ATI RN
ATI RN Maternal Newborn 2023 Questions
Extract:
A nurse is caring for a client immediately following the delivery of a stillborn fetus.
Question 1 of 5
Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Provide the client with photos of the fetus. This action allows the client to have mementos of their baby and aids in the grieving process. Providing photos can help the client in acknowledging the reality of the loss and facilitate closure.
A: Instructing the client that an autopsy should be performed within 24 hr is not within the nurse's scope of practice and may not be culturally or emotionally appropriate.
B: Informing the client that the law requires them to name the fetus is inaccurate and insensitive.
D: Limiting the amount of time the fetus is in the client's room may not align with the client's emotional needs and can be perceived as callous.
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:
Nurses Notes 0700: Breasts soft nipples intact. Uterus palpated firm, midline, and at level of umbilicus. Moderate amount of lochia rubra. Episiotomy site well approximated with mild edema and ecchymosis. Client reports pain as 2 on a scale of 0 to 10. Able to void spontaneously, no bladder distention. Deep tendon reflexes 1+. Peripheral edema 2+ in bilateral lower extremities. 1100: Breasts soft, nipples intact. Uterus palpated soft with lateral deviation and 1 cm above the umbilicus. Large amount of lochia rubra. Episiotomy site well approximated with mild edema and ecchymosis. Client reports pain as 3 on a scale of 0 to 10. Deep tendon reflexes 1+ Peripheral edema 2+ in bilateral lower extremities.
Question 3 of 5
Select the 3 findings that require immediate follow-up.
Correct Answer: C, F,G
Rationale: The correct answer is C, F, and G.
C: Lateral deviation of the uterus indicates a possible uterine abnormality that needs immediate follow-up to prevent complications.
F: Soft breasts could be a sign of inadequate lactation or mastitis, requiring prompt intervention.
G: Large amount of lochia rubra suggests excessive postpartum bleeding, which is concerning and necessitates immediate attention.
Other choices are less urgent:
A: Peripheral edema and blood pressure within normal range are common postpartum findings.
D: Pain rating of 3 is mild and does not necessitate immediate follow-up.
E: Uterine tone being soft can be normal in the early postpartum period.
Extract:
A nurse is caring for a client who is receiving oxytocin via continuous IV infusion and is experiencing persistent late decelerations in the FHR.
Question 4 of 5
After discontinuing the infusion, which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Administer oxygen at 10 L/min via nonrebreather facemask. This action is necessary to ensure adequate oxygenation and prevent hypoxia after discontinuing the infusion. High-flow oxygen via a nonrebreather mask can help maintain oxygen saturation levels and support the client's respiratory function.
Choice B, initiating an amnioinfusion, is incorrect as it is not indicated after discontinuing an infusion.
Choice C, instructing the client to bear down and push with contractions, is inappropriate as it is not related to the situation and could potentially be harmful.
Choice D, placing the client in a supine position, is not recommended as it can compromise respiratory function.
Extract:
A nurse is caring for a client who is at 36 weeks of gestation and has methicillin-resistant Staphylococcus aureus.
Question 5 of 5
Which of the following types of isolation precautions should the nurse initiate?
Correct Answer: C
Rationale: The correct answer is C: Contact precautions. Contact precautions are necessary when the patient is infected or colonized with a microorganism that can be easily transmitted by direct or indirect contact. This includes wearing gloves and gowns when entering the patient's room. Airborne precautions (
A) are for pathogens that remain suspended in the air and require special air handling. Protective environment (
B) precautions are used for patients with compromised immune systems. Droplet precautions (
D) are for pathogens transmitted through respiratory droplets. The other choices are not relevant to the scenario described in the question.