ATI RN Maternal Newborn
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Free ATI RN Maternal Newborn Questions
A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in the teaching?
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"You will have a cesarean birth prior to the onset of labor."
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"Your baby will receive erythromycin eye ointment after birth to treat the infection."
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"You should take oral metronidazole for 7 days prior to 37 weeks of gestation."
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"You should schedule a cesarean birth after your water breaks."
Explanation
Explanation:
Correct Answer: (A) "You will have a cesarean birth prior to the onset of labor."
A client with active genital herpes lesions at the time of delivery should have a cesarean birth performed before the onset of labor and before membranes rupture to prevent transmission of the herpes simplex virus to the newborn during passage through the birth canal.
Why Other Options are Incorrect:
B. Erythromycin eye ointment is administered to all newborns to prevent neonatal conjunctivitis caused by gonorrhea and chlamydia, not herpes. It does not treat herpes infection.
C. Metronidazole is used to treat bacterial infections such as trichomoniasis and bacterial vaginosis, not herpes simplex virus. Antiviral medications such as acyclovir are used for herpes.
D. Scheduling a cesarean after the water breaks defeats the purpose of the procedure. Once membranes rupture, the fetus is already exposed to the virus, making a cesarean ineffective at preventing transmission.
A nurse is obtaining a 2-hr postprandial blood glucose from a client. Which of the following actions should the nurse take?
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Hod the finger above the heart prior to puncture
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Puncture the finger while still damp with antiseptic solution
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Smear the blood onto the reagent strip.
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Select the lateral side of the finger for puncture.
Explanation
Correct Answer: D. Select the lateral side of the finger for puncture.
When obtaining a blood sample for glucose testing, selecting the lateral side of the finger for the puncture is recommended.
This area tends to be less sensitive and avoids hitting nerves, making the procedure more comfortable for the patient.
Why the Other Options Are Incorrect:
A. Hold the finger above the heart prior to puncture:
Holding the finger above the heart level is not recommended for blood glucose testing. The best practice is to keep the hand at the level of the heart to ensure proper blood circulation and avoid influencing the test results.
B. Puncture the finger while still damp with antiseptic solution:
The antiseptic solution should be allowed to dry completely before puncturing the skin. If the antiseptic is still wet, it can alter the blood glucose reading and interfere with the accuracy of the test. Always allow antiseptic to dry before testing.
C. Smear the blood onto the reagent strip:
The blood sample should not be smeared onto the reagent strip. The proper technique is to place the blood drop directly on the strip or allow the strip to absorb the sample. Smearing the blood can affect the accuracy of the reading.
Summary:
The correct action is to select the lateral side of the finger for the puncture to avoid discomfort and ensure an accurate sample for the glucose test.
A charge nurse is providing an in-service about client advocacy to a group of newly licensed
nurses. Which of the following examples should the nurse include?
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Witnessing a client's signature for informed consent
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Instructing a client about how to apply antiembolic stockings
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Ensuring that all clients receive equal treatment
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Requesting a social services consultation for a client who states they cannot afford their
medications
Explanation
overall well-being. Requesting a social services consultation for a client unable to afford
medications ensures the client receives needed resources and continuity of care. This
demonstrates advocacy by addressing barriers to health care and promoting the client’s best
interests.
A nurse is preparing to administer hepatitis B immune globulin to a newborn. The prescription states, "Administer 5 mcg IM once today." Available is 5 mL vial with 10 mcg/mL. How many mL should the nurse administer? (Round to nearest tenth.)
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0. 7mL
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0.4 mL
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0.5 mL
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0.6 mL
Explanation
Here’s the step-by-step calculation:
Identify the amount needed:
The prescription is for 5 mcg to be administered.
Identify the concentration of the solution:
The vial concentration is 10 mcg/mL.
Set up the proportion to calculate the volume needed:
Volume to be administered (mL)=Desired dose (mcg)
Concentration (mcg/mL)
Substitute the values into the equation:
Volume = 5 mcg
10 mcg/mL
= 0.5 mL
So, the nurse should administer 0.5 mL.
