ATI RN
ATI RN Maternal Newborn 2023 II Questions
Extract:
A nurse is assessing a newborn who has neonatal abstinence syndrome.
Question 1 of 5
Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Excessive crying. In infants, excessive crying can be a sign of discomfort or illness, indicating the need for further assessment by the nurse. Absent Moro reflex (
A) is abnormal and indicates neurological issues. Diminished deep tendon reflexes (
C) and decreased muscle tone (
D) can also be concerning neurological findings. However, excessive crying is a more immediate and urgent concern that requires prompt evaluation and intervention.
Question 2 of 5
Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Excessive crying. In infants, excessive crying can be a sign of discomfort or illness, indicating the need for further assessment by the nurse. Absent Moro reflex (
A) is abnormal and indicates neurological issues. Diminished deep tendon reflexes (
C) and decreased muscle tone (
D) can also be concerning neurological findings. However, excessive crying is a more immediate and urgent concern that requires prompt evaluation and intervention.
Extract:
A nurse is caring for an infant who has signs of neonatal abstinence syndrome.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Initiate seizure precautions. This is crucial in caring for an infant at risk for seizures. Seizure precautions involve ensuring a safe environment, padding the crib, keeping the infant away from sharp objects, and having emergency medications ready. Placing the infant on his back with legs extended (
A) is the recommended sleep position but not directly related to seizure precautions. Providing a stimulating environment (
B) may not be appropriate for an infant at risk for seizures. Monitoring blood glucose every hour (
C) is not typically done for seizure precautions unless there is a specific indication.
Extract:
A nurse is assessing a newborn who was born postterm.
Question 4 of 5
Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Nails extending over tips of fingers. This finding indicates clubbing, a condition associated with chronic hypoxia. Clubbing is characterized by the enlargement and flattening of the fingertips, causing the nails to extend over the fingertips. This can be seen in conditions such as chronic respiratory diseases or heart defects, where there is long-term oxygen deprivation. Large deposits of subcutaneous fat (
A) are not typically related to clubbing. Pale, translucent skin (
C) may suggest anemia or dehydration but is not directly related to clubbing. A thin covering of fine hair on shoulders and back (
D) is known as lanugo, which is commonly seen in newborns or individuals with eating disorders, and is not associated with clubbing.
Extract:
A nurse is planning care for a client who is 1 hr postpartum and has peripartum cardiomyopathy.
Question 5 of 5
Which of the following actions should the nurse plan to take?
Correct Answer: A
Rationale: The correct answer is A: Restrict daily oral fluid intake. This is the appropriate action for a patient with fluid overload, as it helps manage fluid balance. Restricting fluid intake can prevent further fluid accumulation and complications. Administering an IV bolus of lactated Ringer's (
B) would worsen fluid overload. Assessing blood pressure twice daily (
C) is important but not the priority in managing fluid overload. Obtaining a prescription for misoprostol (
D) is unrelated to managing fluid overload.