ATI RN
ATI RN Maternal Newborn 2023 II Questions
Extract:
A nurse is assessing a newborn who was born postterm.
Question 1 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 assessing for pain for a client following a cesarean birth 24 hr ago.
Question 2 of 5
Which of the following questions should the nurse ask to determine if a PRN pain medication is indicated?
Correct Answer: C
Rationale: The correct answer is C: "Do you notice increased cramping with breastfeeding?" This question is essential to determine if a PRN pain medication is needed as increased cramping during breastfeeding can indicate discomfort or pain, thus necessitating the use of pain medication. The other options are unrelated to pain assessment or pain management. Option A focuses on swelling, which does not directly relate to pain. Option B pertains to incision leakage, which is more related to wound care rather than pain assessment. Option D is about passing gas, which is not a relevant question when assessing the need for pain medication.
Therefore, option C is the most appropriate question to ask in this scenario to evaluate the need for PRN pain medication.
Extract:
A nurse is caring for a client who is in active labor with a fetus in the occipitoposterior position. The nurse assists the client into a hands-and-knees position.
Question 3 of 5
Which of the following questions should the nurse ask to evaluate the effectiveness of this intervention?
Correct Answer: C
Rationale:
Rationale: The nurse should ask about the improvement in back labor as it directly evaluates the effectiveness of the intervention related to back pain relief. Contractions, pelvic pressure, and suprapubic pain are not directly related to back labor.
Therefore, asking about back labor improvement is the most relevant way to assess the intervention's success.
Extract:
A nurse in a prenatal clinic is caring for a group of clients.
Question 4 of 5
The nurse should recognize that which of the following clients has a contraindication for a contraction stress test?
Correct Answer: B
Rationale: The correct answer is B because a client with a previous classical incision (vertical uterine incision) is at risk for uterine rupture during a contraction stress test due to the weakened uterine wall. A uterine rupture can lead to severe complications for both the mother and the baby. Clients with previous classical incisions should not undergo contraction stress tests.
Choice A is incorrect because a previous stillbirth is not a contraindication for a contraction stress test.
Choice C is incorrect as gestational diabetes mellitus alone is not a contraindication for the test.
Choice D is also incorrect as a nonreactive nonstress test does not directly contraindicate a contraction stress test.
Extract:
A nurse is assessing a newborn whose mother had gestational diabetes mellitus.
Question 5 of 5
The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?
Correct Answer: B
Rationale: The correct answer is B: Jitteriness. Jitteriness is a common manifestation of hypoglycemia due to the brain not receiving enough glucose for energy. This can lead to shakiness, nervousness, and palpitations. Abdominal distention (choice
A) is not typically associated with hypoglycemia. Petechiae (choice
C) are tiny red or purple spots on the skin due to bleeding, not related to hypoglycemia. Increased muscle tone (choice
D) is not a common sign of hypoglycemia. By monitoring for jitteriness, the nurse can promptly recognize and address hypoglycemia in the patient.