ATI RN
ATI RN Maternal Newborn 2023 Exam 4 Questions
Extract:
A nurse is caring for a client who is one day postpartum and breastfeeding her newborn. The client reports sore nipples.
Question 1 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Assess the newborn's latch while breastfeeding. This is important to ensure proper attachment and effective milk transfer, preventing nipple soreness and inadequate milk supply. Option A is incorrect as limiting breastfeeding time can hinder milk production. Option C is incorrect as newborns need frequent feedings. Option D is incorrect as offering formula can interfere with establishing breastfeeding.
Extract:
A nurse is planning care for a client who is 1 hour postpartum and has peripartum cardiomyopathy.
Question 2 of 5
Which of the following actions should the nurse plan to take?
Correct Answer: C
Rationale: The correct answer is C: Restrict daily oral fluid intake. In a scenario where fluid restriction is necessary, the nurse should plan to limit the patient's oral fluid intake to help manage a specific condition such as heart failure or kidney disease. This action helps prevent fluid overload, which can lead to complications like edema and worsening of the patient's condition. Assessing blood pressure (
B) is important but not the most relevant action in this context. Administering an IV bolus of lactated Ringer's (
A) is not appropriate without a specific indication. Obtaining a prescription for misoprostol (
D) is not relevant to fluid management.
Extract:
A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation.
Question 3 of 5
Identify the sequence of actions the nurse should take.
Order the Items
Source Container
Correct Answer: A, B, C, D, E
Rationale: The correct order is A, B, C, D, E. Firstly, instructing the client to empty their bladder ensures a clearer assessment. Positioning the client supine with knees flexed and a rolled towel under the hip promotes comfort and relaxation. Palpating the fetal part in the fundus helps determine the presenting part. Palpating the fetal parts along both sides of the uterus allows for identification of the position and engagement. Lastly, palpating the fetal part above the symphysis pubis helps ascertain the descent and engagement of the presenting part. The other choices are incorrect as they do not follow a logical sequence for a comprehensive fetal assessment.
Extract:
A nurse at an antepartum clinic is caring for four clients.
Question 4 of 5
Which of the following clients should the nurse assess first?
Correct Answer: D
Rationale: The correct answer is D: A client who is at 8 weeks of gestation and reports severe vomiting. This client should be assessed first because severe vomiting in early pregnancy may indicate hyperemesis gravidarum, a serious condition that can lead to dehydration and electrolyte imbalances, endangering both the mother and the fetus. Immediate assessment and intervention are crucial.
Choice A is incorrect because frequent urination is a common symptom in early pregnancy and does not typically require urgent assessment.
Choice B is incorrect because periodic tingling of the fingers at 24 weeks of gestation may be related to carpal tunnel syndrome, which is common in pregnancy but not as urgent as severe vomiting.
Choice C is incorrect because back pain following intercourse at 36 weeks of gestation is likely due to the pressure on the back from the growing uterus and is not as urgent as severe vomiting in early pregnancy.
Extract:
A nurse is caring for a patient who is at 37 weeks of gestation and is being tested for Group B Streptococcus (GBS). The patient is multigravida and multipara with no history of GBS.
Question 5 of 5
Which of the following is an appropriate response by the nurse to the patient's question about why the test was not conducted earlier?
Correct Answer: D
Rationale:
Rationale: The correct answer is D because Group B Streptococcus (GBS) testing is typically done between 35-37 weeks of gestation to accurately detect GBS colonization before delivery. This timing allows for appropriate interventions to prevent neonatal GBS infection.
Incorrect
Choices:
A: Lack of indication in earlier prenatal testing does not justify delaying GBS testing.
B: Previous negative deliveries do not rule out GBS colonization in the current pregnancy.
C: Symptoms are not reliable indicators of GBS presence, as many carriers are asymptomatic.
Summary:
Choice D is correct as it aligns with evidence-based practice guidelines for GBS testing during pregnancy, while the other choices provide inadequate or irrelevant justifications for delaying testing.