ATI RN
ATI RN Maternal Newborn 2023 Questions
Extract:
A nurse is assessing a client who is 3 days postpartum.
Question 1 of 5
Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: The correct answer is B: Cool clammy skin. This finding may indicate poor perfusion or shock, which could be concerning postpartum. The nurse should report this to the provider promptly for further evaluation and intervention.
A: BP 120/70 mm Hg is within normal range for postpartum, so it does not require immediate reporting.
C: Moderate lochia serosa is expected in the early postpartum period, so it is not a concerning finding that requires immediate reporting.
D: Heart rate of 89/min is slightly elevated but not critically high, so it does not necessitate immediate reporting.
In summary, the other choices are not as urgent or abnormal as cool clammy skin, which may indicate a more serious issue requiring prompt attention.
Extract:
A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver.
Question 2 of 5
Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct action is to assist the client in pulling their knees toward their abdomen (
Choice
A) to facilitate the delivery of the shoulders during a shoulder dystocia. This maneuver helps to create more space in the birth canal for the baby's shoulder to pass through. Applying pressure to the fundus (
Choice
B) could potentially cause harm to the baby. Pressing firmly on the suprapubic area (
Choice
C) is not an appropriate action during shoulder dystocia. Moving the client onto their hands and knees (
Choice
D) could worsen the situation by altering the position of the baby. It is crucial to choose the action that is evidence-based and designed to resolve the specific issue at hand effectively.
Extract:
A nurse is caring for a client who is hypotensive following the administration of epidural anesthesia.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct action for the nurse to take is turning the client to a side-lying position (
Choice
B). This is essential for preventing aspiration in unconscious or postoperative clients. Turning the client helps maintain airway patency, promotes lung expansion, and prevents complications such as pressure ulcers. Massaging the fundus (
Choice
A) is specific to postpartum care. Applying oxygen (
Choice
C) is not indicated without assessing the client's oxygenation status. Assisting the client to empty their bladder (
Choice
D) is important but not the priority in this scenario.
Extract:
A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum.
Question 4 of 5
Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct action is to provide the client with a cool sitz bath (
Choice
C). This helps reduce perineal swelling and discomfort postpartum. Administering methylergonovine (
Choice
A) is used to manage postpartum hemorrhage. Applying povidone-iodine (
Choice
B) can cause skin irritation. Applying a warm compress (
Choice
D) may increase perineal swelling.
Extract:
A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding.
Question 5 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Anticipate a prescription for misoprostol. This is the correct action because misoprostol is commonly used in obstetrics to induce labor or manage postpartum hemorrhage. The nurse should anticipate this prescription to be prepared to administer it as needed.
Choice A is incorrect as sterile vaginal examinations may be necessary for assessment and care.
Choice C is incorrect as a Kleihauer-Betke test is used to detect fetal-maternal hemorrhage, not typically indicated in this scenario.
Choice D is incorrect as betamethasone is a corticosteroid used for fetal lung maturity, not indicated in this situation.