ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
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 1 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 in a clinic a caring for a 16-year-old adolescent
Exhibit1:
Provider Prescriptions: Standing prescriptions for clients who present with abdominal. Obtain laboratory
tests, Urinalysis, Cervical culture C-reactive protein Beta Hcg
Question 2 of 5
Which of the following findings should the nurse report to the provider? Select all that apply
| Abdominal assessment. |
| Vaginal Discharge. |
| Heart rate. |
| Temperature. |
| Dyspareunia. |
| Condom usage. |
Correct Answer: B, E
Rationale:
To determine which findings the nurse should report to the provider, we need to consider the significance of each choice. Vaginal discharge should be reported as it can indicate infection or other gynecological issues. Dyspareunia (E), which is painful intercourse, should also be reported as it could suggest underlying health concerns. Abdominal assessment (
A), heart rate (
C), temperature (
D), and condom usage (F) are important but do not necessarily require immediate reporting to the provider unless there are specific concerns related to them.
Choice G is blank, so it is not applicable.
Therefore, the correct answers are B and E.
Extract:
Question 3 of 5
A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: The correct answer is C because continuing to take insulin even during nausea and vomiting is crucial to prevent complications of hyperglycemia. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia without insulin.
Choice A is incorrect as insulin needs may decrease in the first trimester.
Choice B is incorrect as moderate exercise is not recommended if blood glucose is 250 or greater.
Choice D is incorrect as a bedtime snack high in refined sugar can lead to unstable blood sugar levels.
Extract:
The nurse is reviewing laboratory results in the adolescent's medical record.
Exhibit 1
Vital Signs
1300: Blood pressure 118/72 mm Hg, Heart rate 100/min ,Respiratory rate 20/min ,Temperature 38.3° C
(101° F)
Exhibit 2:
Provider Prescriptions 1300: Standing prescriptions for clients who present with abdominal pain: Obtain
laboratory tests: Urinalysis Cervical culture C-reactive protein Beta hCG
Exhibit 3:
Nurses' Notes 1300: Admitted adolescent reporting "cramping in my stomach." Reports pain as a 4 on 0
to 10 pain scale and describes pain as constant and dull. Reports nausea and vomiting over past 24
hours. Reports painful urination and pain during sexual intercourse with minimal vaginal itching-
Tenderness with palpation to lower abdomen, guarding abdomen observed. Greenish vaginal discharge
observed. Reports last menstrual period was 3 weeks ago as normal period lasted 4 days. “
Question 4 of 5
Which of the following conditions is the client most likely developing?
| Pelvic inflammatory. |
| Ectopic pregnancy. |
| Pyclonephritis. |
| C-reactive protein. |
| Beta hCG. |
| Urinalysis. |
Correct Answer: A
Rationale: For the correct answer A : (1, 0, 0, 0, 0, 0)
Rationale: Pelvic inflammatory disease (PI
D) is an infection of the female reproductive organs. It typically presents with symptoms like pelvic pain, abnormal vaginal discharge, fever, and painful urination. It is commonly associated with sexually transmitted infections. In this scenario, the client is most likely developing PID due to the presence of symptoms such as pelvic pain and abnormal discharge. Ectopic pregnancy (
B) presents with abdominal pain and vaginal bleeding, not typically associated with PID. Pyelonephritis (
C) is a kidney infection that manifests with fever, flank pain, and urinary symptoms, not specific to PID. C-reactive protein (
D) is a marker of inflammation, not a condition itself. Beta hCG (E) is a hormone indicative of pregnancy, not specific to PID. Urinalysis (F) can help diagnose urinary tract infections but
Extract:
Question 5 of 5
A nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura (ITP). Which of the following findings should the nurse expect?
Correct Answer: A
Rationale:
Correct Answer: A - Decreased platelet count.
Rationale: In idiopathic thrombocytopenia purpura (ITP), there is a decreased platelet count due to immune-mediated destruction of platelets. This leads to an increased risk of bleeding and bruising. The nurse should expect thrombocytopenia in a client with ITP.
Summary of other choices:
B: Increased ESR - ESR is not typically affected in ITP.
C: Decreased megakaryocytes - Megakaryocytes are usually increased in ITP as the bone marrow tries to compensate for the decreased platelet count.
D: Increased WBC - WBC count is not typically affected in ITP.