A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse provide to the client about the treatment plan?
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"Your partner needs to be cultured and be treated with metronidazole only if his cultures are positive."
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"You and your partner need to take the medication and use a condom during intercourse until cultures are negative."
Explanation
Explanation:
Correct Answer: (B) "You and your partner need to take the medication and use a condom during intercourse until cultures are negative."
Trichomoniasis is caused by Trichomonas vaginalis and affects both men and women. For treatment to be effective and prevent reinfection, both sexual partners must be treated simultaneously with metronidazole regardless of whether the male partner has symptoms or positive cultures. Condoms should be used during intercourse throughout the treatment period.
Why Other Options are Incorrect:
A. Waiting for positive cultures before treating the male partner is incorrect. The male partner should be treated automatically when his female partner is diagnosed, as he is likely infected even without symptoms. Delaying treatment leads to reinfection of the treated partner.
A nurse is assessing a newborn who was born 2 hr ago and was admitted to the neonatal intensive care unit with chest wall retractions and blue discoloration of the hands and feet. Which of the following findings indicates a decline in the newborn’s status?
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Fine crackles
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Nasal flaring
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Oxygen saturation of 89%
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Apneic episode less than 15 seconds
Explanation
Correct Answer: C. Oxygen saturation of 89%
Explanation
An oxygen saturation of 89% is a significant finding that indicates hypoxemia and requires immediate intervention to prevent further decline in the newborn's status. Normal oxygen saturation levels for a newborn should be above 90% to 95%, depending on age and clinical condition. Persistent hypoxemia may result in tissue hypoxia and complications such as respiratory failure.
Why the Other Options Are Incorrect:
A. Fine crackles:
Fine crackles are often normal in newborns as residual lung fluid is absorbed during the first few hours after birth. While they warrant monitoring, they are not an indicator of a worsening condition unless accompanied by other signs of respiratory distress or hypoxemia.
B. Nasal flaring:
Nasal flaring is a sign of respiratory distress, but in isolation, it does not necessarily indicate a decline in status. It should be evaluated alongside oxygen saturation and other clinical findings.
D. Apneic episode less than 15 seconds:
Brief apneic episodes (less than 15 seconds) are common in newborns and are considered normal periodic breathing. However, episodes lasting longer or associated with bradycardia or cyanosis would be concerning.
Summary:
An oxygen saturation of 89% is a critical finding that signals hypoxemia and necessitates immediate action, such as oxygen supplementation or advanced respiratory support, to prevent deterioration in the newborn’s condition.
A nurse is preparing to notify the provider about a change in a client's status. Which of the
following information should the nurse plan to include in the "background" portion of the
Situation, Background, Assessment, Recommendation (SBAR) communication tool?
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Client's present condition
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Questions for the provider regarding client care
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Physical findings
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Previous treatments
Explanation
provides context to the situation. This includes the client’s diagnosis, past medical history
relevant to the current issue, and previous treatments or interventions already attempted.
Providing this background ensures the provider has a clear picture of what has occurred so far to
guide safe and efficient decision-making.
A nurse is assessing a newborn who is 2 hr old. Which of the following findings is an indication of hypoglycemia
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Abdominal distentionExplanation
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Hypotonia
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Jitteriness
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Temperature instability
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Acrocyanosis
Explanation
Correct Answer
B. Hypotonia,
C. Jitteriness
D. Temperature instability
Explanation B. Hypotonia
Hypotonia, or decreased muscle tone, is a potential sign of hypoglycemia in newborns. Low blood sugar can affect the nervous system, leading to weakness or poor muscle tone in affected infants.
C. Jitteriness
Jitteriness or tremors are common signs of hypoglycemia in newborns. These can occur when the infant's blood glucose levels drop below normal, leading to an overstimulation of the nervous system.
D. Temperature instability
Temperature instability, such as difficulty maintaining normal body temperature, can be a sign of hypoglycemia. Newborns who are hypoglycemic may have trouble regulating their body temperature due to metabolic instability.
