ATI RN Maternal Newborn
Access The Exact Questions for ATI RN Maternal Newborn
💯 100% Pass Rate guaranteed
🗓️ Unlock for 1 Month
Rated 4.8/5 from over 1000+ reviews
- Unlimited Exact Practice Test Questions
- Trusted By 200 Million Students and Professors
What’s Included:
- Unlock Actual Exam Questions and Answers for ATI RN Maternal Newborn on monthly basis
- Well-structured questions covering all topics, accompanied by organized images.
- Learn from mistakes with detailed answer explanations.
- Easy To understand explanations for all students.
Free ATI RN Maternal Newborn Questions
A nurse is assessing a client who is at 30 weeks of gestation during a routine prenatal visit. Which of the following findings should the nurse report to the provider?
-
Swelling of the face
-
Varicose veins in the calves
-
Nonpitting 1+ ankle edema
-
Hyperpigmentation of the cheeks
Explanation
The correct answer is A. Swelling of the face.
Explanation
Swelling of the face can indicate preeclampsia, a serious complication during pregnancy characterized by high blood pressure and protein in the urine. This condition can lead to other symptoms such as headaches, visual disturbances, and generalized edema. Swelling, particularly in the face and hands, should be reported to the healthcare provider for further evaluation.
Why the other options are wrong:
B. Varicose veins in the calves: Varicose veins are common during pregnancy due to increased blood volume and pressure on the veins from the growing uterus. While uncomfortable, they are typically not a cause for concern unless accompanied by other symptoms such as pain, swelling, or redness indicating possible clot formation.
C. Nonpitting 1+ ankle edema: Mild, nonpitting edema in the lower extremities is also common during pregnancy, especially as the uterus puts pressure on veins and circulation is affected. This is usually normal unless it is severe or accompanied by other symptoms like sudden weight gain, which could indicate a more serious condition like preeclampsia.
D. Hyperpigmentation of the cheeks: This is a common skin change during pregnancy known as chloasma or the "mask of pregnancy." It is caused by hormonal changes and typically resolves after childbirth. It does not indicate any medical concern.
Summary:
The nurse should report swelling of the face to the provider because it may be a sign of preeclampsia, which requires prompt evaluation and management. The other findings—varicose veins, mild ankle edema, and hyperpigmentation—are typically normal during pregnancy and do not require urgent attention.
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?
-
Administer broad-spectrum antibiotics.
-
Monitor the rectal temperature every 4 hr.
-
Cleanse the site with povidone-iodine.
-
Prepare for surgical closure after 72 hr.
Explanation
Correct Answer: Administer broad-spectrum antibiotics.
Explanation
A newborn with myelomeningocele (a type of spina bifida where the spinal cord and meninges protrude through an opening in the vertebrae) and leaking cerebrospinal fluid (CSF) is at high risk for infection due to exposure of the spinal cord and meninges to the external environment.Broad-spectrum antibiotics are essential in preventing meningitis or other infections, especially if the site is leaking CSF, which provides a potential entry point for pathogens.
Why the Other Options Are Incorrect:
Monitor the rectal temperature every 4 hr: While monitoring the newborn’s temperature is important, rectal temperatures should not be taken immediately after birth for neonates, particularly those with a myelomeningocele, due to the risk of causing trauma or injury to the exposed spinal cord. Instead, axillary temperature or another non-invasive method should be used for temperature monitoring.
Cleanse the site with povidone-iodine: Povidone-iodine is generally avoided in newborns with open wounds or exposed neural tissue, as it can be toxic to the skin and nervous tissue. Instead, the area should be kept moist and sterile, using sterile saline or other appropriate methods to prevent infection without causing further harm.
Prepare for surgical closure after 72 hr: The surgical closure of the myelomeningocele should be performed as soon as possible (within hours of birth) rather than waiting for 72 hours. Delaying surgical closure increases the risk of infection and neural damage. Early intervention is critical for improving outcomes and preventing further complications.
Summary:
The priority action for a newborn with a myelomeningocele and leaking CSF is to administer broad-spectrum antibiotics to reduce the risk of infection. Immediate surgical closure of the defect should also be prepared for, but antibiotics are necessary to prevent infection until surgery can be performed.
