated to voiding effectiveness. Option D indicates a distended bladder, pointing to ineffective voiding.

Extract:

A client who is in labor and has a spontaneous rupture of membranes. The nurse notes that the umbilical cord is protruding from the client's vagina.


Question 3 of 5

After calling for help, which of the following actions should the nurse take first?

Correct Answer: A

Rationale: The correct action is A: Use fingers to exert upward pressure on the presenting part. This is the first step in managing a prolapsed cord to alleviate pressure on the cord and prevent fetal hypoxia. Immediate action is crucial in this emergency situation. Administering tocolytic medication (
B) is not the priority as it does not address the immediate risk to the fetus. Applying oxygen via facemask (
C) is important but secondary to relieving cord compression. Wrapping the cord in a sterile towel (
D) is not recommended as it can further compress the cord.

Extract:

A client and their newborn.


Question 4 of 5

Which of the following observations should indicate to the nurse that the client is in the taking-in phase of maternal role attainment?

Correct Answer: D

Rationale: The correct answer is D because during the taking-in phase of maternal role attainment, the client tends to review their birth experience with others as they seek validation and support. This phase is characterized by a passive and dependent behavior, where the client is reflecting on their experience and may express a need for validation and reassurance.

Choices A, B, and C are incorrect as they do not align with the characteristics of the taking-in phase. The client desiring privacy, taking charge of all tasks, or putting personal needs aside are more indicative of the taking-hold phase or the let-go phase.

Extract:

A client who is pregnant and whose last menstrual cycle started June 21.


Question 5 of 5

Which of the following is the estimated date of delivery in the next year?

Correct Answer: A

Rationale: The estimated date of delivery in the next year can be determined by looking for the last day of March, which is 31st. Since 28-Mar is the closest to the end of March, it is the correct answer.
Choice B, 21-Mar, is too early in March.
Choice C, 4-Apr, is in April.
Choice D, 14-Mar, is also too early in March.

Choices E, F, and G are not provided.

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