ATI RN
ATI Maternal Newborn 2023 Questions
Extract:
A nurse is caring for a client who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise.
Question 1 of 5
Which of the following medications should the nurse anticipate a prescription from the provider for the client?
Correct Answer: B
Rationale: The correct answer is B: Insulin. Insulin is essential for clients with diabetes who have high blood sugar levels and need to regulate their glucose levels. Repaglinide, Glipizide, and Acarbose are oral antidiabetic medications that work differently from insulin and may not be suitable for clients requiring immediate control over blood sugar levels. Insulin is the most direct and effective way to lower blood sugar levels quickly in emergencies.
Extract:
The nurse caring for the pregnant patient understands that which hormone is essential for maintaining pregnancy?
Question 2 of 5
Which hormone is essential for maintaining pregnancy?
Correct Answer: D
Rationale: The correct answer is D: Progesterone. Progesterone is essential for maintaining pregnancy as it helps prepare the uterus for implantation and supports the growth of the placenta. It also inhibits contractions of the uterine muscles, preventing premature labor. Estrogen (
A) plays a role in preparing the uterus for pregnancy, but progesterone is crucial for maintaining it. Oxytocin (
B) stimulates uterine contractions during labor, not for maintaining pregnancy. Human chorionic gonadotropin (hCG) (
C) is produced during pregnancy but its main function is to support the corpus luteum in the early stages, not to maintain pregnancy.
Extract:
1. 08:00 - Client reported feeling pressure in the pelvic area. 2. 10:00 - Observed retraction of the fetal head against the maternal perineum. 3. 12:00 - Client reported increased discomfort; breathing exercises initiated. 4. 14:00 - Client's contractions have become more frequent and intense. Diagnostic Results: 1. Ultrasound: Healthy fetus in cephalic presentation. 2. Blood Test: Hemoglobin levels within normal range. 3. Urinalysis: No signs of infection or preeclampsia. 4. Fetal Heart Rate: Consistent with labor progression. Medical History: 1. First pregnancy, no complications. 2. No history of chronic illnesses. 3. No history of surgeries. 4. No known allergies. Vital Signs: 1. 08:00 - BP: 120/80, HR: 80 bpm, Temp: 98.6°F 2. 10:00 - BP: 122/82, HR: 82 bpm, Temp: 98.7°F 3. 12:00 - BP: 124/84, HR: 84 bpm, Temp: 98.8°F 4. 14:00 - BP: 126/86, HR: 86 bpm, Temp: 98.9°F Provider's Prescriptions: 1. Regular monitoring of vital signs. 2. Pain management as needed. 3. Encourage mobility as tolerated. 4. Regular monitoring of fetal heart rate. Physical Examination Results: 1. Cervix fully dilated. 2. Fetus in cephalic presentation. 3. Membranes ruptured. 4. Contractions regular and progressing. A 28-year-old female client is in the second stage of labor in the maternity ward.
Question 3 of 5
A nurse is caring for a client who is in the second stage of labor. The nurse observes retraction of the fetal head against the maternal perineum. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale: Action to Take: Encourage the client to push during contractions, Prepare for immediate delivery; Potential Condition: Prolonged labor; Parameter to Monitor: Frequency of contractions, Fetal heart rate.
Rationale:
1. Encouraging the client to push during contractions helps progress labor.
2. Preparing for immediate delivery is necessary in case of prolonged labor to prevent complications.
3. Retraction of the fetal head indicates prolonged labor, as the head should not retract back once descended.
4. Monitoring the frequency of contractions helps assess the progress of labor.
5. Monitoring the fetal heart rate is crucial to ensure the baby's well-being during labor.
Incorrect
Choices:
- Administering pain medication is not appropriate for retraction of the fetal head.
- Encouraging pushing without addressing the underlying cause of prolonged labor can be detrimental.
- Monitoring the client's blood pressure and temperature are not directly related to the observed condition.
Extract:
A nurse is preparing an in-service program about preventing medication errors when transcribing a prescription. The nurse is using a dosage example of two tenths of a milligram.
Question 4 of 5
Which of the following examples should the nurse use to show appropriate transcription of this dosage?
Correct Answer: A
Rationale: The correct answer is A: 0.2 mg. This format is the most appropriate for dosage transcription as it clearly indicates the decimal point. B: 0.20 mg is redundant since the zero after the decimal does not add any value. C: 20 mg is incorrect as it represents a different dosage amount. D: 2 mg is also incorrect as it is not the same dosage as the one provided. The key is to accurately represent the dosage with the appropriate decimal place, making A the correct choice.
Extract:
A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus.
Question 5 of 5
Which of the following newborn complications should the nurse recognize as the priority focus of care?
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. This is the priority focus of care in newborns as low blood sugar can lead to serious complications such as seizures and brain damage. Immediate intervention is crucial to prevent long-term harm. Hypomagnesemia, hyperbilirubinemia, and hypocalcemia are important to monitor but are not as urgent as hypoglycemia in newborns. Hypoglycemia requires immediate attention to prevent adverse outcomes, making it the priority over the other choices.