Clinical Context: G2P1, 30 weeks gestation, no prenatal care, uterine contractions every 2 to 3 minutes, SVE 2 cm/80%/-1 station, FHR 160/min, low back pain and abdominal cramping x2 days, small amount of vaginal bleeding, WBC 20,000/mm³ (elevated), Hgb 11 g/dL (normal), Hct 32% (normal), Blood Type O negative, temperature trending up to 37.6°C.
Provide intermittent fetal monitoring
Anticipated — Nonessential — Contraindicated
Correct: Contraindicated
Given that this client is in active preterm labor with a fetal heart rate of 160/min at the upper limit of normal and a rising trend, continuous electronic fetal monitoring is the standard of care, not intermittent monitoring. Intermittent fetal monitoring does not provide adequate surveillance for a high-risk client in preterm labor with signs of possible chorioamnionitis and a non-reassuring FHR trend. Continuous monitoring is required to detect any deterioration in fetal status promptly.
Terbutaline 0.25 mg subcutaneous now
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Terbutaline is a beta2-adrenergic agonist tocolytic used to relax the uterus and suppress preterm labor contractions. At 30 weeks of gestation with regular contractions every 2 to 3 minutes and cervical changes, administering terbutaline is an anticipated prescription to attempt to halt or slow preterm labor and allow time for corticosteroid administration to promote fetal lung maturity.
Assess the client's blood glucose levels every 30 min
Anticipated — Nonessential — Contraindicated
Correct: Nonessential
While blood glucose monitoring is important in clients with gestational diabetes or those receiving corticosteroids such as betamethasone (which can elevate blood glucose), there is no documentation in this client's history of gestational diabetes or hyperglycemia. Monitoring blood glucose every 30 minutes is not a standard or necessary intervention for this client's current clinical presentation and would not directly address the preterm labor or suspected infection.
Prepare magnesium sulfate IV
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Magnesium sulfate is anticipated in this clinical scenario for two important reasons. First, it provides neuroprotection for the preterm fetus at less than 32 weeks of gestation, reducing the risk of cerebral palsy and intraventricular hemorrhage. Second, it may be used as a tocolytic agent to suppress uterine contractions. At 30 weeks with active preterm labor, magnesium sulfate administration is a well-supported and anticipated intervention.
Collect urine and vaginal cultures
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
The client has a significantly elevated WBC count of 20,000/mm³, which is above the normal range of 5,000 to 10,000/mm³, raising concern for an infectious process such as chorioamnionitis or a urinary tract infection as a potential trigger for preterm labor. Collecting urine and vaginal cultures is anticipated to identify the causative organism and guide antibiotic therapy, which is a standard component of preterm labor management when infection is suspected.
Place an 18-gauge intravenous catheter for IV fluids
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Establishing IV access with an 18-gauge catheter is anticipated for this client in active preterm labor. IV access is essential for the administration of tocolytics such as terbutaline or magnesium sulfate, IV fluids for hydration, antibiotics if chorioamnionitis is confirmed, and emergency medications if needed. An 18-gauge catheter is appropriate as it allows for adequate flow rates for all anticipated therapies.
Betamethasone 12 mg IM now and repeat in 24 hr
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Betamethasone is a corticosteroid administered to promote fetal lung maturity in clients at risk for preterm delivery between 24 and 34 weeks of gestation. At 30 weeks with active preterm labor and contractions every 2 to 3 minutes, administering betamethasone 12 mg IM with a repeat dose in 24 hours is a strongly anticipated and evidence-based intervention that significantly reduces the risk of neonatal respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality.
-
Anticipated
-
Nonessential
-
Contraindicated
Explanation
Provide intermittent fetal monitoring
Anticipated — Nonessential — Contraindicated
Correct: Contraindicated
Given that this client is in active preterm labor with a fetal heart rate of 160/min at the upper limit of normal and a rising trend, continuous electronic fetal monitoring is the standard of care, not intermittent monitoring. Intermittent fetal monitoring does not provide adequate surveillance for a high-risk client in preterm labor with signs of possible chorioamnionitis and a non-reassuring FHR trend. Continuous monitoring is required to detect any deterioration in fetal status promptly.
