ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. A client in a prenatal clinic is being taught by a nurse in her second trimester with a new diagnosis of gestational diabetes. Which of the following client statements indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will reduce my exercise schedule to 3 days a week.
- C. I will take my glyburide daily with breakfast.
- D. I know I am at increased risk of developing type 2 diabetes.
Correct answer: B
Rationale: Choice B, 'I will reduce my exercise schedule to 3 days a week,' indicates a need for further teaching. Regular exercise is beneficial in managing gestational diabetes and should not be reduced without proper guidance. Choices A, C, and D demonstrate understanding and appropriate actions in managing gestational diabetes.
2. A client with preterm labor is being admitted. The nurse anticipates a prescription by the provider for which of the following medications?
- A. Prostaglandin E2
- B. Indomethacin
- C. Methylergonovine
- D. Oxytocin
Correct answer: B
Rationale: Indomethacin is used to delay premature labor by inhibiting uterine contractions. Prostaglandin E2, Methylergonovine, and Oxytocin are not typically used to manage preterm labor. Prostaglandin E2 can be used for cervical ripening and labor induction. Methylergonovine is used to prevent or control postpartum hemorrhage. Oxytocin is used for labor induction and augmentation of labor in term pregnancies.
3. A newborn is born to a mother with poorly controlled type 2 diabetes. The newborn is macrosomic and presents with respiratory distress syndrome. The most likely cause of the respiratory distress is which of the following?
- A. Hyperinsulinemia
- B. Increased deposits of fat in the chest and shoulder area
- C. Brachial plexus injury
- D. Increased blood viscosity
Correct answer: A
Rationale: The correct answer is hyperinsulinemia. In infants born to mothers with poorly controlled diabetes, the excess glucose crosses the placenta, leading to fetal hyperglycemia. This results in fetal hyperinsulinemia, which in turn can cause macrosomia (large birth weight), increasing the risk of respiratory distress syndrome due to the immature lungs' inability to handle the increased workload. Hyperinsulinemia, not increased deposits of fat, brachial plexus injury, or increased blood viscosity, is the most likely cause of respiratory distress in this scenario.
4. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?
- A. A client who is at 38 weeks of gestation and reports a cough and fever
- B. A client who has missed a period and reports vaginal spotting
- C. A client who is at 14 weeks of gestation and reports nausea and vomiting
- D. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding
Correct answer: D
Rationale:
5. During the admission assessment of a client at 38 weeks of gestation with severe preeclampsia, what would the nurse expect as a finding?
- A. Tachycardia
- B. Absence of clonus
- C. Polyuria
- D. Report of headache
Correct answer: D
Rationale: Severe preeclampsia is characterized by hypertension and proteinuria after 20 weeks of gestation. Headache is a common symptom in clients with severe preeclampsia due to cerebral edema or vasospasm. Tachycardia (Choice A) is not typically associated with severe preeclampsia. Clonus (Choice B) is a sign of hyperactive reflexes, often seen in clients with severe preeclampsia. Polyuria (Choice C) is not a typical finding in clients with severe preeclampsia.
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