Why the other options are wrong:
A. Abdominal distention
Abdominal distention is not typically associated with hypoglycemia in newborns. It may be a sign of gastrointestinal or feeding issues but is not a direct indication of low blood sugar.
E. Acrocyanosis
Acrocyanosis (a bluish discoloration of the hands and feet) is a common and generally benign finding in the first few hours of life. It is not indicative of hypoglycemia but rather a result of immature circulation in the newborn. It typically resolves as the infant adapts to life outside the womb.
Summary:
Hypotonia, jitteriness, and temperature instability are all possible indicators of hypoglycemia in a newborn. These signs should prompt the nurse to assess the infant's blood glucose levels and take appropriate action if hypoglycemia is confirmed. Abdominal distention and acrocyanosis are not associated with hypoglycemia.
What is the purpose of manual rotation of the fetal head from occipitoposterior (OP) or occipitotransverse (OT) positions to an anterior position?
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To increase the likelihood of a cesarean section
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To facilitate the descent of the fetal head and encourage a spontaneous vaginal birth
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To reduce the risk of preterm labor
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To induce uterine contractions
Explanation
Answer: B) To facilitate the descent of the fetal head and encourage a spontaneous vaginal birth
Explanation
Manual rotation is performed to correct the fetal position when the baby is in an occipitoposterior (OP) or occipitotransverse (OT) position, as these positions can hinder the normal progression of labor. Rotating the head to an anterior position helps the fetal head to engage properly in the birth canal, facilitating descent and potentially leading to a spontaneous vaginal birth.
Why Other Options are Incorrect
A) To increase the likelihood of a cesarean section: Manual rotation is specifically performed to reduce the need for a cesarean section by improving the fetal position and allowing for vaginal delivery.
C) To reduce the risk of preterm labor: Manual rotation is not typically used for preterm labor management. It is done to assist with labor progression when the fetus is in a malposition.
D) To induce uterine contractions: Manual rotation is aimed at improving fetal position, not directly inducing uterine contractions. Uterine contractions are naturally stimulated by the progression of labor.
Summary:
Manual rotation of the fetal head is an intervention used to correct occipitoposterior or occipitotransverse positions, facilitating the descent of the fetal head into the birth canal and improving the chances of a spontaneous vaginal birth. It helps to reduce the need for assisted birth and cesarean section.
A nurse is caring for a client who is postpartum and just delivered a newborn who weighs 4.5 kg (10 lb). Which of the following manifestations should the nurse recognize as a potential sign of hemorrhage?
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Urinary output 40 mL/hr
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Moderate rubra lochia
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Blood pressure 88/40 mm Hg
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Heart rate 90/min
Explanation
Correct Answer C: Blood pressure 88/40 mm Hg
Explanation
A blood pressure of 88/40 mm Hg is a significant sign of postpartum hemorrhage (PPH) due to hypovolemia from excessive blood loss. A drop in blood pressure can indicate inadequate perfusion and shock, which requires immediate intervention such as fluid resuscitation and uterotonic medications.
Why the Other Options Are Incorrect:
Urinary output 40 mL/hr:
A urinary output of 40 mL/hr is within the normal range (≥30 mL/hr) and does not indicate compromised kidney perfusion or shock. A significant concern would be output <30 mL/hr, suggesting hypovolemia.
Moderate rubra lochia:
Moderate rubra lochia (red vaginal bleeding) is expected in the early postpartum period. It becomes concerning when lochia is excessive, saturates a pad within an hour, or includes large clots.
Heart rate 90/min:
A heart rate of 90 bpm is slightly elevated but still within the normal postpartum range. Tachycardia above 100 bpm could be a more significant early sign of blood loss.
Summary:
Blood pressure 88/40 mm Hg is the most critical sign of postpartum hemorrhage in this scenario, as it indicates significant blood loss leading to hemodynamic instability. The other findings, while important to monitor, do not yet indicate a life-threatening condition.
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