Terbutaline 0.25 mg subcutaneous now
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Terbutaline is a beta2-adrenergic agonist tocolytic used to relax the uterus and suppress preterm labor contractions. At 30 weeks of gestation with regular contractions every 2 to 3 minutes and cervical changes, administering terbutaline is an anticipated prescription to attempt to halt or slow preterm labor and allow time for corticosteroid administration to promote fetal lung maturity.
Assess the client's blood glucose levels every 30 min
Anticipated — Nonessential — Contraindicated
Correct: Nonessential
While blood glucose monitoring is important in clients with gestational diabetes or those receiving corticosteroids such as betamethasone (which can elevate blood glucose), there is no documentation in this client's history of gestational diabetes or hyperglycemia. Monitoring blood glucose every 30 minutes is not a standard or necessary intervention for this client's current clinical presentation and would not directly address the preterm labor or suspected infection.
Prepare magnesium sulfate IV
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Magnesium sulfate is anticipated in this clinical scenario for two important reasons. First, it provides neuroprotection for the preterm fetus at less than 32 weeks of gestation, reducing the risk of cerebral palsy and intraventricular hemorrhage. Second, it may be used as a tocolytic agent to suppress uterine contractions. At 30 weeks with active preterm labor, magnesium sulfate administration is a well-supported and anticipated intervention.
Collect urine and vaginal cultures
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
The client has a significantly elevated WBC count of 20,000/mm³, which is above the normal range of 5,000 to 10,000/mm³, raising concern for an infectious process such as chorioamnionitis or a urinary tract infection as a potential trigger for preterm labor. Collecting urine and vaginal cultures is anticipated to identify the causative organism and guide antibiotic therapy, which is a standard component of preterm labor management when infection is suspected.
Place an 18-gauge intravenous catheter for IV fluids
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Establishing IV access with an 18-gauge catheter is anticipated for this client in active preterm labor. IV access is essential for the administration of tocolytics such as terbutaline or magnesium sulfate, IV fluids for hydration, antibiotics if chorioamnionitis is confirmed, and emergency medications if needed. An 18-gauge catheter is appropriate as it allows for adequate flow rates for all anticipated therapies.
Betamethasone 12 mg IM now and repeat in 24 hr
Anticipated — Nonessential — Contraindicated
Correct: Anticipated
Betamethasone is a corticosteroid administered to promote fetal lung maturity in clients at risk for preterm delivery between 24 and 34 weeks of gestation. At 30 weeks with active preterm labor and contractions every 2 to 3 minutes, administering betamethasone 12 mg IM with a repeat dose in 24 hours is a strongly anticipated and evidence-based intervention that significantly reduces the risk of neonatal respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality.
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?
-
Client's present condition
-
Questions for the provider regarding client care
-
Physical findings
-
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 caring for a client who is at 16 weeks of gestation and has severe iron-deficiency anemia. The provider prescribes an injection of iron dextran IM. Which of the following methods should the nurse use to administer the medication?
-
Use a 20-gauge needle, and administer the medication using the Z-track method.
-
Use a 22-gauge needle, and administer the medication deep into the thigh.
-
Use a 25-gauge needle, and administer the medication into the deltoid muscle.
-
Use an 18-gauge needle, and administer the medication into the rectus femoris muscle.
Explanation
Explanation:
Correct Answer: (A) Use a 20-gauge needle, and administer the medication using the Z-track method.
Iron dextran must be administered using the Z-track method to prevent leakage of the medication into subcutaneous tissue, which would cause permanent skin staining, irritation, and pain. A 20-gauge needle is appropriate for IM injection of this viscous medication, and the ventrogluteal or dorsogluteal site is preferred over smaller muscle groups.
Why Other Options are Incorrect:
B. A 22-gauge needle may be too small for the viscous iron dextran solution, and the thigh is not the recommended injection site for this medication.
C. A 25-gauge needle is too small and fine for an IM injection of iron dextran. The deltoid muscle is also too small to accommodate this medication safely.
D. An 18-gauge needle is unnecessarily large and would cause excessive tissue trauma. The rectus femoris is not the preferred site for iron dextran administration.
A nurse is caring for a client in labor who has herpes simplex virus (HSV) with active lesions. Which of the following interventions should the nurse plan to implement to prevent the transmission of HSV to the newborn?
