ATI RN
ATI RN Maternal Newborn 2023 IV Questions
Extract:
A nurse is assessing a client who is 6 hr postpartum and is saturating perineal pads every 10 to 15 min.
Question 1 of 5
Which of the following actions should the nurse take first?
Correct Answer: B
Rationale: Collecting hemoglobin and hematocrit levels assesses the extent of blood loss first, guiding further interventions for potential postpartum hemorrhage.
Extract:
A nurse is assessing a newborn who is 2 hr old.
Question 2 of 5
Which of the following findings is an indication of hypoglycemia? (Select all that apply.)
Correct Answer: D, E
Rationale: Hypotonia (
D) and jitteriness (E) are common signs of hypoglycemia in newborns due to low glucose affecting muscle tone and neurological function. The others are not specific to hypoglycemia.
Extract:
A nurse is caring for a client who has a placenta previa.
Question 3 of 5
Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: Painless vaginal bleeding is a hallmark of placenta previa due to placental disruption near the cervix. Painful or rigid findings suggest other conditions like abruptio placentae.
Extract:
A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver.
Question 4 of 5
Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The McRoberts maneuver involves flexing the client’s hips toward her abdomen to widen the pelvic outlet and relieve shoulder dystocia, making it the correct action.
Extract:
A nurse is caring for a newborn who was born at 39 weeks of gestation and is 36 hr old.
Nurses' Notes
Term newborn birthed via spontaneous vaginal delivery at 39 weeks of gestation. Apgar 9/9 at 5-minute score. Breastfeeding 3 to 4 times per day. Newborn has voided once since birth and has not passed meconium stool since birth.
Physical Examination
• Fontanels soft and flat
• Head molded with caput succedaneum
• Eyes symmetric, no discharge, sclera yellow
• Mucous membranes dry
• Abdomen soft and rounded, bowel sounds present x 4 quadrants
Vital Signs
• Heart rate 154/min
• Respiratory rate 44/min
• Temperature 36.9° C (98.4° F)
Diagnostic Results
• Coombs positive (negative)
• Glucose 50 mg/dL (40 to 60 mg/dL)
Question 5 of 5
Which finding(s) from the assessment should be reported to the provider for further evaluation or intervention? Select all that apply.
Correct Answer: A, B, D
Rationale: Dry mucous membranes (
A) and low output (
D) suggest dehydration from inadequate feeding (3-4 times/day vs. 8-12). Yellow sclera (
B) indicates jaundice, needing bilirubin checks.