ATI RN
RN Maternal Nursing OB Newborn 2023 2024 Exam Questions
Extract:
A nurse is caring for a newborn.
Exhibit 1
Medical History
1600:
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. Exhibit 2
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. Exhibit 3
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 plexus injury resulting in Erb-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:
Rationale: Educate the parents to begin range of motion exercises on the affected arm after 1 week is indicated. Passive ROM exercises of the arm are indicated to restore function of the extremity. The initiation of these exercises is delayed for approximately 1 week to prevent additional injury to the brachial plexus. Assess for grasp reflex in the affected extremity is indicated. With Erb-Duchenne paralysis, only the upper arm is affected. The function of the wrists and fingers should be unaffected; the nurse should assess for a palmar grasp reflex.Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt is indicated. Intermittent immobilization of the affected arm across the newborn's abdomen can be achieved by pinning the sleeve to the shirt.Instruct parents to limit physical handling for 2 weeks is contraindicated. Parents and guardians should participate in the physical care of their newborn to increase parental-infant attachment. Providing education and practice opportunities for the parents will decrease their fears of injuring the newborn and increase confidence and bonding.
Extract:
Question 2 of 5
What is the function of the placenta during pregnancy?
Correct Answer: D
Rationale: The placenta serves multiple functions, including transporting oxygen and nutrients, removing waste products, and helping regulate fetal temperature.
Question 3 of 5
Which of the following is a potential complication of hypoglycemia in a newborn?
Correct Answer: D
Rationale: The correct answer is D: All of the above. Hypoglycemia in a newborn can lead to hypothermia due to decreased energy production, hyperbilirubinemia as a result of increased breakdown of red blood cells, and respiratory distress syndrome due to compromised lung function. All these complications are interconnected and can occur simultaneously in a newborn with hypoglycemia, highlighting the importance of prompt diagnosis and management.
Choices A, B, and C are incorrect because they do not encompass the comprehensive range of potential complications associated with hypoglycemia in a newborn.
Question 4 of 5
What is the function of the amniotic fluid during fetal development?
Correct Answer: D
Rationale: Amniotic fluid serves multiple functions including cushioning the fetus allowing movement and regulating temperature. These roles are essential for healthy fetal development.
Question 5 of 5
Which of the following is a potential legal issue related to maternal and newborn healthcare?
Correct Answer: D
Rationale: Legal issues include informed consent, patient confidentiality, and medical malpractice.