-
Anticipate a scheduled cesarean birth.
-
Administer erythromycin ointment in the newborn's eyes after birth.
-
Apply cortisone ointment on the lesions prior to birth.
-
Initiate IV penicillin G during the labor.
Explanation
Correct Answer: (A) Anticipate a scheduled cesarean birth.
Active genital herpes simplex virus lesions at the time of labor are a primary indication for cesarean birth. Vaginal delivery in the presence of active HSV lesions places the newborn at significant risk for neonatal herpes, which can cause severe neurological damage, disseminated infection, and death. A scheduled cesarean birth prevents direct contact between the newborn and the active lesions during passage through the birth canal.
Why the other options are incorrect:
B. Administer erythromycin ointment in the newborn's eyes after birth – Erythromycin ophthalmic ointment is administered to all newborns after birth as prophylaxis against ophthalmia neonatorum caused by gonorrhea and chlamydia, not herpes simplex virus. It does not prevent HSV transmission.
C. Apply cortisone ointment on the lesions prior to birth – Cortisone is a corticosteroid with anti-inflammatory properties. It has no antiviral effect against HSV and would not reduce the risk of transmission to the newborn. Antiviral medications such as acyclovir are used for HSV management, not cortisone.
D. Initiate IV penicillin G during the labor – Penicillin G is an antibiotic used for bacterial infections, most notably for Group B Streptococcus prophylaxis during labor. It has no antiviral activity and is ineffective against herpes s’implex virus.
A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B12. Which of the following foods should the nurse recommend?
-
Raw carrots
-
Brown rice
-
Fortified soy milk
-
Fresh citrus fruits
Explanation
Correct Answer: (C) Fortified soy milk.
Vitamin B12 is found almost exclusively in animal products, making deficiency a significant nutritional concern for vegan clients during pregnancy. Fortified soy milk is enriched with vitamin B12 and provides a reliable plant-based source of this essential nutrient. B12 is critical for fetal neurological development and the prevention of megaloblastic anemia in the mother.
Why Other Options are Incorrect:
Raw carrots is incorrect because carrots do not contain vitamin B12. They are a good source of beta-carotene and vitamin A but contribute nothing to B12 intake.
Brown rice is incorrect because brown rice does not contain vitamin B12. It is a whole grain providing fiber, B vitamins such as thiamine and niacin, and minerals, but not B12.
Fresh citrus fruits is incorrect because citrus fruits are excellent sources of vitamin C and folate but contain no vitamin B12. Recommending citrus fruits would not address the client's goal of increasing B12 intake.
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (select all that apply)
-
Vacuum-assisted delivery
-
Newborn weight 2.948 kg (6 lb 8 oz)
-
Labor induction with oxytocin
-
History of uterine atony
Explanation
The correct answers are: A. Vacuum-assisted delivery, D. Labor induction with oxytocin, and E. History of uterine atony.
Postpartum hemorrhage (PPH) is excessive blood loss following childbirth, often caused by uterine atony, trauma, retained placenta, or coagulopathy. Each choice is evaluated below:
A. Vacuum-assisted delivery
Correct.
A vacuum-assisted delivery can increase the risk of trauma to the birth canal (e.g., lacerations or hematomas), which can contribute to postpartum hemorrhage.
B. Newborn weight 2.948 kg (6 lb 8 oz)
Incorrect.
A newborn weighing 6 lb 8 oz is within the normal range and is not associated with an increased risk of PPH. A macrosomic infant (>4,000 g or 8 lb 13 oz) would increase the risk due to potential uterine overdistension.
C. Labor induction with oxytocin
Correct.
Oxytocin induction can lead to uterine overstimulation or tachysystole, which can exhaust the uterine muscle and increase the risk of uterine atony, a major cause of PPH.
D. History of uterine atony
Correct.
A prior history of uterine atony is a significant risk factor for PPH, as the uterus may have difficulty contracting effectively after delivery.
Additional Risk Factors for Postpartum Hemorrhage:
Prolonged labor or rapid delivery
Use of instrumental delivery methods (e.g., forceps, vacuum)
Uterine overdistension (e.g., twins, macrosomic infant)
Retained placental fragments
Coagulopathy or bleeding disorders
A nurse is preparing to administer phytonadione 0.5 mg to a newborn. Which of the following routes should the nurse choose for administration of the medication?
