ATI RN
ATI RN Maternal Newborn Updated 2023 Questions
Extract:
A newborn who has a prescription for a total serum bilirubin.
Question 1 of 5
Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct action is to puncture the lateral side of the heel for the procedure. This is because the lateral side of the heel is the recommended site for a heel stick, as it has fewer nerve endings and blood vessels, reducing the risk of injury and pain. Selecting a 21-gauge needle (option
A) is not specific to the procedure and may not be appropriate. Applying an alcohol pad after the procedure (option
B) is not recommended as it can cause unnecessary pain and irritation. Placing a cool cloth at the site before the procedure (option
C) is not necessary and may not be effective for pain relief. Puncturing the lateral side of the heel is the correct and most appropriate action for this procedure.
Extract:
A client who plans to use hypnosis to control labor pain.
Question 2 of 5
Which of the following pieces of information should the nurse include?
Correct Answer: A
Rationale: The correct answer is A. Hypnosis can be beneficial if practiced during the prenatal period because it can help reduce anxiety, fear, and pain during labor. By starting hypnosis practice before labor, the individual can develop effective techniques and coping strategies. Option B is incorrect as hypnosis has shown to be effective for pain management in labor. Option C is incorrect as synchronized breathing is not always required during hypnosis. Option D is incorrect as hypnosis focuses more on relaxation and mental focus rather than controlling body functions.
Extract:
A client who is 1 hr postpartum and has preeclampsia without severe features.
Question 3 of 5
Which of the following actions should the nurse plan to take?
Correct Answer: B
Rationale: The correct answer is B: Assess for edema. It is important for the nurse to assess for edema as it can indicate fluid overload or renal dysfunction, both of which require prompt intervention. Edema assessment involves checking for swelling in the extremities, pitting edema, and monitoring intake and output. Obtaining a prescription for misoprostol (
A) is not necessary without a specific indication. Restricting daily oral fluid intake (
C) could be harmful, especially if the patient is already dehydrated. Administering an IV bolus of lactated Ringer's (
D) is not appropriate without a physician's order and assessment indicating the need for fluid resuscitation.
Extract:
A client who is at 28 weeks of gestation and received no immunizations during childhood.
Question 4 of 5
Which of the following vaccines should the nurse plan to administer?
Correct Answer: C
Rationale: The correct answer is C: Tetanus. Tetanus vaccine should be administered routinely to prevent tetanus, a serious bacterial infection. The other choices are incorrect because: A: Human papillomavirus vaccine is typically given to prevent HPV-related cancers; B: Rubella vaccine is given to prevent rubella, a viral infection that can cause birth defects; D: Varicella vaccine is given to prevent chickenpox, a viral infection. In this case, the nurse should plan to administer the tetanus vaccine for routine preventive care.
Extract:
A newborn.
Question 5 of 5
Which of the following routes should the nurse choose for administration of the medication?
Correct Answer: B
Rationale: The correct answer is B: IM in the left vastus lateralis. The nurse should choose this route for administration of the medication because the vastus lateralis muscle is a recommended site for intramuscular injections due to its size and low risk of injury to nerves and blood vessels. IM injections in this site allow for the medication to be absorbed into the bloodstream more quickly compared to subcutaneous injections. Subcutaneous injections (choices A and
D) are typically used for medications that require slower absorption. IM in the right deltoid (choice
C) may cause injury to the radial nerve. As for the blank options, since they are not provided, we cannot assess their appropriateness.