ATI RN
ATI RN Maternal Newborn Updated 2023 Questions
Extract:
A client who is in the second stage of labor and is experiencing a shoulder dystocia.
Question 1 of 5
Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Assist the client in pulling their knees toward their abdomen. This position helps facilitate the delivery of the baby by widening the pelvic outlet, reducing pressure on the perineum, and promoting descent of the fetus. This action also eases the process of childbirth and minimizes the risk of perineal tears.
Choice B is incorrect as pressing firmly on the client's suprapubic area can increase discomfort and is not a recommended practice during labor.
Choice C, moving the client onto their hands and knees, may not be suitable for all women and does not provide the same benefits as pulling knees toward the abdomen.
Choice D, applying pressure to the client's fundus, is not recommended during labor as it can cause complications.
Extract:
A client who is in labor and has received epidural analgesia.
Question 2 of 5
Which of the following findings should the nurse recognize and document as an adverse effect of epidural analgesia?
Correct Answer: A
Rationale: The correct answer is A: Hypotension. This is a known adverse effect of epidural analgesia due to sympathetic blockade leading to vasodilation. It can cause decreased blood pressure and compromise perfusion. Polyuria is not a typical effect of epidural analgesia. Fetal heart rate and maternal temperature are not directly related to the adverse effects of epidural analgesia.
Extract:
A newborn who was born at 39 weeks of gestation and is 36 hours old.
Question 3 of 5
Which of the following findings should the nurse report to the provider? Select all that apply.
Correct Answer: C,D,F
Rationale: The nurse should report findings that indicate potential issues requiring provider intervention. Coombs test result (
C) is crucial for detecting autoimmune hemolytic anemia. Abnormal sclera color (
D) may indicate liver dysfunction or jaundice. Intake and output (F) are essential for monitoring fluid balance. Glucose level (
A) is important but typically not an urgent concern. Head assessment finding (
B) may be relevant, but it depends on the specific abnormality. Heart rate (E) and mucous membrane assessment (G) are vital but generally do not require immediate provider notification.
Extract:
A client who delivered by cesarean birth 6 hr ago.
Question 4 of 5
The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Administer 500 mL lactated Ringer's IV bolus. This action is necessary to address potential hypovolemia due to the steady vaginal bleeding. Lactated Ringer's solution helps restore intravascular volume and maintain perfusion. Evaluating urinary output (
A) is important but not the priority when immediate action is needed. Replacing the surgical dressing (
B) is not the first step in managing ongoing bleeding. Applying an ice pack to the incision site (
C) is not indicated and may not address the underlying issue.
Extract:
A client who is in labor and experiences abruptio placenta.
Question 5 of 5
Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Uterine tenderness. In the context of pregnancy, uterine tenderness may indicate a potential issue such as uterine infection or preterm labor. It is important for the nurse to assess this finding further to ensure the safety of the mother and baby. Hypertension (choice
A) may indicate preeclampsia, fetal tachycardia (choice
C) may suggest fetal distress, and leukorrhea (choice
D) is a common finding in pregnancy.
Choices E, F, and G are not provided.