-
Subcutaneous in the right deltoid
-
Subcutaneous in the left vastus lateralis
-
IM in left vastus lateralis
-
IM in right deltoid
Explanation
Correct Answer IM in left vastus lateralis
Explanation
Phytonadione (vitamin K) is administered to newborns to prevent vitamin K deficiency bleeding (VKDB). The recommended route for administration of phytonadione in newborns is intramuscular (IM), specifically in the vastus lateralis muscle, which is located on the outer thigh. This is the preferred site because it is a large muscle and has minimal risk of nerve injury or complications.The vastus lateralis is the preferred site for IM injections in newborns because it is a large, well-developed muscle, making it suitable for safe injection.
Why the Other Options Are Incorrect:
Subcutaneous in the right deltoid: The deltoid is not the preferred site for newborn injections, and subcutaneous administration is not the correct route for phytonadione. The correct route is intramuscular.
Subcutaneous in the left vastus lateralis: The subcutaneous route is not recommended for phytonadione. The medication should be administered intramuscularly.
IM in right deltoid: The deltoid muscle is not the preferred site for IM injections in newborns. The vastus lateralis is safer due to the larger muscle mass and lower risk of complications.
Summary:
The correct route for administering phytonadione (0.5 mg) to a newborn is intramuscular in the left vastus lateralis. This site is safe, effective, and recommended for newborns.
A nurse is obtaining the vital signs of a newborn who is 24 hr old. Which of the following findings should the nurse report to the provider?
-
Axillary temperature 36.5° C (97.7° F)
-
Irregular apical pulse 140/min
-
Apnea lasting 25 seconds
-
Blood pressure 64/41 mm H
Explanation
Correct Answer C: Apnea lasting 25 seconds
Apnea lasting more than 20 seconds in a newborn is considered abnormal and should be reported to the provider.
This can indicate a potential issue with respiratory function, such as apnea of prematurity, and requires further assessment.
Why the Other Options Are Not Concerning:
- Axillary temperature 36.5° C (97.7° F): This is within the normal range for a newborn's temperature. The normal range for a newborn's axillary temperature is between 36.5° C to 37.5° C (97.7° F to 99.5° F). Therefore, there is no need for concern with this finding.
- Irregular apical pulse 140/min: A pulse rate of 140/min is normal for a newborn. It is typical for newborns to have heart rates ranging from 120 to 160 bpm. Irregularity in the pulse can also be normal, particularly in the early days of life. However, if the irregularity is persistent or accompanied by other signs, further evaluation may be needed.
- Blood pressure 64/41 mm Hg: This blood pressure is normal for a newborn. Normal neonatal blood pressure ranges are typically 60-80/40-50 mm Hg in the first few days of life, so this is an expected and normal finding.
Summary:
Apnea lasting longer than 20 seconds in a newborn is a concern and should be reported to the provider. The other vital signs listed are within normal limits for a 24-hour-old newborn.
How to Order
Select Your Exam
Click on your desired exam to open its dedicated page with resources like practice questions, flashcards, and study guides.Choose what to focus on, Your selected exam is saved for quick access Once you log in.
Subscribe
Hit the Subscribe button on the platform. With your subscription, you will enjoy unlimited access to all practice questions and resources for a full 1-month period. After the month has elapsed, you can choose to resubscribe to continue benefiting from our comprehensive exam preparation tools and resources.
Pay and unlock the practice Questions
Once your payment is processed, you’ll immediately unlock access to all practice questions tailored to your selected exam for 1 month .
Frequently Asked Question
Yes! Ulosca.com allows you to track your progress as you complete practice questions. Our platform shows your strengths and weaknesses, enabling you to focus on areas that need improvement for optimal results on your exam.
Currently, Ulosca.com is accessible via any web browser on both desktop and mobile devices. You can log in anytime and anywhere to study, making it convenient for you to prepare on the go.
While we offer some free sample content, full access to our comprehensive practice questions, rationales, and study guides is available through a paid subscription.
Yes! Ulosca.com offers dedicated customer support. If you have any questions or face any issues, you can reach out to our team, and we will assist you promptly.