ATI RN
ATI RN Maternal Newborn 2023 Questions
Extract:
A nurse is caring for a newborn who is 5 days old. Medical History: History of maternal opioid use prior to pregnancy and prescribed methadone use during pregnancy. Maternal and neonatal positive urine drug screens for methadone. Newborn is exhibiting clinical findings of neonatal abstinence syndrome (NAS).
Question 1 of 5
Which of the following actions should the nurse take? Select all that apply.
Correct Answer: A, F, G
Rationale: The correct actions for the nurse to take are A, F, and G.
- A: Maintaining a low stimulation environment is important for newborns to promote rest and decrease stress.
- F: Weighing the newborn daily helps monitor their growth and detect any potential issues early.
- G: Swaddling the newborn with flexed extremities can provide comfort and mimic the womb environment, helping to soothe the baby.
Other choices are incorrect:
- B: Naloxone is not routinely administered to newborns unless specific circumstances warrant it.
- C: Breastfeeding is typically encouraged unless contraindicated by specific circumstances.
- D: Eye contact during feeding is important for bonding and communication between the parent and newborn.
- E: Performing Ballard newborn screening each shift is not necessary and may cause unnecessary stress to the newborn.
Extract:
A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum.
Question 2 of 5
Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct action is to provide the client with a cool sitz bath (
Choice
C). This helps reduce perineal swelling and discomfort postpartum. Administering methylergonovine (
Choice
A) is used to manage postpartum hemorrhage. Applying povidone-iodine (
Choice
B) can cause skin irritation. Applying a warm compress (
Choice
D) may increase perineal swelling.
Extract:
A nurse is assessing a client who is 3 days postpartum.
Question 3 of 5
Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: The correct answer is B: Cool clammy skin. This finding may indicate poor perfusion or shock, which could be concerning postpartum. The nurse should report this to the provider promptly for further evaluation and intervention.
A: BP 120/70 mm Hg is within normal range for postpartum, so it does not require immediate reporting.
C: Moderate lochia serosa is expected in the early postpartum period, so it is not a concerning finding that requires immediate reporting.
D: Heart rate of 89/min is slightly elevated but not critically high, so it does not necessitate immediate reporting.
In summary, the other choices are not as urgent or abnormal as cool clammy skin, which may indicate a more serious issue requiring prompt attention.
Extract:
A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation.
Question 4 of 5
Which of the following findings should the nurse report to the provider?
Correct Answer: C
Rationale: The correct answer is C: Fasting blood glucose 180 mg/dL (74 to 106 mg/dL). This finding should be reported to the provider because it indicates hyperglycemia, which may require adjustment in the patient's diabetes management plan to prevent complications. A: WBC count within the range, so not urgent. B: Hematocrit within the range, so not critical. D: Creatinine within the range, so not an immediate concern. Reporting C is crucial for timely intervention.
Extract:
A nurse is assessing a newborn who has neonatal abstinence syndrome.
Question 5 of 5
Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Excessive crying. In infants, excessive crying is a common finding indicating pain, discomfort, hunger, or other needs. It is a crucial communication method for infants. Decreased muscle tone (
B) and absent Moro reflex (
C) are abnormal findings that may suggest neurological issues. Diminished deep tendon reflexes (
D) are typically seen in conditions affecting the nervous system. The absence of other choices indicates they are not relevant to the expected findings in this scenario.