ATI RN
ATI RN Maternal Newborn Updated 2023 Questions
Extract:
A client who is postpartum and just delivered a newborn who weighs 4.5 kg (10 lb).
Question 1 of 5
Which of the following manifestations should the nurse recognize as a potential sign of hemorrhage?
Correct Answer: A
Rationale: A blood pressure of 88/40 mm Hg indicates hypotension, a key sign of postpartum hemorrhage due to significant blood loss, especially after delivering a large newborn, which increases risk. The other findings are within normal postpartum ranges.
Extract:
A newborn immediately following birth.
Question 2 of 5
How should the nurse interpret the findings? For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication that the client's condition is improving, or an indication that the client's condition is worsening.
| Finding | Unrelated to diagnosis | Indication client's condition is improving | Indication client's condition is worsening |
|---|---|---|---|
| Color: Consistent with genetic background - Unrelated | |||
| Axillary temperature 36.3° C (97.4°F), Reflex irritability: cry - Improving | |||
| Muscle tone: flaccid - Worsening | |||
| Respiration effort: good cry - Improving | |||
| Heart rate 140/min - Improving |
Correct Answer: A,B,C,D,E
Rationale: A: Color consistent with genetic background is unrelated to initial findings, suggesting normal adjustment. B: Normal temperature and cry indicate improvement. C: Flaccid tone suggests worsening, possibly neurological. D: Good cry shows respiratory improvement. E: Normal heart rate (140/min) indicates cardiovascular stability.
Extract:
A newborn who is 2 hr old.
Question 3 of 5
Which of the following findings is an indication of hypoglycemia? (Select all that apply.)
Correct Answer: B,D,E
Rationale: Jitteriness (
B), hypotonia (
D), and temperature instability (E) are signs of hypoglycemia due to low glucose affecting the nervous system and thermoregulation, unlike abdominal distention (
A) or acrocyanosis (
C), which are unrelated or normal.
Extract:
A postpartum client who has a prescription for a rubella immunization.
Question 4 of 5
Which of the following client statements indicates understanding of the teaching?
Correct Answer: D
Rationale: Avoiding pregnancy for at least 1 month post-rubella immunization is correct due to theoretical fetal risk from this live vaccine, unlike the incorrect options: breastfeeding is safe, it's a single dose, and joint pain is a mild side effect not requiring immediate reporting.
Extract:
A client and their newborn.
Question 5 of 5
Which of the following observations should indicate to the nurse that the client is in the taking-in phase of maternal role attainment?
Correct Answer: D
Rationale: Reviewing the birth experience is typical of the taking-in phase, where the mother focuses on her own needs and reflects, unlike the other options, which align with later phases.