ATI RN Maternal Newborn 2023 at Baton Rouge Community College
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Free ATI RN Maternal Newborn 2023 at Baton Rouge Community College Questions
A nurse is caring for a client who is at 37 weeks of gestation immediately following an eclamptic seizure. Which of the following actions should the nurse take?
- Prepare the client for cerclage placement.
- Insert a nasogastric tube.
- Insert an intrauterine pressure catheter.
- Prepare to administer magnesium sulfate IV.
Explanation
Explanation
Magnesium sulfate is the medication of choice for the prevention and treatment of seizures in clients with eclampsia. After an eclamptic seizure, the priority is to prevent recurrent seizures and stabilize the client. Magnesium sulfate acts as a central nervous system depressant, reducing neuromuscular excitability and lowering the risk of further seizure activity. Prompt administration is essential to protect both maternal and fetal safety.Correct Answer Is:
D. Prepare to administer magnesium sulfate IV.A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?
(Select All That Apply.)
- Exaggerated Moro reflex
- Acrocyanosis
- Tachypnea
- Shrill pitched cry
- Hypotonia
Explanation
Explanation
A. Exaggerated Moro reflex
Newborns with neonatal abstinence syndrome commonly exhibit neurologic hyperexcitability due to withdrawal from substances such as opioids. This hyperexcitability results in exaggerated reflexes, including an exaggerated Moro reflex. The infant may startle easily and display excessive motor responses to minimal stimulation.
C. Tachypnea
Tachypnea is a frequent finding in neonatal abstinence syndrome and reflects autonomic nervous system dysregulation. Withdrawal increases metabolic demands and sympathetic nervous system activity, leading to rapid breathing. Persistent tachypnea can also contribute to feeding difficulties and increased caloric expenditure.
D. Shrill pitched cry
A high-pitched, shrill cry is a classic and hallmark sign of neonatal abstinence syndrome. It occurs due to central nervous system irritability and heightened sensitivity to environmental stimuli. This type of cry is often persistent, difficult to console, and serves as an important clinical indicator of withdrawal severity.
Correct Answer Is:
A. Exaggerated Moro reflexC. Tachypnea
D. Shrill pitched cry.
A nurse is caring for a client who is in active labor. Which of the following medications should the nurse plan to administer to address the client's pain?
- Secobarbital sodium
- Tramadol
- Ibuprofen
- Nalbuphine
Explanation
Explanation
Nalbuphine is an opioid agonist–antagonist commonly used for pain management during active labor. It provides effective analgesia by acting on opioid receptors while causing less respiratory depression in both the mother and newborn compared with pure opioid agonists. Nalbuphine can be safely administered intravenously or intramuscularly during labor and is frequently used to manage moderate to severe labor pain without significantly suppressing uterine contractions or fetal oxygenation.Correct Answer Is:
D. Nalbuphine.A nurse is preparing to perform a heel stick on a newborn who has a prescription for a total serum bilirubin. Which of the following actions should the nurse take?
- Place a cool cloth at the site for 15 min before the procedure.
- Puncture the lateral side of the heel for the procedure.
- Select a 21-gauge needle to perform the procedure.
- Apply an alcohol pad to the site after the procedure.
Explanation
Explanation
When performing a heel stick on a newborn, the nurse should puncture the lateral or medial plantar surface of the heel to avoid injury to the calcaneus bone, nerves, and blood vessels. These areas provide adequate capillary blood flow while minimizing the risk of complications such as osteomyelitis or nerve damage. The center of the heel should be avoided, and only approved lancets—not large needles—should be used for safety.Correct Answer Is:
B. Puncture the lateral side of the heel for the procedure.A nurse is caring for a newborn immediately following birth and notes a large amount of mucus in the newborn's mouth and nose. Identify the sequence the nurse should follow when performing suctioning with a bulb syringe.
(Place the steps in the correct order.)
- Compress the bulb syringe.
- Place the bulb syringe in the newborn’s mouth.
- Use the bulb syringe to suction the newborn’s nose.
- Auscultate breath sounds.
Which of the following sequences is correct?
- 1, 2, 3, 4
- 2, 1, 3, 4
- 1, 3, 2, 4
- 2, 3, 1, 4
Explanation
Explanation
- Compress the bulb syringe.
The bulb syringe is compressed first to expel air before it is placed in the newborn’s airway. If the nurse inserts the bulb without compressing it first, squeezing it while it is in the mouth or nose could push air and secretions deeper into the airway, worsening obstruction. Compressing first ensures the syringe will suction outward when released. - Place the bulb syringe in the newborn’s mouth.
The mouth is suctioned before the nose because suctioning the nose first can stimulate the newborn to gasp or inhale sharply. If secretions are still present in the mouth, that gasp increases the risk of aspiration into the trachea and lungs. Clearing the mouth first helps establish a safer airway and improves effective breathing. - Use the bulb syringe to suction the newborn’s nose.
