ATI RN
ATI RN Maternal Newborn 2023 II 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: A
Rationale: The correct answer is A: Provide the client with photos of the fetus. This action promotes bonding and helps the client cope with the loss by creating lasting memories. It allows the client to visually connect with the fetus and aids in the grieving process. Providing photos can offer comfort and closure.
Incorrect
Choices:
B: Informing the client that the law requires them to name the fetus is incorrect because there is no such legal requirement.
C: Limiting the amount of time the fetus is in the client's room may not be necessary and could hinder the client's grieving process.
D: Instructing the client that an autopsy should be performed within 24 hours is incorrect as it may not be the best timing for the client emotionally and may not be necessary in all cases.
Extract:
A nurse is caring for a client who is at 36 weeks of gestation and has methicillin-resistant Staphylococcus aureus.
Question 2 of 5
Which of the following types of isolation precautions should the nurse initiate?
Correct Answer: D
Rationale: The correct answer is D: Contact precautions. Contact precautions are necessary when a patient has an infection that spreads through direct or indirect contact. This includes wearing gloves, gowns, and proper hand hygiene. Droplet precautions (choice
A) are for infections spread through respiratory droplets, airborne precautions (choice
C) are for infections spread through airborne particles, and protective environment (choice
B) is for patients with compromised immune systems. The other choices are not relevant to the scenario described.
Extract:
A nurse is caring for a newborn immediately following birth.
Question 3 of 5
For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?
Correct Answer: B
Rationale: The correct answer is B:
To facilitate bonding between the newborn and parent. Delaying the instillation of antibiotic ointment allows for crucial bonding time between the newborn and parent, promoting emotional connection and attachment. This early bonding is essential for the newborn's overall well-being and development.
Choice A is incorrect because the newborn's weight does not impact the timing of antibiotic ointment instillation.
Choice C is incorrect as delaying the ointment does not help in identifying infection manifestations.
Choice D is incorrect as the mode of delivery does not affect the timing of antibiotic ointment instillation.
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: C
Rationale: The correct answer is C. The nurse should assess the client at 8 weeks of gestation reporting severe vomiting first as it may indicate hyperemesis gravidarum, a serious condition causing dehydration and electrolyte imbalances, risking maternal and fetal health. Severe vomiting can lead to complications like malnutrition and weight loss, affecting the developing fetus. Assessing this client first is crucial to provide immediate interventions and prevent further harm.
Other choices are less urgent: A - tingling fingers can be related to carpal tunnel syndrome common in pregnancy; B - back pain post-intercourse is common in late pregnancy due to pressure on the pelvis; D - frequent urination is a common early pregnancy symptom. These symptoms are not as concerning as severe vomiting, making choice C the priority.
Extract:
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding.
Question 5 of 5
After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
Correct Answer: C
Rationale: The correct answer is C: Perform a vaginal examination by applying upward pressure on the presenting part. This action is crucial to assess the progress of labor, ensure proper fetal positioning, and determine if there are any complications such as cord prolapse. Administering oxygen (
B) or IV fluids (
D) may be important interventions but are not the immediate priority in this scenario. Covering the umbilical cord (
A) with a towel may increase the risk of infection.
Therefore, the key step is to perform a vaginal examination to gather essential information for appropriate decision-making.