After the mouth is cleared, the nurse suctions the nares to remove mucus that can block airflow. Newborns are primarily nose breathers, so nasal obstruction can quickly cause respiratory distress, poor oxygenation, and difficulty feeding. Suctioning the nose after the mouth promotes better airway patency and decreases work of breathing. - Auscultate breath sounds.
Auscultating breath sounds confirms whether suctioning successfully cleared the airway and whether the newborn is ventilating effectively. The nurse assesses for equal air entry, the presence of crackles or rhonchi from retained secretions, and any signs of ongoing respiratory compromise. This step verifies the intervention worked and guides whether further airway support is needed.
Correct Answer Is:
A. 1, 2, 3, 4.A nurse is caring for a newborn immediately following birth who is grunting and retracting, and has nasal flaring, a respiratory rate of 72/min, and a heart rate of 174/min. Which of the following actions should the nurse take?
- Initiate chest compressions.
- Administer oxygen therapy.
- Place the newborn in a prone position.
- Give the newborn epinephrine.
Explanation
Explanation
The newborn is showing clear signs of respiratory distress, including grunting, nasal flaring, retractions, and tachypnea. These findings indicate impaired oxygenation. The priority intervention is to administer supplemental oxygen to improve oxygen delivery and reduce the work of breathing. Chest compressions and epinephrine are reserved for severe bradycardia or cardiac arrest, and prone positioning is not appropriate for stabilizing an acutely distressed newborn.Correct Answer Is:
B. Administer oxygen therapy.A nurse is preparing to perform a gestational age assessment for a newborn who is 36 hr old. Which of the following assessment tools should the nurse use?
- Biophysical profile
- Apgar score
- Braden Scale
- New Ballard score
Explanation
Explanation
The New Ballard score is specifically designed to assess gestational age in newborns up to 96 hours after birth. It evaluates neuromuscular and physical maturity characteristics to estimate the infant’s gestational age accurately. This tool is appropriate for a newborn who is 36 hours old and is commonly used when prenatal dating is uncertain. The other tools assess fetal well-being, immediate post-birth adaptation, or pressure injury risk and are not appropriate for gestational age assessment.Correct Answer Is:
D. New Ballard score.A nurse in a clinic is caring for an adolescent client who requests a prescription for birth control. Which of the following questions should the nurse ask?
- “What do you know about contraception?”
- “Why are you requesting a prescription for birth control?”
- “Are you sure your partner loves you?”
- “Is your partner pressuring you to have sex?”
Explanation
Explanation
Asking what the adolescent already knows about contraception is an open-ended, nonjudgmental question that supports therapeutic communication and client-centered care. It allows the nurse to assess the client’s level of understanding, correct misconceptions, and tailor education appropriately. This approach respects the adolescent’s autonomy, encourages honest dialogue, and aligns with best practices for providing reproductive health counseling without implying judgment, pressure, or assumptions about the client’s motivations or relationships.Correct Answer Is:
A. “What do you know about contraception?”A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client with which of the following vaccines?
(Select All That Apply.)
- Diphtheria-acellular pertussis
- Human papillomavirus
- Inactivated influenza
- Varicella
- Measles, mumps, and rubella
Explanation
Explanation
A. Diphtheria-acellular pertussis
The Tdap vaccine is recommended during each pregnancy, ideally between 27 and 36 weeks of gestation. Administering Tdap during this window allows the mother to develop antibodies that cross the placenta and provide passive immunity to the newborn, protecting the infant from pertussis during the first months of life when the risk of severe illness is highest.
C. Inactivated influenza
The inactivated influenza vaccine is recommended for pregnant clients during any trimester of pregnancy, including at 30 weeks of gestation. Pregnancy increases the risk of severe complications from influenza due to physiological changes in the immune and respiratory systems. Vaccination protects both the pregnant client and the newborn, as maternal antibodies are passed to the infant after birth.
Correct Answer Is:
A. Diphtheria-acellular pertussisC. Inactivated influenza.
A nurse manager is revising a maternal unit policy to ensure proper identification of newborns. Which of the following should the nurse include in the policy?
- Obtain an imprint of the infant's feet prior to taking him to the nursery.
- Require visitors to wear an identification band.
- Replace the infant's identification band after his name has been recorded.
- Check the newborn's identification using the crib card.
Explanation
Explanation
Obtaining a footprint of the newborn before separation from the parent is an accepted supplemental identification measure that helps ensure correct identification. Although identification bands are the primary method, footprints provide an additional layer of verification if bands are lost or questioned. Newborn identification must occur immediately after birth and before transport to reduce the risk of misidentification.Correct Answer Is:
A. Obtain an imprint of the infant's feet prior to taking him to the nursery.How to Order
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